There are many characteristics that place a person at higher risk for suicide – depression, substance use, a prior suicide attempt, as examples. It is important for clinicians to know that an especially dangerous characteristic, one that exponentially increases the chances of suicide, is recent discharge from a psychiatric hospital.
I am at the Aeschi West conference this week in Vail, CO. Sponsored by the Mayo Clinic, it is a meeting of 70 or so mental health professionals from around the world who work extensively with suicidal clients. Here, we learn from the best and share our own experiences with other clinicians who have a passion for preventing suicide.
David Rudd, a nationally known suicide expert, gave an excellent presentation about warning signs and risk factors for suicide. He reviewed research showing that in the week following discharge from a psychiatric hospital, people are at dramatically high risk for suicide. One study found that women were 246 times more likely than would be expected – and men were 102 times more likely – to die by suicide in that crucial week. Chances of suicide remain markedly high for at least a month following discharge from a psychiatric hospital.
As Dr. Rudd notes, the elevated risk for suicide following hospitalization does not necessarily mean that the patient was discharged in error. Instead, suicidal intent is fluid, impossible to predict from one moment to the next, let alone day to day. Of course, whatever led to hospitalization in the first place, whether a suicide attempt, mental illness, or some other crisis, places a person at higher risk than normal for suicide.
So What Should a Clinician Do During this Period of Danger?
Dr. Rudd recommends seeing your therapy client at least twice in the week after discharge. Importantly, he states that the first session should, whenever possible, occur on the same day as discharge.
This is one of the most practical pieces of advice ever on preventing suicide, one that has the potential to save many lives.
© Copyright 2013 Stacey Freedenthal, PhD, LCSW, All rights Reserved. Written For: Speaking of Suicide
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