how should therapist deal with suicidal patients?

[bluebluesky]

I remember from Ethics class that if the patient has a plan to kill himself/herself, the therapist should do something about it. But I am not sure where to draw the line. This is a question from my student. So if the patient says that she wanted to drive off the bridge and kill herself while she was driving a car but decided not to do so at the last moment, should the therapist reports this to the police or hospitalize the patient by force?

Hypothetically if the patient did commit suicide, and if the therapist lies about that the patient did not mention about the suicidal intent during the therapy session. Is there any way to find out that the therapist was lying?

I know this is a gray area and it's hard to draw a line. But I just want to know more about this and maybe provide a more specific and practical answer to this question. Thanks.

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[erg923]

Suicidal ideation vs. current suicidal intent is the key issue here. You will see many patients that have had suicidal ideation in the recent past. Many people can have the belief that they would be better off dead, but are not necessarily grossly suicidal. First step is a thorough assessment for risk of suicide, which of course includes questions about intent, plan, and lethality. If the patient is voicing intent currently, or deemed to be in significant imminent risk of suicide, you should consult with your supervisor. Least restrictive means are utilized first, including an extensive therapeutic crisis intervention on your (or supervisor's) part. If this fails, other methods maybe employed, including encouraging the patient to voluntarily go to the ER or seek inpatient hospitalization. Assuming the patient remains grossly suicidal and refuses to go voluntarily, confidentiality can then be breached in order to keep the patient safe. Contacting the proper authorities for mandatory commitment may be necessary at this point.

 

[cara susanna]

I'm only an undergrad so take this with a grain of salt, but I was told in one of my classes to look for whether or not the person has the following: mean, motive, intent, plan.

 

[bluebluesky]

Least restrictive means are utilized first, including an extensive therapeutic crisis intervention on your (or supervisor's) part. If this fails, other methods maybe employed, including encouraging the patient to voluntarily go to the ER or seek inpatient hospitalization.

What does an "extensive therapeutic crisis intervention" usually involves?
So if the patient kills himself/herself during the process of this crisis intervention, will the therapist be liable for not trying to hospitalize the patient right away? Thanks.

 

[erg923]

Well I would hope you would not have any lethal objects lying around your office during the crisis interventions...... I keep the knives, guns, and razor blades out of the therapy room.