Suicidality

It is important to note that suicidal ideation, or SI, does not always result in an attempt. Suicidal ideation can be divided into two categories: passive and active. Passive SI consists of fleeting thoughts or urges to commit suicide; people with active SI have a plan in place that they intend to act upon. Risk factors for active SI include having a family member who has attempted suicide, being widowed or divorced, living alone, stressful life events, access to drugs, medications or firearms, prior experiences of familial violence, and psychiatric diagnoses such as major depression, substance abuse (alcoholism in particular), schizophrenia, panic disorder, personality issues (BPD), or trauma. Symptoms of active SI include feelings of hopelessness, an inability to feel happiness (anhedonia), anxiety, difficulty concentrating, panic attacks, and agitation.

PCH Treatment Center does accept clients with suicidality. We have helped many people get past their issues around self-harm and suicidality. When someone arrives at PCH with issues of suicidality, they are asked to contract for safety. This process consists of an assessment, during which they are asked to rate the intensity of their urges, whether they have a plan, whether they have the means to carry out their plan, and whether they intend to make an attempt. They are also asked about previous suicidal thoughts and attempts. Following the assessment, the person is asked to sign our written contract for safety, which is a verbal agreement to remain safe. This contract explains all of our rules around suicidality and what will happen if a client actually makes a suicide attempt (transfer to a higher level of care).

At PCH Treatment Center, we address suicidality in several manners. First, clients are immersed in our safe treatment milieu, where they are closely watched and evaluated repeatedly for their level of suicidality. Clients receive individual daily psychodynamic psychotherapy with an individual therapist who has specific experience with suicidality. Clients are evaluated by our psychiatric team to address the need for medication. While PCH has a strong belief that minimal medicating is best, clients may be prescribed an antidepressants or mood stabilizer to supplement their therapy schedule. Clients are exposed to a wide array of psychotherapeutic modalities, which gives them a toolset to help deal with their strong feelings and mood changes. PCH has specific groups to address suicidality, including Seeking Safety and Process Groups. Cognitive behavioral therapy, or CBT, may also be used to reduce feelings of hopelessness and suicide attempts. Dialectical behavioral therapy, or DBT, and Mentalization can be used to manage overwhelming feelings that can lead to SI. Mindfulness-based stress reduction, trauma-informed yoga, somatic experiencing or sensorimotor therapy are also efficacious. PCH also has a three day family weekend, where families can learn how to deal with their loved one’s suicidality and coexisting psychological problems. Family, couples, or family group therapy sessions can also be added in order to improve interpersonal relationships and strengthen the client’s support system.