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After a suicide attempt

by Mark Rowe

The hours and days after a suicide attempt can be very emotional to an individual, writes American healthcare security man Kevin Mulcahy.

The intention of this article is to explain what generally happens from the time the victim of a suicide attempt is discovered and transported to an emergency department, to the time they are released from the hospital or transferred to another facility. This article is not written by a nurse or doctor, but by a hospital security officer. I do not have any formal medical training. I do not have any advice or suggestions. I have spent countless shifts over many years in the emergency department monitoring suicide survivors for safety purposes. I will offer a glimpse into this emotional period of time in a suicide survivor’s life.

Many individuals that survive a suicide attempt are discovered by someone close to them. Whether a friend or family member finds them, they usually call the local police department. The police dispatcher will send an officer or officers along with an ambulance. The ambulance workers will stabilize the victim as best as possible and transport the victim to the emergency room.

Victims have often reported to me that they feel embarrassment and shame. It can be overwhelming to be wheeled into a room and suddenly be surrounded by nurses and doctors poking and prodding and asking personal questions. All suicide attempts are serious, but if the physical damage is not significant the medical staff will often call security to monitor patients for safety. When I arrive at the emergency room I conduct a search of the patient. This is in no way meant to be demeaning. After a suicide attempt people can be very unpredictable. After searching a patient they will be wanded with a hand-held metal detector to check for weapons. Personal belongings will be inventoried and stored in a secure location until the patient is discharged or transferred.

At this point the patient is escorted to the restroom to change into paper scrubs. Paper scrubs are comprised of a lightweight shirt and pant set that are designed for the safety of the patient. From there a urine sample and blood sample will be taken. This is done to determine how much of any substances are present in the patient’s body. It also provides a baseline for a mental health evaluator to understand the situation.

Once the results of the blood and urine samples return from the lab, medical staff will contact a mental health evaluator. From the time a mental health evaluator is called to the time they speak to a patient can be several hours. Budget cuts for mental health services have slowed the process significantly and waiting for hours in a small room in the emergency department is not ideal. I do my best to provide exceptional service to anyone in their time of need. There is a cable television in the room and hospitals provide an extensive menu of food to choose from. Medical staff is able to provide calming medications if they are deemed necessary.

Once a mental health evaluator speaks with the patient they will discuss thoughts, feelings, and help to determine the best course of action. Patient safety is the number one concern and the decision to hold or release a patient is not taken lightly. After a conversation with the patient, the mental health evaluator will speak to medical staff.

The decision reached depends on many variables. If a patient no longer feels suicidal they may be released. Having a strong support system increases the chances of a patient going home. Friends and family that are positive influences are able to offer support once a patient is discharged.

Sometimes a patient may still be at risk of harming themselves and the decision to hold the patient for safety is made. As stated above, budget cuts have significantly reduced services for people that could utilize mental health services. An at risk patient may spend several days in an emergency department room waiting for a bed at a psychiatric hospital. Every effort will be made to make the emergency department stay as tolerable as possible. Visits from friends and family are permitted as long as it doesn’t cause the patient distress. Once a bed becomes available at a psychiatric hospital the patient will be transported in the back of a law enforcement vehicle. Unfortunately the patient will usually be handcuffed during the journey. It is important to note that the patient is not under arrest and did not commit a crime.

This article is not intended to be an all inclusive list of everything that happens after a suicide attempt. It is merely a general description of the process that occurs through the eyes of someone that has spent years witnessing the process of treating and releasing or transferring victims of suicide attempts. This article is written to help others understand the process. Patients, friends, and family are often scared and confused during this difficult time and hopefully this article explains some of the unknown.

About the author

Kevin Mulcahy is a Security Sergeant for Lakes Region General Healthcare in New Hampshire, USA. He holds a B.S. in Business Management and is currently pursuing an MBA in Hospital Administration at Plymouth State University. He is certified in both hospital security and hospital safety. He has experience in loss prevention, risk management, and law enforcement. He is also a member of the International Association for Healthcare Security and Safety.

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