How do Drs. keep someone from committing suicide?

[Jean in Newcastle]

If someone has tried twice and has been hospitalized twice - how actually do they try to keep someone from continuing to try? Are they just trying to keep them from having opportunity? No details - I just want to keep this to unemotional information because that is all I can handle right now.

[KidsHappen]

If they are commintted they will be restrained and medicated until they are no longer a threat to themselves. If they are not, well then it becomes much harder.

[Jean in Newcastle]

but what makes someone not a threat to themselves? Wouldn't they need a drastic change in their thinking?

[Greta]

but what makes someone not a threat to themselves? Wouldn't they need a drastic change in their thinking?

 

I think that is, theoretically at least, where the drugs come in. I believe that a pretty powerful cocktail of anti-depressants is used. I'm not sure, though. Have you attempted any research on the web?

 

ETA: I'm looking and will let you know if I find anything. All I'm finding so far is very vague, and not much help at all.

Edited February 13, 2010 by GretaLynne

[Scarlett]

If someone has tried twice and has been hospitalized twice - how actually do they try to keep someone from continuing to try? Are they just trying to keep them from having opportunity? No details - I just want to keep this to unemotional information because that is all I can handle right now.

 

I have a friend whose dh made at least 3 serious attempts. They tried many things. They locked him up...they did shock treatment on him which IMO damaged him....BUT I think it worked. He has recovered now...no attempts that I know of for many years. However, my friend, (his wife) nearly lost her mind during that time. It is a horrible thing to watch. She never knew what she would come home to. This went on for several years.

 

So.....((((Jean)))))

[Maria from IN]

I'm sorry that you're going through this right now. Whatever the particulars are, it is a stressful time for everyone.

 

I work in an inpatient behavioral health unit at a local hospital. Many of the patients have tried to kill themselves, some of them many times-and for many reasons. Unfortunately, there is very little a hospital can do. Some people are "ED'd" (emergency detained) by family members if they voice suicidal ideation and have a specific plan. Others are brought in by police after "well-checks." Others, I'm sorry to say, use a suicide attempt as a means to gain attention because they can think of no other way to obtain help. Typically, if their symptoms are severe, they are put on 15-minute watch and are assessed several times daily for suicidal ideation. After three straight days, if a person denies that they are suicidal--and their demeanor matches what they say-- they must be released if they wish to go.

 

It is up to the individual to not try to commit suicide again. Sometimes they say all the right things to get out and just go and try again. Sometimes they take advantage of medications and therapist appointments and work on the reasons behind wanting to end their lives. We work with every patient as if it is the first time they have been on the unit and offer them every chance to let us help them. Ultimately it is their responsibility...with the help of meds, therapists, and helpful families, they can get better.

 

Sometimes doctors and therapists will ask the patient to sign a "no-harm" contract in which they promise to seek help if they feel suicidal, but again, it's ultimately up to them.

 

I don't mean to sound negative in any way, but when you get right down to it that's the way things are. People choose every day whether to avoid foods that cause cardiac issues or whether to keep tabs on their blood sugar...it's a day-by-day thing--sometimes hour-by-hour.

 

I hope this helps you.

[OnTheBrink]

Doctors use a combination of restraint, medications and talk therapy. How one is determined to no longer be a threat to themselves varies by person.

 

:grouphug:

[Jean in Newcastle]

I don't mean to sound negative in any way, but when you get right down to it that's the way things are. People choose every day whether to avoid foods that cause cardiac issues or whether to keep tabs on their blood sugar...it's a day-by-day thing--sometimes hour-by-hour.

 

I hope this helps you.

 

No more negative than the reality. Yes, this helped. Thank you.

