The loss of control over urges and behaviors may be the central component of gambling disorders, but there is so much more to consider. Individuals with these problems have exponentially higher rates of suicide attempts and completions.
Professions, psychiatry included, do not have a stellar record of protecting those they serve. Do we have reason to believe that professional organizations or corporate entities can be trusted to protect their clientele?
“I may never know who you are,” writes this psychiatrist, “but if you provided medical or psychiatric care for the co-pilot of Germanwings Flight 9525, we are colleagues. And you too are his victims, of sorts. I hope your reputation does not suffer unduly.”
The recent tragedy with the Germanwings crash in the Alps has started a worldwide discussion about mental illness and suicide. NIMH Director Thomas Insel reflects on the larger issues we continue to face.
The authors differentiate between 3 types of deliberate self-harm: nonsuicidal self-injury, culturally sanctioned body modifications (tattooing or body piercing), and unintentional or accidental injury.
The authors review mechanisms of suicide and the effectiveness of current treatments, and zero in on ketamine--a potential novel, rapidly acting treatment for suicidality.
Take the ethics quiz about a cognitively intact, highly intelligent patient with good ego strength and coping skills who plans to commit suicide.
The articles in this Special Report address suicidal behavior in the context of the role of sexual identity, the effects of antidepressants and lithium on suicidal behavior, and clinicians’ reactions in the aftermath of suicide.
An interesting pharmacological approach in terms of anti-suicidal strategies is the use of lithium for treatment of patients with affective disorders. Details here.
As an occupational hazard, preparing for the possibility of patient suicide will help the clinician anticipate the types of support that our colleagues or we may need to weather the event.