Guidelines for the telecare of a person with suicidal ideation
The Official College of Psychologists of Catalonia (COPC) has created an infographic to guide the actions of psychology professionals who are communicating remotely with a person contemplating suicide. This resource can be useful for keeping all available resources and techniques readily accessible.
According to this professional entity, the arrival of the pandemic launched telecare mechanisms which, in these two years, have become another care option, so many professionals may find themselves in a situation of managing such a critical moment as the request for help from the person with suicidal ideation.
Guide to recommendations for suicide prevention
The infographic , available in Catalan, outlines the key questions to ask to determine suicide risk and the steps or actions to take if the answer is positive. It also indicates some relevant aspects to consider in these cases. Given its importance, we are reproducing the content of this infographic, created by the Emergency Section of the Official College of Psychologists of Catalonia.
Guidelines to guide the actions of psychologists who are in non-face-to-face communication with a person with suicidal ideation
- Ask openly: Have you thought it would be better to die or have you wished you were dead?
- Then ask: Have you thought about suicide? Have you recently thought about the method to carry it out?
If the answer is yes, it's important to arrange for medical help. How?
- Get the location .
- Find out if there is anyone else with the person (family at home, friends)
- If there is any doubt about the risk, prioritize the need for immediate medical attention . Consider whether to activate the emergency services or send the person to the nearest hospital's emergency department. In both cases, the person should be accompanied by a significant other.
We activate emergency services when the person is alone or locked in a place where family members cannot access them. We inform the person that we will call, that we know they must be suffering a lot, and that we will help them. We get them to agree to open the door when the emergency services arrive. We maintain the call and obtain as much information as possible.
If the person is sent to the emergency department, they must be accompanied and we make sure that they stay with the designated contact person. - Maintain the conversation, listen, validate and do not judge, knowing that time is on our side (the more time, the less impulsiveness).
- Express and positively value that they asked for help.
- Don't make promises you can't keep.
- Limit the environment of potential facilitators (you can move away from the window, you can leave the kitchen, you can sit on the floor please...).
- If the person is accompanied , ask to speak with them.
- Do not cut off communication until the assistance resource arrives or the accompanying person is spoken to.
Aspects to consider:
- Never underestimate the risk of the attempt.
- The urgent objective is not to modify the idea but to postpone the decision.
- Explore 4 areas: when, how, where, and why.
- In case of medication ingestion: find out the address and activate the emergency service, ask them to open the door of the house, and ask them to notify a neighbor.
- Do not hang up or leave the call at any time (continuous presence).
- Time is on our side
- Nonverbal communication is important (a calming voice, tone, intonation, and clear articulation). Your calmness is contagious.
- Validate suffering, validate emotions. Identify the dominant emotion.
- Give feedback on what the person is telling us: You're telling me that… (and repeat what they explain).
- Find anchors (friendships, children, hobbies...) and get them to talk about them.
- If the person appears emotionally overwhelmed, ask cognitive questions: describe their surroundings, what they have done during the day so far...
- Our intervention does not end until we have linked the person with the appropriate support resources in their case.
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