The Aeschi Working Group

MEETING THE SUICIDAL PERSON

The therapeutic approach to the suicidal patient

1ST AESCHI CONFERENCE, 17. - 19 February 2000
UNDERSTANDING ATTEMPTED SUICIDE: DO WE NEED A NEW APPROACH?

"Dear Konrad
I am glad my message made sense, sounds like we are in synch on this focus. I spoke to Ed Shneidman last night and mentioned our meeting in Aeschi. He was very excited and supportive! There is some important work in all this that we must get out into the field.
Best regards, Dave."

Observing what transpires in emergency clinical interviews following attempted suicide at hospitals in Europe and North America, some of us were sufficiently alarmed to attend a special conference in February 2000. A group of suicide experts (members of the Aeschi-group) from representative centers in Europe and North America convened at Aeschi, a small traditional mountain village situated at the bottom of a mountain called "Niesen" (see picture by Paul Klee), in the Bernese Oberland, Switzerland, to share experiences, weigh the problems, and to think of improvements.

The participants quickly agreed that following a suicide attempt a patient's emergency assessment experience was likely to be the same, whether in Canada, Israel, Switzerland, or the United States. Ushered into a corner of a busy emergency department, patients are likely to be quizzed in a hurried manner by a physician, or a medical assistant, who will fire a number of questions at them regarding their history of suicide and mental difficulties, hasten them through a check-list of suicide risk factors, and interrogate them respecting their mental state. This examination is likely to be carried out in a half-hour or less. At the end of it patients will feel they have been impersonally processed, had little opportunity to contribute to their own evaluation, and more than likely, will feel bruised and misused by the hospital personnel who hurry along to decide what to do to them by way of a "disposition" - to admit (often by involuntary hospitalization), to refer to the outpatient department, or to send them home.

During the three day conference at a conference Hotel at Aeschi, the conference participants went through a tough programme which included lectures, discussions, presentation of video recorded assessment interviews with patients who had attempted suicide. It was a most stimulating and rewarding experience, and the participants all left full of the Aeschi-spirit.

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