Help for attempted suicides

Press, 28 July 1976, Page 4

Help for attempted suicides

A special team to help those who have attempted suicide has been set up in Christchurch — the result of a study of 195 such persons by the department of psychological medicine at the Christchurch Clinical School. Professor K. S. Adam, professor in psychological medicine at the school and head of psychological medicine at Christchurch Hospital, said a major epidemic of attempted suicides was being dealt with in Christchurch, as in most of the world. The team, which is not fully staffed or fully operational yet, works from the outpatient department at Christchurch Hospital. It already contains a psychiatrist, two psychologists, a social worker and house surgeon. The group acts on referrals and hopes to involve itself with those who have attempted suicide, while simultaneously meeting family or any others involved in the immediate crisis. Suicide attempts by drug overdose seen at the accident and emergency department of Christchurch Hospital in 1968, 1969 and 1970 were consistently about 400, rising to about 550 in 1971, about 650 in 1972, about 775 in 1973 and levelling to about 750 in 1974 and 1975. Professor Adam said this pattern had been reflected in the United Kingdom, the United States, Canada and Australia, where there had been a sharp increase in drug overdoses in recent years. Actual suicide deaths had not increased in most countries, he said, and in Great

Britain and to some degree, New Zealand, there had been a slight decrease. About 90 per cent of recorded attempted suicides were from drug overdose, said Professor Adam. Other minor suicide attempts might not be seen in hospitals and would not be recorded, but he suspected the total number of suicide attempts in the community as a whole was easily double that quoted. About 12 months ago the department of psychological medicine undertook the study of 195 people who had been seen at the hospital after a suicide attempt — to get some idea of who they were, why they were making an attempt on their life, to evaluate possible reasons for the behaviour, and decide how serious the attempt was. The main finding was similar to overseas studies: most were young women — 71.3 per cent women and 28 per cent men. Of the women. 40.5 per cent were under 24, compared with 10 per cent of the men. And 70 per cent who came in after a drug overdose were already receiving or had been prescribed some form of prescription drug by their doctors. In most cases this was the drug taken in the attempt. Professor Adam said it was not certain whether the higher percentage of young women coming to the hospital after attempted suicide

was a reflection of the help looked for by young women in distress, it might be, he said, that in a period of emotional distress girls were more likely than men to take pills, while men were more likely to get drunk—in another form of self-destructive behaviour. The men might end up in prison with a conviction. or in hospital after an accident. The answer had not been established. When men made a suicide attempt though, they were more likely to use more violent means—such as a firearm, cutting themselves or jumping from a high place. To follow up the study, the department several weeks ago established the special team with the approval of the North Canterbury Hospital Board. The pilot research had shown that over 75 per cent of the group attempted suicide after some disruption in a close and valued relationship. The threat to the relationship was not something “out of the blue,” but in most cases had been there for some time. From this, the team was looking at behaviour in the context of the difficulties in interpersonal relationships with wives, husbands, girl friends and boy friends.

By counselling the person who had attempted suicide, and those closely involved with them, it was hoped to diminish the possibility of a subsequent attempt. One

strikin gthing about the 195 people studied was that 50 per cent had previously attempted suicide, he said. People who subsequently killed themselves had in many cases had repeated suicide attempts. The team would like to intervene to prevent a worsening in the situation, and resolve the crisis of which the attempt was part through counselling. It was important here that patients be followed up for at least three months after the attempt, when the risk of a subsequent attempt was greatest. Professor Adam said those who maintained serious suicidal tendencies were usually transferred to psychiatric units in hospitals such as Princess Margaret and Sunny, side. Traditional procedure for serious suicide attempts by drug overdose was to admit the person to the medical ward of a hospital with a referral to the department for an evaluation and, once out, to follow up with outpatient treatment. For minor attempts the usual procedure was to send the person home, sometimes with a referral to an outpatient psychiatric clinic or general practitioner. The team, he said, would attempt to see natients sooner than this, and al«o talk to family and close friends. The service was just beginning, and it would take time to find how effective it was.