[lisabees]

Hugs Jean. You're in a scary place, I'm sure. :grouphug:

[sleepymommy]

Keeping one in a hospital and under supervision is one way. Sometimes a patient can be released to the supervision of a relative, daily or weekly therapy (talks) can be effective depending on the severity of the situation. These are mostly to get the the root of the issue. If it is something that medication can help, then that is usually the next step. But prior to that anxiety type medication is often prescribed until the patient is stable or until an underlying condition can be diagnosed.

:grouphug::grouphug::grouphug:

[Greta]

Well, my search was pretty unsuccessful, but I am glad to see that others with more knowledge have posted replies to help you. I am sorry. :grouphug:

[MamaT]

Jean, nothing to add. Just :grouphug:

[Joanne]

Health professionals are trained in a series of intake and general questions to ascertain suicide risk. This is, of course, to help and assist people, but it is also to cover our butts as clinicians.

 

The reality, though, is that people are autonomous adults and we have little to no power to keep them for long under "suicide risk" designations.

 

Most people who have made the decision don't tell people, including professionals.

[Laurie4b]

It helps for the moment--while they are in there, the risk is much diminished because of the supervision. In a best case scenario, the mood is stabilized and a patient is discharged only after they are not admitting to being suicidal and with a plan of care in place for continued mental health treatment, support, etc.

 

One means of assessment is to assess the plan. Most suicidal people have one plan using a certain method. If you can separate a person from their chosen method, you greatly reduce the risk of suicide. This is often done with a suicide contract in consultation with the suicidal person. So if the plan is pills, there would be an agreement to give the pills to someone else who will keep them locked away--same with a gun, etc. More common things such as knives or the car are harder to deal with by this method. As long as the person is still talking about it, they have ambivalence, which you can picture like a seesaw. On one side is life--on the other side is suicide. If an outside person pushes down on the "reasons to live" side , the suicidal person will push down on the "reasons to die" side to keep the seesaw balanced. So if you know the person, be careful to listen to the pain part, so that they can be free to come up with the "reasons to live" part. (Don't know if that makes sense.) I had one supervisor who had not lost a patient in 17 years of suicide counseling. He would really explore the "die" part with them. "What do you think will happen after you die?" "How do you know? (that it will be peaceful, etc. and not hellish) This is why it can be a danger sign if someone suicidal is suddenly cheerful and calm: they may have resolved the ambivalence. At this point, they are unlikely to talk about it.

 

Also, it's kind of an axiom that "every suicide is a multiple homicide." IOW, it "kills" everyone who loves them. Sometimes, this is the point of the suicide. Sometimes it is a point not considered by the person in pain: the act of suicide multiplies their pain times the number of people who love them and gives each of those people the pain as a dying legacy.

 

Ultimately, each person makes their own decision. Some kill themselves even when hospitalized.

 

If you have a loved one who is suicidal, seek out some help for yourself from someone knowledgeable about suicide.

[Karen in CO]

If someone has tried twice and has been hospitalized twice - how actually do they try to keep someone from continuing to try? Are they just trying to keep them from having opportunity? No details - I just want to keep this to unemotional information because that is all I can handle right now.

 

The only experience I have with this involved a loved one being involuntarily committed for several months, followed by almost daily visits to a mental health facility for many more months. 15 years later, she knows that the only reason she still hasn't done it is the connections and the ties to a few people who are very close. She is biploar, and her medication is carefully monitored along with her mental and physical well-being. She cannot live alone and will never be able to because she is constantly in danger of losing those ties that bind her to this world.

 

It wasn't a treated and released type of fix. It was and continues to be something that is dealt with by those of us who are trying to keep her here. Even though it gets easier as time goes by, it is that constant looming storm on the horizon.

 

:grouphug: take a deep breath and hold on. It is hard.

[Karen in CO]

but what makes someone not a threat to themselves? Wouldn't they need a drastic change in their thinking?

From my experience, the drastic changes don't happen. My loved one who was in this situation, still struggles. She is on a variety of medications, but it was through long-term therapy that she was able to hold onto her life and learn to anchor herself to loved ones and to this world. It was and is a thought for her and a battle in a way that most people never face. She was cleared after a few months as not in immediate danger, but in a way, she will always be a threat to herself.

