Effectiveness of rating scales for suicide risk

[Faith No More]

I've been held against my will for nothing more than having a serious suicide attempt 8 years prior and being very upset because of grieving. It's really not hard at all. All the doctor needs is a strong suspicion that you're a danger to yourself or others. They don't have to prove anything.

I'm going to guess that the people interviewing your patients, chimp3, are either lazy or don't give a shit, which is not unusual in the mental health field.

[chimp3]

Not without substantial evidence. I have attempted to send people threatening suicide to the State Hospital. One was actually jamming a sharpened paper clip into his wrists. Repeatedly. They go in, get interviewed, and are sent right back to the institutions where I work. I know of 2 that were successful at suicide within a few days after we sent them home. 72 hour holds are still legally defined and confined.

That just tells me that something is being missed, either within the institution/process itself or by clever deception on the part of the patient.

We send detailed clinical notes describing their statements and self abuse. They respond to the shrink or Psychiatric Social worker differently. However, most of the time people are not making plans to kill themselves. Try it and see. If your are in the E.R. mention suicide as an option. We are required to follow a protocol and you will be professionally assessed. (Please do not do this, I am pointing out how the system works.)

[vorlon13]

I recall many years ago making up a story about needing help to pick up some items at the farm supply store to get 2 cousins in my car, one to help with the other, as we were really taken the other one to the hospital for observation, not knowing what else to do.

Borrowed another cousins Accord since I remembered the back door locks could be configured to only allow opening from outside, and got 'other' in the back seat. And away we went.

Diagnosis was more along the depression side of things, and 'other' is still with us to this day. Medicated, but doing 'fine'.

[brewer]

I've been held against my will for nothing more than having a serious suicide attempt 8 years prior and being very upset because of grieving.  It's really not hard at all.  All the doctor needs is a strong suspicion that you're a danger to yourself or others.  They don't have to prove anything.

I'm going to guess that the people interviewing your patients, chimp3, are either lazy or don't give a shit, which is not unusual in the mental health field.

bold mine

Not all, don't forget that they also have administrative guidelines that must be followed if the staff want to stay employed. Those guidelines do not always include compassion. Ever since the 80"s and the concept that institutional inpatient psychiatry was over utilized, the norm became to stabilize ASAP and then outpatient as many as possible (right or wrong). That concept continues to today. I'd say NE mental health inpatient facilities got cut by 1/2 to 2/3.

[Faith No More]

True, I wasn't even thinking about money. Or maybe there is even a lack of beds. It's a sad fact that many facilities are under funded and don't have the resources they should.

Still, if I only had a dollar for every mental health worker that didn't give a shit about the patients...

[Ravenshire]

Yes and no. While a person cannot be institutionalized against their will without a court order, a 72-hour hold without one is perfectly legal.

Not without substantial evidence. I have attempted to send people threatening suicide to the State Hospital. One was actually jamming a sharpened paper clip into his wrists. Repeatedly. They go in, get interviewed, and are sent right back to the institutions where I work. I know of 2 that were successful at suicide within a few days after we sent them home. 72 hour holds are still legally defined and confined.

And none of that changes the fact that no court order is required for a 72-hour psych hold. The patients may be faking the doctors or the doctors may be missing something, but if the evaluation shows reason for a psych hold, they can and will hold them whether a judge gives an ok or not.

[brewer]

And none of that changes the fact that no court order is required for a 72-hour psych hold. The patients may be faking the doctors or the doctors may be missing something, but if the evaluation shows reason for a psych hold, they can and will hold them whether a judge gives an ok or not.

bold mine

I don't like being hugged that long. (insert shudders here)

[brewer]

Not to be a debbie downer but this related article came across my feed: Suicide following deliberate self harm.

Quote: "Adults treated for deliberate self-harm frequently repeat self-harm in the following year. Patients who use a violent method for their initial self-harm, especially firearms, have an exceptionally high risk of suicide, particularly right after the initial event, which highlights the importance of careful assessment and close follow-up of this group."

http://ajp.psychiatryonline.org/doi/10.1...7.16111288

[Faith No More]

Wait, people use firearms for self-harm that isn't suicide? Damn...

Do they shoot themselves in the leg or something?