The Aeschi Working Group
MEETING THE SUICIDAL PERSON
The therapeutic approach to the suicidal patient
PROBLEMS IN CLINICAL PRACTICE
The usual clinical practice
When clinicians are called to see a patient who has attempted suicide, they usually try to assess the risk of further suicidal behaviour by interviewing the patient in their search for clinical risk factors, particularly for signs of a psychiatric disorder, such as depression, substance abuse, severe personality disorder or schizophrenia. Clinical research has established that approximately 90% of suicides as well as suicide attempters are associated with psychiatric disorder (Isometsä et al, 1995, Haw et al. 2001).
Consistent with the medical model is that psychiatric diagnosis serves as a frame for the medical treatment, which, in the case of the suicidal patient, includes inpatient or outpatient treatment of the underlying psychiatric disorder, pharmacotherapy and psychotherapy. The medical model is undoubtedly helpful for physicians because it allows the administration of evidence based treatment strategies.
Yet we have to consider that even in the case of a severe depression, it is not the disorder itself, which initiates the suicidal act, but the "owner" of the depression, the individual itself.
Haw, C., Hawton K., Houston, K., Townsend, E.: Psychiatric and personality disorders in deliberate self-harm patients. British Journal of Psychiatry (2001), 178, 48-54.
Isometsä, E., Henriksson, M., Marttunen,
M., Heikkinen, M., Aro, H., Kuoppasalmi, K., Lönnqvist, J. (1995)
Mental disorders in young and middle aged men who commit suicide. British
Medical Journal, 310:
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|The usual clinical practice||Clinicians' attitudes||Patients' dissatisfaction||Non-attendance in aftercare||Treatment failures||New perspectives||Patients' narratives|
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Theoretical (NAT) approach
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