Suicide (cont.)
How are suicidal thoughts and behaviors treated?
Those who treat people who attempt suicide tend to adapt immediate
treatment to the person's individual needs. Those who have a responsive and
intact family, good friendships, generally good social supports, and who are
hopeful and have a desire to resolve conflicts may need only a brief
crisis-oriented intervention. However, those who have made previous attempts,
have shown a high degree of intent to kill themselves, seem to be suffering from
either severe depression or other mental illness, are abusing alcohol or other
drugs, have trouble controlling their impulses, or have families who are
unwilling to commit to counseling are at higher risk and may need psychiatric
hospitalization and long-term mental-health services.
Suicide prevention measures that are put in place following a psychiatric
hospitalization usually involve mental-health professionals trying to implement
a comprehensive outpatient treatment plan prior to the individual being
discharged. This is all the more important since many people fail to comply with
outpatient therapy after leaving the hospital. It is often recommended that all
firearms be removed from the home, because the individual may still find access
to guns stored in their home, even if locked. It is further often recommended
that potentially lethal medication be locked up as a result of the attempt.
Vigorous treatment of the underlying psychiatric disorder is important in
decreasing short-term and long-term risk. Contracting with the person against
suicide has not been shown to be especially effective in preventing suicidal
behavior, but the technique may still be helpful in assessing risk since refusal
to agree to refrain from harming oneself or to fail to agree to tell a specified
person may indicate an intent to harm oneself.
Talk therapy that focuses on helping the person understand how their thoughts and behaviors
affect each other (cognitive behavioral therapy) has been found to be an
effective treatment for many people who struggle with thoughts of harming
themselves. School intervention programs in which teens are given support and
educated about the risk factors, symptoms, and ways to manage suicidal thoughts
in themselves and how to engage adults when they or a peer expresses suicidal
thinking have been found to decrease the number of times teens report attempting
suicide.
Although concerns have been raised about the possibility that antidepressant
medications increase the frequency of suicide attempts, mental-health
professionals try to put those concerns in the context of the need to treat the
severe emotional problems that are usually associated with attempting suicide
and the fact that the number of suicides that are completed by mentally ill
individuals seems to decrease with treatment. The effectiveness of medication
treatment for depression in teens is supported by the research, particularly
when medication is combined with psychotherapy. In
fact, concern has been expressed that the reduction of antidepressant
prescribing since the Food and Drug Administration required warning labels be
placed on these medications may be related to the 18.2% increase in U.S. youth
suicides from 2003 to 2004 after a decade of steady decrease. Mood-stabilizing medications like lithium (Lithobid), as
well as medications that address bizarre thinking and/or severe anxiety, like
clozapine (Clozaril), have also been found to decrease the likelihood of individuals
killing themselves.
Next: How can people cope with suicidal thoughts? »
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