a full assessment by staff trained in suicide risk assessment and prevention methods
fast track referral if deemed necessary
frequent, regular contact with the same key worker or other mental health professional
if required, easy access to appropriate inpatient care in accommodation suitable for their age group
on how to access immediate help in a crisis
to help them understand what has happened
about their medication
• details of contacts and organisations that can give support
of an impending discharge from hospital following a suicide attempt. The first few days following discharge are a particularly risky time. Wherever possible the GP should seek a meeting to establish a trusting relationship with the person who has been suicidal and their supporters, so that if another crisis occurs everyone knows where to go to for help.
The personal support team….. family, partners, friends, carers
Families are often in the best position to judge when things are bad. Parents consulted by PAPYRUS have spoken of their 'gut feelings' prior to their child's suicide. The young person’s personal supporters need to know where they can access immediate help in a crisis.
Members of the immediate support network can be pivotal to the young person's recovery, therefore it is recommended that wherever possible, they are included at every stage – from consultation through to treatment - and given advice on what to do.
In a life threatening situation vital pieces of information and advice can be communicated to the family without compromising confidentiality. Information from family members (who, unlike professionals, are not bound by confidentiality issues) can be of value in assessing the 'bigger picture'. Services need to discuss issues of confidentiality and capacity prior to it becoming a ‘hot’ issue. With young people, limited confidentiality due to their safety needs / child protection issues may be in their best interests.
It can take a long time for trust to develop between the person seeking help and the professional. People are less likely to unburden themselves to a stranger. If this is unavoidable, links can be made between professionals and client and / or introductions made. This trusting relationship provides a source of security for the family too.
Whenever there is an element of doubt about diagnosis or treatment a second opinion should be sought. If the young person is not able to relate to the professional they are seeing they should be offered the opportunity to be seen by a different practitioner.
Those closest to the person at risk of taking their own life are often living with the worry of suicidal behaviour on a daily basis. They need to be emotionally strong to cope; to be able to respond appropriately to the range of situations that may arise.
Not everyone who feels suicidal is mentally ill. However thoughts of suicide can sometimes develop when a person is depressed or anxious. Suicidal thoughts can be very frightening. To know that others have been through the same thing and recovered can lessen the fear. Knowledge brings understanding and therefore better management of the situation for all concerned.
Families and those who are ill need to know how often their medication should be taken, how long it will take to have an effect and how to recognise adverse reactions. When adverse reactions have been reported to the doctor he/she may then consider prescribing an alternative form of treatment.
People need to be made aware that sometimes medication can increase suicidality.
When worried about their child, parents have said they ‘didn’t know where to turn for help’. The PAPYRUS helpline HOPELineUK was originally set up to address this need. Our advisors can give emotional support and advice to young people at risk or to anyone who may be concerned about them.
Communication is key
Whilst we are constantly telling people how important it is to talk through suicidal feelings, it is equally important that those who are listening respond sympathetically in a non-judgemental or critical way. Further erosion of a person’s self esteem should be avoided since it may compound the negative feelings which have brought the person to a suicidal crisis in the first place.
readily available support
Schools, colleges, universities and the workplace need to have close links to appropriate health services to facilitate a chain reaction that can take a distressed young person from, for example, college tutor right through to appropriate treatment.
Often several individuals or different agencies are involved with the one person. It is vital that everyone knows what is going on. The extended family is an important part of this team and should be included wherever possible.
People who have been bereaved can become vulnerable to suicide and therefore need ongoing monitoring and support. Professionals should ensure that families are aware of bereavement support organisations such as Survivors of Bereavement by Suicide (previously known as SOBS), Compassionate Friends and CRUSE.
Help Is At Hand: a resource for people bereaved by suicide and other sudden, traumatic death (2008 edition)