Suicide Intervention
According to the Living Works Treatment Project, there are five helpful things to consider when managing suicidal individuals.
These are:
1. Engage the suicidal person and explore his or her world from his or her perspective (using active listening techniques).
2. Identify the person’s thoughts of suicide, identify the risk of suicide by asking directly: “Are you thinking about killing yourself?”
3. Inquire about the reasons for his or her suicide
4. Estimate the risk, – assess the seriousness of the threat, the risk factors, the protective factors, and the person’s potential for violence
5. Form a contract with the individual to intervene, so as to reduce the risk of suicide (Living Works 1999, p. 58).
Successful intervention involves helping the suicidal person find hope and helping him/her move from a focus on the past and its losses and failures, through to the here and now, to look to the future, seeing options he or she does not see. At this stage one should try to work toward a plan or a contract with the subject that reduces the threat to life and encourages his desire to live. To instill hope, the paramedic needs to get the suicidal person to challenge two ideas. Firstly, that the pain will last forever, and secondly that the loss is everything. According to Seligman it is ‘these dimensions of permanence and persuasiveness that lead to hopelessness and helplessness’ (Seligman1991, p. 67).
Building a therapeutic relationship with a patient can be one of the most beneficial forms of intervention in this circumstance. The World Health Organization states that: ‘the clinician who is regarded as trustworthy, interested, helpful and understanding is more likely to engage the individual in ongoing and beneficial treatment’ (World Health Organization 2000, p 28). Avoid unusually prolonged eye contact and do not confront or corner the patient as this may cause him to become more aggressive and feel as though you are out to get him (NSW Health Department 2001, p. 9). Furthermore, try not to give patient ultimatums or ‘make or break’ situation, as these will only increase his agitation and possible violence.
Successful intervention involves helping the suicidal person find hope and helping him/her move from a focus on the past and its losses and failures, through to the here and now, to look to the future, seeing options he or she does not see. At this stage one should try to work toward a plan or a contract with the subject that reduces the threat to life and encourages his desire to live. To instill hope, the paramedic needs to get the suicidal person to challenge two ideas. Firstly, that the pain will last forever, and secondly that the loss is everything. According to Seligman it is ‘these dimensions of permanence and persuasiveness that lead to hopelessness and helplessness’ (Seligman1991, p. 67).
Building a therapeutic relationship with a patient can be one of the most beneficial forms of intervention in this circumstance. The World Health Organization states that: ‘the clinician who is regarded as trustworthy, interested, helpful and understanding is more likely to engage the individual in ongoing and beneficial treatment’ (World Health Organization 2000, p 28). Avoid unusually prolonged eye contact and do not confront or corner the patient as this may cause him to become more aggressive and feel as though you are out to get him (NSW Health Department 2001, p. 9). Furthermore, try not to give patient ultimatums or ‘make or break’ situation, as these will only increase his agitation and possible violence.