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March 21, 2013

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aek

Is anyone looking at why previous suicide attempt(s) is the leading risk factor for suicide, and why the majority of people who attempt have recent healthcare provider contact?

What about the inpatient experience is actually therapeutic? The principles of psychiatric ward management are direct holdovers from prison ward management (containment, control, coercion). It's dehumanizing, distressing and not conducive for building self-esteem, self confidence, self efficacy and reduction of psychologic distress. The usual experience is to suffer "leers, jeers and sneers" from hospital staff/first responders - at the best, indifference, but a loss of civil rights, labeling, stigma and quality of life degradation as a result of having been swept up in the mental health system. Isn't it likely that the chief lesson learned is that there not only is no help, but that one is egregiously dehumanized and punished for having sought or received treatment as usual?

What effective treatment is there for directly addressing the causative distressors of suicidality?

DBT addresses impulsiveness, but not suicidality. Suicide/crisis hotlines even directly state that they do not offer help for suicidality. The purpose of those is to serve as a suicide deterrant by slowing down impulsive behavior.

Until causative stressors of suicidality are directly treated in an effective and sustained manner, I expect suicide rates to remain unchanged.

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