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World Suicide (bleep) Day

And now for something completely different:

 

I find World Suicide Prevention Day kind of annoying. Not the day itself, I suppose, but what happens – and doesn’t happen – every year at around this time.

 

Since the world of mental health is fond of assessments, I’ve devised the following questionnaire to help you assess our healthcare system’s ability to prevent suicides.

 

Does that sound okay? Good. Let’s get started. Let me know if you have any questions.

 

1.            The theme for 2014 World Suicide Prevention Day is, “Connections,” highlighting the fact that reducing social isolation can be effective in preventing suicide.

 

With that in mind, if a person at high risk for suicide seeks help at a hospital Emergency Department, would the five-hour average wait for psychiatric service seem (please select one):

o            Very helpful

o            Somewhat helpful

o            Neither helpful nor unhelpful

o            Somewhat unhelpful

o            Very unhelpful

 

2.            Imagine that you have sought emergency help because you are having strong urges to kill yourself. The psychiatrist states that, because you have readily admitted to thinking about suicide, you can’t be that serious, can you? Because, like, if you were really serious, you wouldn’t tell anyone for fear that they would try to stop you. You learn from this that if you want to get help for your suicidal feelings, you must not tell anyone that you are having them.

 

Would you consider the doctor’s comment:

o            Very helpful

o            Somewhat helpful

o            Neither helpful nor unhelpful

o            Somewhat unhelpful

o            Very unhelpful

o            Deeply disturbing

 

3.            Say that you had sought help for your suicidal urges at a hospital Emergency Department. You’re now ready to go home, but are concerned about what to do if you have another crisis sometime in the future. Your physician tells you in all seriousness that, while they have done their best to “idiot-proof” their staff rotation, it’s better if you have your crisis on a weekday between 10 a.m. and 3 p.m., when senior staff are on shift.

 

How willing would you be to return to this hospital if you had another crisis (regardless of the time of day):

o            Very willing

o            Somewhat willing

o            Neither willing nor unwilling

o            Somewhat unwilling

o            Very unwilling

o            Downright reluctant

 

4.            You’re feeling very down. The only way you can think of to end your suffering is to kill yourself. You’re diagnosed with Depression, Borderline Personality Disorder (BPD), and Obsessive-Compulsive Disorder (OCD). Which of the following options do you choose:

o            Wait one and a half years for a comprehensive OCD assessment

o            Wait two years to get into comprehensive treatment for BPD

o            Wait indefinitely to get into treatment for Depression

o            Wait indefinitely + three-and-a-half years to be treated as a whole person

o            Kill yourself

 

5.            You are at work at a hospital Emergency Department when a suicidal patient arrives. She states that she intends to kill herself, has a detailed suicide plan, and has made all the necessary preparations. You leave her alone in a room for seven hours, and then inform her that there are no beds available at your hospital or at any other hospital. You then leave her alone for a few more hours. The patient takes a very heavy dose of her medication to go to sleep. Later, she points out that she is not receiving any help and wants to go home. Because there is no secure area to prevent her from leaving, you put her in restraints and leave her in isolation for ten hours. The physician decides that since the patient has been non-compliant, she should not be admitted for treatment. Though the patient is still so groggy from the medication that she weaves down the hall like a drunk, you send her off on her own to catch a bus.

 

Does it at any point occur to you that the patient may subsequently (choose as many as you wish):

o            Fall under the wheels of the bus

o            Carry out her suicide plan

o            Be rescued by chance moments before her death

o            Spend several days in Intensive Care hooked up to a ventilator

o            Require a week in hospital to recover

 

You’re done! Now review your answers. Based on what you’ve learned, how well equipped would you say our healthcare system is to be able to prevent suicides?

 

(Caveat: The author freely admits that this assessment is biased due to the fact that all the questions are based on her own experiences and not on any kind of silly scientific methodology.)

 

And now for something completely different:

 

Let’s not talk about Suicide Prevention Day when, honestly, we are not doing much of anything to prevent people from committing suicide. We don’t even succeed in supporting people before they become suicidal.

 

Let’s also be clear about what is and is not actual suicide prevention. Making videos; sending out statements, recommendations, and press releases; providing an expert opinion on radio shows; and telling personal stories about suicide are all great, and in some cases, very brave. They are not suicide prevention.

 

Actual prevention involves actually doing something to stop people from actually killing themselves. Something like allocating enough funds to programs and treatments that already exist and are proven to prevent suicide, so that the people who need them can actually access them before someone has to ID their body at the morgue.

 

Until then, happy World Suicide Awareness Day.