Tuesday 23 December 2008

How to Deal with Your Teen's Suicidal Risk

Good rules of thumb for dealing with suicidal risk include:

• If you think your child is at risk, go to the nearest emergency department.

• If your child is sent home from the emergency room, remember that you can return there if the situation deteriorates before your next scheduled visit with the doctor.

• It doesn't hurt to lock up medications, sharp objects, or weapons if your child is or has recently been suicidal.

• Safety concerns always take priority over privacy concerns (i.e., this is the one situation where it's OK to search your teen's room).

• Children or teens with suicidal tendencies usually stabilize more readily if they learn to trust one therapist or one group of professionals. This is not the time to "shop around" for new treatments or additional assessments if you and your teen are already working with competent professionals. (Trust takes time to develop, so don't necessarily leave it to your teen's judgment as to whether or not a therapist is competent.)

• Hospitalization can provide a temporary safe haven for the suicidal child or teen, but it doesn't really solve the problem. If prolonged, it can result in your child becoming overly dependent on staff (a detrimental result). Most hospitals these days insist on family involvement from the start, and begin planning for the child's return home starting on the day of arrival.

• Teens who are uncooperative with hospitalization (for example, they refuse to go into the hospital or threaten to run away from it) may have to be admitted to the hospital on an involuntary basis. In Canada, this may require transfer to a so-called "Schedule 1" facility, which is equipped to prevent patients from leaving. They do have a right to legal advice, however, and can challenge their involuntary status. In most states in the U.S., parents can have children who are not of legal age admitted to the hospital without their consent. Check with your child's doctor if considering this option.

As children and teens recover from their crises, it is also important to allow for a gradual increase in freedoms and responsibilities. Teens who are struggling with autonomy can find a "hovering" parent very difficult to live with, sometimes exacerbating their mood. The same principles apply as in a younger child: when the teen behaves responsibly, demonstrating the ability to handle more independence, greater freedom is granted, a little bit at a time.

Finally, let us cite the old adage "an ounce of prevention is worth a pound of cure." If you see your child or teen deteriorating, call the doctor or mental health professional who usually sees her. Scheduling an earlier appointment with a familiar mental health professional is often far more helpful than ending up with an unfamiliar professional in the emergency department.



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