Improving the care of people with non-fatal suicide attempts

Part of the National Suicide Prevention Strategy is to improve the care of people with non-fatal suicide attempts. This is a noble goal, and one that needs some attention. Why? Because suicide attempts are often treated pretty bloody poorly.

Suicide attempts are treated as a waste of time, a waste of resources, a waste of energy. If you want to die, the attitude often runs, then do it properly and don’t waste our time. One in two will give it another go, and one in ten will ultimately take this unspoken advice and go on to complete suicide. So much of this could be helped with good post-survived attempt intervention.

The Strategy talks about improving after-care and support, but it does’t address the underlying attitudes that are brought to the emergency room by the staff. I don’t know if there’s a lot that can be done to change that. empathy with people suffering debilitating mental illnesses just can’t be taught. A better level of professionalism might help, but the way people really feel has a way of bleeding through to people they don’t respect in any way.

It’s even worse for self-harmers, who are treated dreadfully. They’re looked at as the ultimate waste of time – people that want to hurt themselves (no matter what complex psychological processes are going on to cause that self-harm) have no place in a department set up for those who are in medical crisis. What? Self-harming that leads to hospitalisation is a medical crisis? Naaah. It’s just a waste of time.

People seeking help before the crisis gets too bad aren’t treated that terribly much better. Emergency department staff can be more sympathetic, because you’re at least trying not to clog up their resuscitation rooms with failed suicide, but mental health unit staff sometimes don’t have much respect for people who aren’t in complete crisis. They don’t have the space or the time or those who aren’t suffering the absolute worst they can endure. If you can still ask for help, you’re not at the point of total disaster, and therefore you’re not really ill enough for the unit.

Perhaps I’m speaking from my own, rather shit, experience. I’m not alone, though, and I know people who have had similar experiences. Surviving a suicide attempt only to be treated roughly and harshly is a cruel experience. The follow-up is often perfunctory – a harassed mental health worker will come and chat for five minutes, and sign you out with little in place to follow up – perhaps an outpatient appointment three weeks into the future that gets ignored or forgotten. The missing patient is written off as a no-show, and that’s it, good luck with your life, and there’s a fifty percent chance that we’ll see you again.

I feel like this isn’t very well written, and such a topic deserves better. Maybe I should revisit this when I’m not suffering new-medication blues and public holiday chaos.

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