Suicide carries with it a profound series of serious consequences, which often changes the lives of everyone around that person. We all know those drastic effects. What is often overlooked or chalked up to being a sad occurrence, are the pre-suicidal circumstances, which actually increase suicide rates, and probability of, that disaster. Suicide prevention is the goal of thousands of professionals when a depressed patient makes the issue recognizable.
But, what happens to the large numbers of suicidal candidates who show no suicide warning signs nor openly communicate their deepest thoughts of suicide? Certainly, not all depressed people contemplate taking their own life, at least won’t admit it. Wedged in between the person who is depressed and their choice of death by suicide by that person is a trigger of some type that changes the thought of suicide into a planned commitment.
The danger related to suicide that can and will increase suicide risk can be anything that may be intentional or unintentional and words or actions by others, even lack of supportive remedies. Medications may reduce the tone of the dilemma but may not actually alter the decision about suicide at the time it’s made. It must be the greatest frustration for all mental health providers when they try to alter the course of events and fail.
One dangerous and destructive facet of efforts for suicide prevention that increases the risk of suicide is the perception that a suicidal person is not only dangerous to themselves, but also dangerous to others around them. As a result, a potentially suicidal patient, as determined by a psychiatrist or other qualified mental health professional, becomes a victim instead of a patient.
Just imagine a situation where a person truly is suicidal and surrounded by those who want to help. But, instead, those standing there see the person as a highly potential homicidal person to be reckoned with. This happens in reality to American military veterans being treated for mental illness of one type or another by the Veterans Administration physicians. In fact, when the civilian armed police (usually four) show up at the VA mental health clinic, they are quick to quote the legal statutes that mandate their action.
How would that make you feel if you were being treated for depression at the VA mental health clinic, went there for help one day, then were physically forced into a lockup institution immediately for a minimum of three days, with the doctor’s option to keep you for many more days? Most veterans probably never heard of that law, nor understood that they could be physically confined involuntarily to a psychiatric facility. Most understand that it occurs with alcoholics and drug addicts commonly known to harm others, but to suicidal patients bent on harming only themselves…….incredibly cruel punishment.
Mind you, this unlucky individual was not armed nor threatening anyone. He just needed counseling. The three keywords that trigger this confinement are those elicited during the scripted questions psychiatrists ask depressed patients to screen them, like these:
1. Do you have a weapon at home? Yes (Who doesn’t-a knife in the kitchen drawer, the rifle your uncle gave you for hunting, a rope in the shed for hanging, etc.)
2. Have you thoughts about suicide? Yes (depressed patients intermittently think about suicide off and on for years, depending on the depth of their depression.)
3. Have you planned how you would commit suicide? Yes (Your answer would reveal which method you would use if it ever came to that—most probably have thought of it)
Answering these three questions with three “Yes’s” will get the veteran involuntarily confined. Many extraneous factors influence the psychiatrists decision about that person, which are often enough to avoid triggering the confinement-but are totally disregarded intentionally, are not considered at all, are not going to change the mind of the psychiatrist no matter what, and are indicative of a second rate physician who barely made it through medical school.
Take that depressed person suddenly into lockup, and it results is additional significant increased mental trauma, which exaggerates the depression and increases suicidal risk. Anyone who has a brain must understand it happens in every single person treated in the same manner to some degree.
What are the additional traumatic conditions added by confinement:
a. Isolation-no friends, patients there keep to themselves, rare staff attention, lack of family support and attention, controlled phone calls outside.
b. Controlled environment-complete loss of self-esteem, hopelessness, boredom, group counseling usually about a topic not pertinent to the patient’s situation.
c. Physical disintegration-loss of appetite, decreased care about cleanliness, reduction of physical activity with sleep used as an escape.
d. Incompetent staff-especially psychiatric social workers who are making decisions and diagnoses far above their competency and training. They are the cause of many patients being kept well over the usual three days—for extra counseling this staffer has decided the patient needs because patients are sicker than everyone else can see.
e. Mental confusion-forget time and date, concern about what family will think and how they’ll treat them later, increases the isolation feeling, future worries about what this episode will do to jobs, life pattern, and medical treatment.
f. Increased desire for suicide-all of the above increase the desire to escape life and treatments, elicits fear of ever going back to the VA clinic for mental help for fear that it could happen again, have disappointed family and deserve punishment, worthlessness becomes supreme.
This patient, once confined, is now permanently labeled by the VA as a violent person on the records, even if they have never performed a violent action in their life. Any history of combat experience makes it easier to label him or her.
This experience of confinement suddenly by police action insures that the veteran will need to do certain things to protect themselves, like, lie to the psychiatrist or psychologist, give up on any mental health help from the VA, alert all the other vets about the trickery.
This is the system in force now. It may be a wakeup call for other agencies who treat depression, and function in a suicide prevention format.