We had a grand rounds lecture about suicide prevention in the Southeast Asian population. After gnawing at my fingernails during one of the most tedious hours I have endured of residency to date, the speaker graciously spent the last 60 seconds or so of her suicide prevention talk giving us clinicians some actual guidance on how to prevent suicide.
Relevant slide #1 - up 50% of people who successfully commit suicide have seen a doctor within the past 1 week
Relevant slide #2 - ask your patients about whether they are suicidal
The scientifically astute clinicians out there will note a logical leap between slides #1 and #2 that olympic medalist Andrei Silnov wouldn't have been able to make. We have: if A then B, if B then C. A therefore C. WRONG!
I have yet to see any data to suggest that asking patients about suicidal thoughts leads to suicide prevention. I have yet to see any data to suggest that treatment for depression leads to fewer suicides. If anything, it seems that the opposite may be true. If I am wrong about this, please educate me. To echo Cuba Gooding Jr.'s character in Jerry McGuire, "Show me the data!"
Is suicide preventable? Perhaps. But please find out before subjecting me to an hour long lecture on suicide prevention.
One Comment
Hi James,
OK. Good Question. I can't quote chapter and verse but YES! asking about suicide helps but it's how you ask.
1. Are you thinking about suicide? Do you have a plan? How urgent is your plan? What would have to happen for you to act on your plan? Would you be willing to hold off on your plan for any length of time( say 24 hours or 5 minutes). Do you have the equipment necessary to carry out your plan?
Are their any deterrents to your plan, say that 3 legged cat who's been with you through thick and thin who would likely be Euthanized were you to kill yourself? What would have to change for you to give up the idea of killing yourself?
There is data on over 500 people rescued from suicide plans on the Golden Gate Bridge. Over 95% of them are alive 25 years later. If you ask people about suicide then you can ask about how easy it is for them to kill themselves and prevent them from doing it until the urge passes which it does sooner or later. Over 80% of people have suicidal thoughts at some time so we know they pass unless you could call the American Diet a suicide act. Can't quote chapter and verse on this but that's the common sense of it. Also social isolation predicts suicide so just having a relationship of some kind, even with Dr. James Logan helps.
Feel free to pass this on to the lecturer if you think it would make that hour any less tedious.