 

and for perspective, the first time she attempted suicide was in 1967. The most recent time was 1993.

[Tree House Academy]

I am sorry you are in this place with someone you love. My heart, thoughts, and prayers go out to you today. *hug*

[jujsky]

(((Hugs))) My dad committed suicide. It's very painful for the family. You haven't shared the details of your story, but I'm sorry for whomever this is affecting.

[Impish]

:grouphug:

[kalanamak]

If someone has tried twice and has been hospitalized twice - how actually do they try to keep someone from continuing to try? Are they just trying to keep them from having opportunity? No details - I just want to keep this to unemotional information because that is all I can handle right now.

 

In our state, a CDMHP (county designated mental health professionals...gag) evaluates a person as to grave disability (too psychotic to eat, e.g.) or a danger to self or others. If they think they are, they can offer them voluntary placement. If they decline this and the CDMHP think they can convince a judge of it, they detain them and the patient sees the judge post-haste and are given a "72 hour hold". The psychologist and psychiatrist then decide whether to let them go in 72 hours (business days) or file a petition for an additional 14 days. In 14 days it is repeated but for a 90 day court commit.

 

When someone arrives suicidal, they are placed in an environment of watchful staff and no shoelaces or razors, etc. If they seem like they will do something like chew the sheets and hang themselves they are placed on a line of sight one to one. If they are hitting their head, they are placed in arm's reach one to one. If that fails to keep them from strangling themselves, plucking their eyes out, etc. they are placed in restraints.

 

If they are anxious and panicked, they are given benzos orally, or if refused, IM. They are queried and listened to in depth. Their history is searched out and a plan is made. Some people are doing this as "gestures" for attention or because they don't know how else to get help for an intolerable situation. Some people are deeply depressed, some are psychotic (killing themselves because a deity tells them to). Each case is much more complex than I can go into. Feel free to p.m. me, Jean. I don't mind shop talk on my off hours.

 

It is terrifying, and makes one feel very helpless, and, if a person is really set on it and learns they are stopped, they will figure out a way to get out, via the doc or the judge (either one can free you), and complete the act. It is more common than is let on, and is only infrequently mentioned in the obits, unless one is famous.

:grouphug::grouphug::grouphug:

[TravelingChris]

What other said about the 72 hour hold. In our case, my son was hospitalized 3 times in 5 months. He had major depression. The first was for a few days. The next was about a month later and for about 2 weeks. The last was for about 4 weeks. THe last time, the final medication combination helped to a little degree but enough to make him not threaten it anymore. In our case, he was saying stuff on the internet and people were calling the police and we were being visited at 2 am or whenever. Extremely frightening. It was part of what I call my Jobean year. He finally got over major depression probably mostly naturally and has not had a re-occurence in over 1.5 years. ALthough I know it is mostly a chemical thing, I think his situation in a college in a northern State with high stress and low sleep helped cause the crisis. Prayers for you.

[Melissa in Australia]

My father committed suicide .

I have come to a different view from most people. If someone is in so much mental anguish etc. Isn't it better to let them go than force them to go through shock treatment, and drugs for the rest of their lives?

 

my Aunt committed suicide last year after 20 years of shock therapy, and antidepressant drugs. She had a miserable life.

 

I realize that my view isn't what most people hold with , and it is possible that I have come to this view to cope with the loss of my father when I was young.

[jenL]

:grouphug::grouphug::grouphug:

[Scarlett]

My father committed suicide .

I have come to a different view from most people. If someone is in so much mental anguish etc. Isn't it better to let them go than force them to go through shock treatment, and drugs for the rest of their lives?

 

my Aunt committed suicide last year after 20 years of shock therapy, and antidepressant drugs. She had a miserable life.

