The International Handbook of Suicide Prevention: Research, Policy and Practice

By Rory C. O’Connor; Jane Pirkis | Go to book overview

21
After the Suicide Attempt—
The Need for Continuity
and Quality of Care

Lars Mehlum and Erlend Mork


Introduction

Attempted suicide is a major public health problem in most countries. Although several alternative terms and definitions have been proposed, in most clinical contexts, the term ‘attempted suicide’ has been defined broadly as an acute nonfatal act of self-harm deliberately carried out with or without suicide intent. This corresponds well to typical definitions of self-harm in clinical policy documents such as the U.K. NICE Quality standards for self-harm (NICE, 2013). Not all people who make a suicide attempt come to the attention of health-care services. However, patients who are referred for general hospital treatment after a suicide attempt are numerous enough (Doshi, Boudreaux, Wang, Pelletier, & Camargo, 2005; Perry et al., 2012) to represent a significant clinical challenge to the hospitals and their staff, who have a responsibility to provide adequate and effective treatment. Hospital services provided for people presenting after a suicide attempt may, however, vary greatly (Kapur, House, May, & Creed, 2003; Mehlum, Mork, Reinholdt, Fadum, & Rossow, 2010). An additional problem is poor communication between patients and staff, which has been frequently reported in studies examining the experiences of patients seeking help after suicidal behavior (Taylor, Hawton, Fortune, & Kapur, 2009). The negative staff attitudes, especially toward patients with a pattern of repeated suicide attempts (Saunders, Hawton, Fortune, & Farrell, 2012), may be exacerbated by time constraints and work stress (Suokas & Lönnqvist, 1989). Several studies have also indicated a lack of staff knowledge with regard to suicidal behavior (Taylor et al., 2009), which may lead to the discharge from hospital of many patients without adequate clinical assessments having been carried out (Bennewith, Peters, Hawton, House, & Gunnell, 2005; Bergen & Hawton, 2007). A study by Kapur, House, Dodgson, May, and Creed (2002) reported that patients who had been admitted for self-poisoning and who had not received a psychosocial assessment were more likely to poison themselves again. There is reason to believe that, in the long run, these unfavorable conditions may

The International Handbook of Suicide Prevention, Second Edition. Edited by Rory C. O’Connor and Jane Pirkis. © 2016 John Wiley & Sons, Ltd. Published 2016 by John Wiley & Sons, Ltd.

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