Mental Health Professionals

Is Suicide Inevitable for Some People?

Is Suicide Inevitable for Some People?

A 61-year-old man, E.H., survived suicide attempts, received care for depression in psychiatric hospitals, and battled alcoholism for many years. His father died by suicide. E.H. was convinced that one day he, too, would kill himself. In 1961, he fatally shot himself in the head. Was his suicide inevitable? Ernest Hemingway, the famous author and the […]

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Should Therapists Attend the Funeral of a Client who Dies by Suicide?

Should Therapists Attend the Funeral of a Client who Dies by Suicide?

The loss of a client to suicide is devastating. If as a therapist you experience this tragic loss, you may go through the familiar questions that beleaguer all suicide survivors. Could I have done something differently? Why couldn’t I prevent their suicide? There is another question for mental health professionals that is not talked about […]

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“You Can’t Do Everything”: Limitations in Helping a Suicidal Person

“You Can’t Do Everything”: Limitations in Helping a Suicidal Person

Just about every list of “suicide myths” mentions this one: “If a person is serious about killing themselves then there is nothing you can do.”  But is it always a myth? In important ways, yes, it is a myth. There are many things that loved ones of a suicidal individual can do to help – things like […]

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“How Would You Listen to a Person on the Roof?”

“How Would You Listen to a Person on the Roof?”

What would you say to a person on the roof? That is, if you were called out to a crisis scene, where a young woman sat on the roof of a tall building weeping and shouting that she would jump at any moment, what would you say to her? This provocative question – What would […]

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Preventing Suicide Attempts in 4 Sessions: Is It Possible?

Preventing Suicide Attempts in 4 Sessions: Is It Possible?

In just four sessions, the Attempted Suicide Short Intervention Program aims to stop somebody who recently attempted suicide from making another attempt. This is quite an important goal, because a previous suicide attempt is the largest predictor of eventual suicide. Is it really possible to prevent another suicide attempt with just four sessions of therapy? […]

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The Most Dangerous Time: Suicide After Discharge from a Psychiatric Hospital

The Most Dangerous Time: Suicide After Discharge from a Psychiatric Hospital

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 […]

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Documentation: Do it Well, for the Client’s Sake and Yours

Documentation: Do it Well, for the Client’s Sake and Yours

  “Client denied suicidal ideation.” “Client reports suicidal ideation but lacks plan or intent.” “Client reported only mild suicidal thoughts.” Many clinicians use these phrases in their clinical notes – and then say nothing else about suicide risk. Such minimalism is not good practice, for either the clinician or the client. Good documentation enables the […]

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Involuntary Hospitalization: From Ally to Adversary?

Involuntary Hospitalization: From Ally to Adversary?

You are listening to a client describe very specific plans to attempt suicide by overdosing. She has 94 pills of a potentially lethal medication at home. She knows the number because she has counted, again and again, in a sort of ritual to prepare herself for the act. A familiar unease settles in you. You ask […]

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Why Prevent Suicide? Here Are My Reasons.

Why Prevent Suicide? Here Are My Reasons.

 “If someone’s life is so awful that they want to die by suicide, why stop them?” I am frequently asked some variation of this question, even by mental health professionals. Once, a therapist told me about a client of hers with schizophrenia. “He is miserable, and he will always have schizophrenia. I think letting him […]

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Uncovering Suicidal Thoughts

Uncovering Suicidal Thoughts

To help a person deal with suicidal thoughts, you first need to know they have them. The challenge here is that many people who seriously consider suicide do not tell their therapist, at least not fully.  What To Do? Shawn Shea, M.D., a psychiatrist and expert on suicide risk assessment, has described excellent techniques for […]

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