A model for assessment of inpatient suicide potential

Cardell, Rebecca; Horton-Deutsch, Sara

doi:10.1016/0883-9417(94)90005-1

Cited by 6 publications

(7 citation statements)

References 15 publications

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“…Our participants reported that ambivalence and confusion (difficulty thinking clearly and being unable to solve problems) are common features of suicidality. Similar assertions have been made in Western literature, with suicidologists describing the presence of ambivalence (Cardell & Horton-Deutsch, 1994) and of problem-solving deficits among suicidal individuals (Pollock & Williams, 1998). Our participants also attributed SIB to ''bad genes'' and described a psychotic-like state in some suicidal individuals; this too is consistent with Western psychiatric accounts of the role of psychotic…”

Section: Discussionsupporting

confidence: 65%

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“Our lifestyle is a mix-match”: Traditional healers talk about suicide and suicide prevention in South Africa

Bantjes

Swartz

Cembi

2017

Transcult Psychiatry

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Practitioners of traditional African medicine (traditional healers) are an important part of the health care system in South Africa, yet their voices are often absent from discussions about public health. In this context, we set out to investigate how a group of traditional healers in South Africa understand suicide and suicide prevention. In-depth, semistructured interviews were conducted with 6 traditional healers and analysed using thematic content analysis. The traditional healers report they are frequently consulted by suicidal individuals and they are confident about their ability to help people in a suicidal crisis. Findings suggest that traditional healers understand suicidal behaviour as a symptom of social disconnection and cultural discontinuity. Traditional healers report that suicidal individuals can be helped by reestablishing interpersonal connections, reconnecting to family and ancestors, and renewing their cultural identities through rituals. These findings suggest that there is some congruence between the way traditional healers understand suicide and the Western scientific and biomedical literature. Our findings raise important questions about cultural approaches to suicide research which are commonly premised on dualistic thinking that constructs culture as something distinct from Western biomedicine.

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Section: Discussionsupporting

confidence: 65%

“…[But still] They want to live or feel a certain way.'' Cardell and Horton-Deutsch (1994) (Pollock & Williams, 1998).…”

Section: Declaration Of Conflicting Interestsmentioning

confidence: 99%

“Our lifestyle is a mix-match”: Traditional healers talk about suicide and suicide prevention in South Africa

Bantjes

Swartz

Cembi

2017

Transcult Psychiatry

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“…T he clinical decision to admit a psychiatric patient to hospital is primarily based on judgment about acuity, severity, and danger to self or others. [1][2][3][4][5][6][7][8][9][10] Patient safety is a prerequisite sine qua non for admission to a psychiatric inpatient unit, whether in a general or psychiatric hospital. Clearly, in supporting such an admission, the patient's family and friends expressly assume that the patient will be protected from harm, including harm to the self, and that this protection will extend for some reasonable time into the future, postdischarge.…”

mentioning

confidence: 99%

Preventing Suicide among Inpatients

Sakinofsky

2014

Can J Psychiatry

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The bulk of inpatient suicides actually occur not on the ward but off premises, when the patient was on leave or had absconded. Peaks occur shortly after admission and discharge. It is possible to reduce suicide risk on the ward by having a safe environment, optimizing patient visibility, supervising patients appropriately, careful assessment, awareness of and respect for suicide risk, good teamwork and communication, and adequate clinical treatment.

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“…In a later work Shneidman attempts to produce a clinically useful definition of suicide arguing for far less concern for classification and more emphasis on developing clinically useful understanding (1985). To this end he has developed the following definition of suicide: The addition of the qualification of ambivalence has become clinically significant (Cardell & Horton-Deutsch, 1994;Shneidman, 1988) for it describes a point where the individual is between dichotomous thoughts and feelings; at this point caught between hostility and love, wanting to die and wanting to be rescued, to cut one's throat and yet call for help. Shneidman's definition asserts that while the perceived current best solution is suicide it is not the only solution.…”

Section: Edwin Shneidmanmentioning

confidence: 99%

“…Mental health nursing practice is in need of frameworks or models that translate nursing research that explores the meaningfulness of client experience into a structure that may be implemented in nursing settings with people who are suicidal. Cardell and Horton-Deutsch (1994) developed a model for assessing suicide potential based on the notion of ambivalence in the interactional context of a psychiatric admission. Rickelman and Houfek (1995) have proposed an interactional model based on a cognitive therapy framework for "nurse psychotherapists".…”

Section: Implications For Mental Health Nursing Researchmentioning

confidence: 99%

An Interpretation of Four Men's Experiences of Suicidality

Phillips¹

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<p>Mental health nurses are frequently called upon to care and provide intervention for suicidal men. While there is substantial literature on male suicide, far less is known about the understandings men have of their suicidal experiences. This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of my own particular horizon of meaning as researcher and mental health nurse, and as such, seeks to engage with a tradition of mental health nursing. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, I explore the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. This involved a process of repeated cycles of revisiting and reflecting on their personal histories from vantage points permitting understandings that opened up opportunities for personal growth and learning. Relationships were significant for either enabling or disabling this process. Recovering was therefore a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change. The exploration of suicidality in this study also alerts us to the possibility that through fusion with clients' pre-understandings, mental health intervention can inadvertently further constrain choices to survive.</p>

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A model for assessment of inpatient suicide potential

Cited by 6 publications

References 15 publications

“Our lifestyle is a mix-match”: Traditional healers talk about suicide and suicide prevention in South Africa

“Our lifestyle is a mix-match”: Traditional healers talk about suicide and suicide prevention in South Africa

Preventing Suicide among Inpatients

An Interpretation of Four Men's Experiences of Suicidality

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