Suicide risk assessment protocol and warning signs

In recent years, the suicide rate has increased dramatically in several countries around the world; however, for many people it is still a taboo subject and they are not informed or do not know how to identify the warning signs, so the possibility of avoiding them is complicated.

This is linked to the low sensitivity that exists in many countries towards mental health, as suicide is often one of the consequences of suffering from a mental disorder which has not been treated properly, or which never was at all.

Thoughts of suicide are something that can be experienced by anyone, which is why it is important that we know about it, that we know what is true about suicide and what the myths are, and how we can help someone we know how to go through a difficult time. and has ideas or has attempted suicide.

    Characteristics of suicide

    The main common features of suicide are as follows.

    1. Stimulus

    What prompts a person to engage – is usually unbearable psychological pain.

    2. Purpose

    The goal is to find a solution to this pain that you are feeling.

    3. Emotion

    the person you may experience various emotions such as shame, guilt, and hopelessness.

    4. Internal attitude

    In many cases, the individual presents a sense of ambivalence that, on the one hand, he wants to die to end this pain, but on the other hand he hopes to be saved; a struggle between our life drive and our death drive.

    5. Meta

    Similar to the goal, the goal is to end the self-awareness that carries all the psychological pain.

    6. Cognitive state

    The person is in a state of constriction in which they see suicide as the only option and can hardly see other alternatives to achieve the goal.

    Suicide prevention: risk signals

    Each person can express or communicate their suicidal thoughts in their own way, verbally or not. It can be easy to recognize when he openly says phrases like “I’m useless”, “I don’t want to live anymore”, “Anyone would be better off if I die”, “my life is meaningless,” In between other; But, there are signs that are not so easy to identify and that may go unnoticed such as becoming more listless, starting with specific arrangements to keep things “in order”, having irregular sleep patterns, shedding highs that they enjoy, or that she has a depressed mood.

    When a psychological intervention is performed with a patient who has thoughts of suicide and / or who has attempted to end his life, it will be important to start investigating using words or terms that have been these by the patient himself, to prevent him from feeling judged or from being judged. misinterpret the situation.

    In these cases, psychologists ask neutral questions preventing them from being critical or from pursuing. With this, you can build a trusting patient-therapist relationship because you won’t feel judged and you will know that the therapist is genuinely interested in helping you.

    Suicidal Ideation Assessment Protocol

    For the evaluation of the danger, it will be important to take into account 3 variables:

    1. Plan

    How far has the idea gone? It assesses whether you have the means to do it or how difficult or easy it is to achieve them.

    2. History of previous attempts

    It is intended to know how many were, how they happened and how they unfolded; with each attempt, it increases the chances of success.

    3. Willingness to use external assistants

    Lone patients are generally at higher risk, Since there is no one who can support the containment; if the patient is reluctant to seek help, an emergency plan should be developed.

    The goal is to be able to gain time to ensure the well-being of the patient and that an agreement can be reached with him.

      Myths about it

      Although some ideas about suicide have already been changed, there are still myths that can hinder or prevent its prevention. These are the following misconceptions.

      • Suicide attempts must attract attention.
      • People who really want to end their life don’t warn, they just do it.
      • Those who kill themselves are selfish or courageous (this can change people’s perspective).
      • If the information is given in the media, it encourages more people to do so.
      • Suicide cannot be avoided.

      Suicide attempts are a manifestation of hopelessness, frustration and psychological pain; that a person commits suicide does not mean that he is selfish or courageous, but that it reflects a person with a very high level of suffering. Usually people “warn” or somehow convey their desire to die, although unfortunately we don’t always perceive it and don’t know how to read the signals they are giving us.

      The publication of responsible and accurate information in the media is a very useful prevention tool, because yes, it is possible to prevent suicide.

      Bibliographical references:

      • Suicide and psychiatry. Recommendations for the management of preventive and suicidal behavior. Bobes García J, Giner Ubago J, Saiz Ruiz J, editors. Madrid: Triacastela; 2011

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