Some patients (e.g. such as those with a diagnosis of personality disorder and attachment issues) may often have an ongoing, chronic level of suicide ideation.
Recommendations for Chronic Risk
If chronic suicidal ideation…
- Hospitalization has little value in preventing suicide and may have negative effects such as revolving door admissions (Paris, 2002)
- Refer / (Re)connect with outpatient services
- Partial hospitalization in a highly structured day program where possible (Bateman & Fonagy, 1999).
- Dialectical behavioural therapy (DBT) shown effective for persons with recurrent suicidal behaviour (McMain, 2009).
Refer to psychiatry and/or consider admission if:
- Acute psychosis
- Marked increased in level of suicidality (i.e. acute on chronic suicidal ideation)
- Following a serious suicide attempt