 

I realize that my view isn't what most people hold with , and it is possible that I have come to this view to cope with the loss of my father when I was young.

 

:grouphug:

[Terabith]

I'm bipolar, and there have been some pretty bad times with some very serious suicidal ideation. One attempt.

 

You can't really keep anyone from it. My husband is philosophically opposed to trying to stop someone, because he agrees about "if you are in that much pain, I hope you find relief." I can respect that, although I think I could have used a bit more intervention a couple times.

 

It's very, very hard. If you can, let us know how things are going? :grouphug:

[Parrothead]

:grouphug: I pray you get help to the person in need.

[MariannNOVA]

:grouphug: :grouphug: and prayers for you and the person in need. So sorry.

[Denisemomof4]

If someone has tried twice and has been hospitalized twice - how actually do they try to keep someone from continuing to try? Are they just trying to keep them from having opportunity? No details - I just want to keep this to unemotional information because that is all I can handle right now.

 

my hands are tied w/brother and there's nothing I can do. They only keep them if they're a threat to themselves or others. It's awful, he needs SO MUCH HELP, I don't think there's any out there.

 

Perhaps check out a local NAMI meeting for more answers?

[Starr]

:grouphug: Praying for you and all connected with this. :grouphug:

[Jean in Newcastle]

Thank you all for your thoughtful words. All I can say is that the person is being helped.

[Audrey]

Thank you all for your thoughtful words. All I can say is that the person is being helped.

 

That's good to hear, Jean. :grouphug: May I gently suggest that the person's loved ones also seek help in processing this? It is hard to go through these things with a loved one, and having a soft place to fall makes a tremendous difference for everyone involved.

[nd293]

My father committed suicide .

I have come to a different view from most people. If someone is in so much mental anguish etc. .

 

I have a friend (with two young children) whose husband commited suicide after a previous attempt. She and his sister knew he would try again, and knew he was vehemently opposed to being medicated, and hated being hospitalised against his will, as he was after the first attempt. They let him make his choice. I am not always sure I agree with her decision, but I always admire her bravery.

[Jackie in NE]

If someone has tried twice and has been hospitalized twice - how actually do they try to keep someone from continuing to try? Are they just trying to keep them from having opportunity? No details - I just want to keep this to unemotional information because that is all I can handle right now.

 

:grouphug::grouphug: I'm so sorry that you're dealing with this.

 

FWIW, a dear friend of mine dealt with this with her dd. The young woman was in and out of the hospital. After a LOT of searching and pain and heartache, the dd was diagnosed as bipolar. They tried a lot of different combinations of meds. Still the dd would hit bottom and be back in the hospital. It was just a very long and painful process. The good news is that everyone got through it. The young woman is graduating from college this year, and has not been hospitalized for 3 years. That is success.

 

Another person I know was helped "almost overnight" by hypnotherapy. As one poster said, it helps immensely to remove the thing that the person has planned to use as the means to end their life (pills or gun, etc.).

 

:grouphug:

Jackie

[asta]

My father committed suicide .

I have come to a different view from most people. If someone is in so much mental anguish etc. Isn't it better to let them go than force them to go through shock treatment, and drugs for the rest of their lives?

 

my Aunt committed suicide last year after 20 years of shock therapy, and antidepressant drugs. She had a miserable life.

 

I realize that my view isn't what most people hold with , and it is possible that I have come to this view to cope with the loss of my father when I was young.

 

One of the hardest things for many people who are not mentally interesting to come to terms with is the fact that the available treatments simply do not work for everyone. And even if they did, not everyone wants them. Human beings have free will.

 

I have known (well) at least four people who have committed suicide. What I have had to come to terms with in the ensuing years with is this: if they hadn't died at that particular instant, in that particular manner, they would still be dead.

 

When your head is telling you that you do not belong , not of this place, but even of this earth, moving on is merely an eventuality.

 

It is very sad, yes.

 

I wish you peace.

 

 

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