Intervention in suicidal behavior
Suicide is not an illness , so there is no specific treatment for someone who wants to commit suicide. However, there are many approaches that have proven effective in suicide prevention, especially those that recognize that suicidal crises require medium- or long-term follow-up.
In reality, when it comes to suicide, it's important to tailor treatment to the factors that led the person to make this decision. But generally speaking, treatments aimed at increasing life coping skills have the greatest impact on reducing suicide, especially among adolescents.
The World Health Organization Brief Intervention and Contact Program (WHO BIC) has been recognized in a meta-analysis as the intervention with the best results for suicide reduction, surpassing lithium and cognitive behavioral therapy . This intervention consists of a discharge visit and a scheduled follow-up of nine contacts, either by phone or in person, distributed over 18 months on a weekly and monthly basis (weeks 1, 2, 4, 7, and 11, and months 4, 6, 12, and 18).
Many other therapies have shown benefits in addressing suicidal behavior: dialectical behavior therapy (DBT), cognitive behavioral therapy ( CBT), transference-focused psychotherapy (TFP), multisystemic family therapy ( MST), family -based crisis intervention (FBCI), and attachment-based family therapy ( ABFT).
Some pharmacological treatments, such as lithium or clozapine, have also proven effective in suicide prevention. Psychopharmacological strategies for addressing suicidal ideation are primarily aimed at reducing and mitigating the pain or suffering underlying the thoughts of death, by treating the underlying psychiatric disorders and psychiatric symptoms, such as depression, anxiety, or insomnia.
Suicide prevention
Many studies have demonstrated the effectiveness of specific interventions in reducing suicide deaths. It seems clear, therefore, that suicide can be prevented, but it is also evident that to achieve this, many, if not all, of us will need to get involved and commit to this essential goal.
There are three levels of prevention depending on the target group. Universal prevention is aimed at the general population, indicated prevention is aimed at a population group at higher risk of developing a problem, for example, people with depression, and selective prevention is aimed at people who have already attempted suicide.
Paradoxically, the best preventative action at all levels is the simplest: restricting access to lethal methods . This is the best intervention for all ages. Thus, in our sociocultural context, this deprivation of methods refers to that kitchen drawer full of medications that, in most cases, we don't even use. We have become culturally accustomed to medications, so we keep them next to the salt and sugar as a matter of course, forgetting or being unaware of the high toxicity of some of the most common ones (any reader of this text would do well to stop reading and make that drawer disappear). Meanwhile, information about their toxic effects is increasingly available to people in crisis, as they find it on websites that promote suicide. In other sociocultural contexts, prevention may have other characteristics, such as preventing access to firearms or pesticides.
In relation to suicidal behavior, when we talk about universal prevention in the adolescent population, we are mainly talking about universal treatments that are framed within the school environment, such as the Empowering a Multimodal Pathway Toward Healthy Youth (EMPATHY) program or the Saving and Empowering Young Lives in Europe (SEYLE) project.
Regarding targeted and selective suicide prevention, we are referring to interventions that address the essential elements of suicide, such as pain, hopelessness, and attachment, as well as reducing suicidal capacity, and that help alleviate distress and incorporate personal resources. Examples of these interventions include treatments such as dialectical behavior therapy (DBT), cognitive behavioral therapy ( CBT), and mentalization-based therapy ( MBT ). These three interventions, in particular, are not only geared toward treating individuals at risk but are also specifically designed for suicidal ideation and attempts.