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The Most Difficult Lesson
Published in Meidan Turel, Michael Siglag, Alexander Grinshpoon, Clinical Psychology in the Mental Health Inpatient Setting, 2019
Suicide completion within psychiatric hospitals is fortunately rare but, when it occurs, can have deleterious effects on both patients and staff. For a trainee studying to be a psychologist, it can have a profound impact on their development as a clinician. Although graduate programs are now more mindful of core competencies needed in suicide assessment and treatment, training related to these competencies varies widely across different programs and facilities. This chapter focuses on several topics germane to working with suicidal young adults within an inpatient psychiatric hospital. It highlights an approach to suicide intervention that is collaborative and patient-centered. The chapter describes an approach in the training of psychology interns working with suicidal patients, which includes careful supervision with respect to risk assessment, clinical intervention, and reactions to loss. Case examples are provided to elucidate the difficulty in providing training and education during this challenging time.
Editorial Introduction
Published in John R. Cutcliffe, José Carlos Santos, Paul S. Links, Juveria Zaheer, Henry G. Harder, Frank Campbell, Rod McCormick, Kari Harder, Yvonne Bergmans, Rahel Eynan, Routledge International Handbook of Clinical Suicide Research, 2013
John R. Cutcliffe, José Carlos Santos, Paul S. Links, Juveria Zaheer, Henry G. Harder, Frank Campbell, Rod McCormick, Kari Harder, Yvonne Bergmans, Rahel Eynan
In Chapter 18, Yvonne Bergmans et al. reflect on the needs and factors necessary to create an intervention for people with recurrent suicide-related behaviours from the perspective of the lead co-creator and facilitator of the group intervention. It is noteworthy that this is one of a ‘handful’ of suicide intervention-focused studies; an area of literature that this is most lacking — and not only in allied disciplines but this is a critique that can be applied (accurately) to Suicidology per se.
Theorizing the Intersections of Ableism, Sanism, Ageism and Suicidism in Suicide and Physician-Assisted Death Debates
Published in Joel Michael Reynolds, Christine Wieseler, The Disability Bioethics Reader, 2022
On the other side, some disability activists/scholars/bioethicists question the emphasis put on the right-to-die question for disabled/sick/ill people in bioethics discussions at the expense of other more pressing issues, while others condemn PAD and its ableist roots. From an anti-ableist perspective, since the causes of the wish to die among disabled/sick/ill people result from society’s oppression, PAD doesn’t constitute an appropriate response, and social and political solutions should be put forward (Gill 1992, 1999, 2004; Ho 2014; Ho and Norman 2019; Braswell, this volume). By doing so, disability activists/scholars/bioethicists either don’t question or address suicidal people’s realities and needs or reaffirm the importance, for all citizens including disabled/sick/ill people, of suicide intervention. For example, Gill (2004, 178–179) emphasizes the necessity of suicide prevention strategies, including “psychotherapy, dissuasion, hospitalization, or forms of protective vigilance.” In their analysis of the double standard about the suicidality of disabled/ill/sick people, the well-known disability rights group Not Dead Yet is another example of this acritical endorsement of suicide prevention strategies. Not Dead Yet calls for “enforc[ing] laws requiring health professionals to protect individuals who pose a danger to themselves” (Coleman 2010, 44). Not only does Not Dead Yet not interrogate some of the harmful practices such as involuntary hospitalization (Szasz 1999; Stefan 2016; Baril 2017, 2018, 2020; Borecky et al. 2019) put forward in the suicide prevention script adopted by all official organizations, the State, and the Law, but adds that suicidal people, be they disabled or not, should be left to fend for themselves in their search for death: “[…] the law should leave them to their own devices. Any competent person, however disabled, can commit suicide by refusing food and water” (Coleman 2010, 49). This solution seems, to me, insensitive to suicidal people, by forcing them to die through solitary and violent means, such as starvation, poisoning, gunshots or hanging. Furthermore, this laissez-faire attitude toward a highly marginalized group such as suicidal people who are often criminalized, institutionalized, or stigmatized based on their perceived or actual mental illness (Szasz 1999; Stefan 2016; Baril 2017, 2018, 2020) seems at odds with the structural analyses usually put forth by disability, crip and Mad movements.
Negative life events and suicide risk in college students: Conditional indirect effects of hopelessness and self-compassion
Published in Journal of American College Health, 2021
Jameson K. Hirsch, Benjamin B. Hall, Haley A. Wise, Byron D. Brooks, Edward C. Chang, Fuschia M. Sirois
The development of successful suicide intervention and prevention strategies is predicated on the identification of risk and protective factors that may be targeted for treatment,4 and a growing body of research has focused on collegiate-related transitional risk factors.5 Stressors, including changes in responsibilities, increased academic demands, new financial obligations, increased opportunity for consumption of drugs and alcohol, and separation from one's primary support group, are often components of the college experience,6,7 and the distress arising from such negative life events is related to suicidal ideation and attempts in this population.8,9 This finding is particularly alarming, as college students report more life stressors than their non-collegiate peers.10
The Long-Term Efficacy of Suicide Prevention Gatekeeper Training: A Systematic Review
Published in Archives of Suicide Research, 2021
Glenn Holmes, Amanda Clacy, Daniel F. Hermens, Jim Lagopoulos
The availability of accessible help is a fundamental tenet of any effective community-based suicide intervention strategy. A common suicide prevention strategy is the provision of services providing support and highlighting pathways to professional help for individuals who experience suicide related crisis. Unfortunately, the majority of individuals who experience suicidal thoughts do not seek or receive assistance from formal helping relationships, as they are either unaware of their existence or they are hesitant to seek help on their own initiative (Corrigan, 2004; Pisani et al., 2012). Promisingly, although many individuals contemplating suicide do not seek formal support structures, they do seek help from informal sources of support in their social networks such as friends and family (Michelmore & Hindley, 2012). Educating individuals at the informal social level with knowledge, skills, and confidence to identify an at-risk individual and provide support has been shown as an effective suicide prevention method (Wyman et al., 2008).
Exploring Health Care Professionals’ Knowledge of, Attitudes Towards, and Confidence in Caring for People at Risk of Suicide: a Systematic Review
Published in Archives of Suicide Research, 2020
Evelyn Boukouvalas, Sarira El-Den, Andrea L. Murphy, Luis Salvador-Carulla, Claire L. O’Reilly
The immediate impact of suicide training interventions was explored in all 19 studies. With the exception of the study by Suokas et al. (2009), all found that training led to improvements in attitudes towards suicide and confidence in caring for people at risk of suicidal behaviors. Chan et al. (2009) reported that nurses regarded themselves as more competent in assessing, communicating with, and helping suicidal patients after an 8.5-hour reflective learning training program. In the United States, a 2-day suicide training program significantly improved clinicians’ attitudes toward suicide, confidence to work with clients at risk of suicide, and clinical practice skills (Jacobson et al., 2012). These improvements in beliefs and attitudes were sustained over the four-month testing period. Medical residents in Japan had improved confidence and attitudes towards suicidal people immediately after participation in a 2-hour suicide intervention program based on the Mental Health First Aid program (Kato et al., 2010). However, the participants’ social distance towards people with mental health problems was found to worsen after 6 months when compared to their baseline data. In contrast to the studies that reported improvements after training, Suokas et al. (2009) reported that medical and nursing staff’s attitudes towards suicide did not improve post-training. In this study, nurses’ understanding of and willingness to treat patients who had attempted suicide did not improve after the establishment of a psychiatric consultation service and the completion of the associated suicide education program.