suicide crisis intervention techniques

suicide crisis intervention techniques With regard to suicidality there is one primary goal of crisis intervention: to keep
the patient safe until the crisis has resolved. Therefore, extraordinary means of
maintaining safety and stability, including voluntary or even involuntary hospitalization,
are sometimes necessary. Crisis intervention with suicidal students
typically includes these protective measures: (a) restricting access to means of
death; (b) decreasing the patient’s interpersonal isolation; (c) decreasing agitation,
anxiety, sleep loss; (d) structuring the treatment (e.g., increasing the
number of sessions, providing increased accessibility via phone contacts); (e)
working on problem-solving skills; (f) creating future linkages; (g) negotiating
the maintenance of safety and the development of a˛contingency plan; and (h)
use of hospitalization in cases of clear and imminent suicide risk (Berman, Jobes,
& Silverman, 2006; Cimbolic & Jobes, 1990; Jobes & Berman, 1993).Often an acute suicidal crisis emerges from a synergy of intrapersonal,
environmental, social, and situational variables. Because young adults may
respond to life crises with suicidal behaviors, clinicians must be prepared to
assess possible and imminent self-harm behavior while concurrently protecting
against that possibility. Often these twin tasks must be accomplished
under conditions of incongruent expectations and goals between clinician
and patient. Suicidal people tend to defy the professional’s expectation that
fostering and maintaining a positive approach to life is a shared aim of patient
and clinician (Hoff, 1984). Indeed, the assessment, treatment, and general
management of acute suicidal crises, even though these crises are not uncommon,
are among the most diffi cult mental health emergencies faced by any
mental health professional (Kleespies, 1998; Roberts, 1991).
It is well established that suicidal impulses and behaviors are, for the most
part, transient and situation specifi c. Suicide intent is state dependent and
tends to wax and wane. Empirical research indicates that most people who
kill themselves give some form of prior warning and often desire an outcome
other than the termination of their biological existence (Shneidman, 1993).
The crisis clinician is thus in a pivotal, and potentially lifesaving, position.
The accuracy of risk assessment and appropriateness of interventions can literally
mean life or death.