Suicide risk assessment protocol and warning signs

In recent years, the suicide rate has increased significantly in several countries around the world; However, for many people this is still a taboo subject and they are not informed or know how to identify warning signs, therefore, the possibility of preventing it is complicated.

This is related to the low sensitivity that exists in many countries about mental health, since many times the Suicide is one of the consequences of suffering from a mental disorder that was not treated properly, or that never was in absolute.

Suicidal ideation is something that anyone can experience, and that is why it is important that we know about the subject, that we know what is true about suicide and what are myths, and how to help a person we know who is going through a difficult time and has ideation or has had attempts suicidal.

• Related article: "The interpersonal psychological theory of suicidal behavior"

Suicide characteristics

The main common characteristics of suicide are as follows.

1. Stimulus

What leads a person to commit it is usually excruciating psychological pain.

2. Purpose

The purpose is to find a solution to that pain that he feels.

3. Emotion

Person may experience various emotions such as shame, guilt, and hopelessness.

4. Internal attitude

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

5. Goal

Similar to the purpose, 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 he sees suicide as the only option and can hardly see other alternatives to achieve the goal.

Suicide Prevention: Risk Signs

Each person can express or communicate her suicidal ideation in her own way, either verbally or non-verbally. It can be easy to recognize him when he openly says phrases such as “I'm useless”, “I don't want to live anymore”, “everyone would be better off if I die”, “my life has no meaning”, among others; However, there are signs that are not so easy to identify and can go unnoticed such as the fact that the person becomes more apathetic, that he begins with specific arrangements to put his things, having irregular sleeping patterns, getting rid of cherished belongings, or being in high spirits depressing her.

When a psychological intervention is performed with a patient who has suicidal ideation and / or that you have had attempts to end your life, it will be important to start investigating using words or terms that have been said by the patient himself, to avoid that he feels judged or that incorrect interpretations are made of the situation.

In these cases, psychologists ask neutral questions avoiding criticism or prosecution. With this you can establish a trusting patient-therapist relationship, as you will not feel judged and you will know that the therapist is really interested in helping you.

Protocol for evaluating suicidal ideation

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 is evaluated if it has the means to carry it out or what is the difficulty or ease of achieving them.

2. History of previous attempts

It is intended to know how many there have been, how they have happened and how they have turned out; each attempt increases the chance of being successful.

3. Willingness to make use of external assistants

Lonely patients are often at higher risk, because there is no one who can support in the containment; If the patient is reluctant to ask for help, a contingency plan should be devised.

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

• You may be interested: "Medicine: a profession with a high risk of suicide"

Myths on this topic

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

• Suicide attempts are to get attention.
• People who really want to end their life, do not warn, they just do it.
• Those who commit suicide are selfish or brave (it can change people's perspective).
• If information is given in the media, it causes more people to do so.
• Suicide cannot be prevented.

Suicide attempts are a manifestation of despair, frustration and psychological pain; The fact that someone commits a suicide does not mean that they are selfish or brave, but rather it reflects a person with a very high level of suffering. Normally people "warn" or transmit their wish to die in a certain way, although unfortunately we do not always perceive it and we do not know how to read the signals they give us.

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

Bibliographic references:

• Suicide and Psychiatry. Preventive and management recommendations for suicidal behavior. Bobes García J, Giner Ubago J, Saiz Ruiz J, editors. Madrid: Triacastela; 2011