Course of action after a suicide attempt

An American lady in my area called me on Saturday to inform me that her German partner had passed out in the apartment and was taken away by the parameds and police. Turned out that he spiked his vodka with dishwasher tablets in an apparent suicide attempt, and he landed in the ICU.

I was shocked to discover that less than 24 hours later he was released back into society and he is back at home where there are two young children, one of whom actually saw him putting the tablets in his drink. Back home, this would have not been the case. This person would have to undergo psychiatric treatment before he is allowed to go anywhere.

Does anyone know if this is normal here?

I haven't dealt with it here in Germany. But someone very close to me tried to kill herself by overdosing on a variety of drugs. She was hospitalized for a couple of days and then released and her family told that she needed to be in some sort of program to monitor her until she was no longer a danger to herself (and others). But it was not forced on her by the medical professionals. It was up the family and her to seek help.

I don't think it's normal - unless they played it off as an accident. Several years ago I got a phone call in the middle of the night from my old roommate - she came home to find her new roommate incoherently babbling and lolling around, and we knew this girl had a prescription to sleeping pills, was stressed/depressed etc. So she called an ambulance and I went over. By the time I got there she had been taken to Bogenhausen. At Bogenhausen they pumped her stomach and then sent her to Haar. She was there for a couple weeks. She had not even tried to kill herself, but had decided to have a couple of night caps (brandy) on top of the extra sleeping pill she took because she hadn't been sleeping well. Anyway, it was a total blackout and she didn't remember insulting the ambulance driver or trying to kick the doctor - that's probably the real reason they sent her for observation though. Her behaviour and not the accidental slight overdose.

I always thought a suicide attempt meant a stay out at Haar for a while...

Haha, that is funny. Death by the shits. Hell, we used to spike the Scoutmasters food with some of the strongest detergent known to man and it is like extra strength black draught. Sorry for laughing, but that was a lame attempt by the person involved.

From what I've heard, people who really mean to commit suicide, unfortunately, get it right the first time around...

Nice Eurovol, real classy, you and your high IQ.

I believe dishwasher tablets are extremely caustic, the ones that go in the dishwashing machine, we're not talking about washing up liquid here!

You heard wrong.

Most suicide victims have a history of suicidal attempts and ideation before they actually suceed.

Geez if someone really wants out, and I dont blame people at all if they do decide that this crazy world is not for them, then why not just let them? This guy was probably just attention seeking though so all hospitalisation would do would pander to that.

Interesting issue raised by JW. Women ttend to "attempt suicide" more often than men but it is if you like a "cry for help" and they don't mean to kill themselves. However men, tend not to go for that cry for help and actually DO kill themselves. Men tend to choose the most effective methods of killing themselves. There is a real big problem particuarly of young men committing suicide.

Interesting. I was under the impression that a lot of the time suicide attempts were "calls for help" and that people who were really desperate "got it right" in the sense that the methods used left little room for error (see Hunter S. Thompson, Kurt Cobain, etc.).

EDIT: Woah! MonksTown and I posted something very similar there!? There are some weird vibes on TT this morning...

MT, I don't think that's necessarily true. Women tend to use different methods such as pills and slitting wrists which are less effective than men who tend to use guns and hanging. The intent isn't necessarily different only the means.

JW, a lot of suicide attempts do start out as calls for help but when help isn't given it progresses to the next step. This is not to say that there isn't the odd case of someone commiting suicide completely out of the blue but for the most part there are obvious signs and a previous suicide attempt is the number one indicator that a succesful attempt is to follow.

I'll try and find stats but it's my understanding that very few people suceed on the first attempt.

Household Product Database.

Sorry, it struck me as funny because me and my IQ know that there are better ways to kill yourself than trying to choke on a tab.

Jules - This "cry for help" bollocks was made famous by Princess Di in her autobiography. It became the in phrase for many many years after that...

I dunno. I find suicide one of the most selfish acts anyone could ever consider. Especially those arseholes who throw themselves in front of trains and the like.

In University I worked as a pharmacy technician for a Level I trauma center hospital. I would receive weekly a phone call from someone who ingested the whole medicine cabinet. I would normally transfer them to a counselor or the Emergency Department (ED), depending on my perceived urgency. However, the first time I received one of these calls I tried to transfer them to the ED, and when the ED answered the phone the transfer did not work and I hung up on the caller. I quickly spoke with my boss and explained what I did. His response was that I would read about it in the newspaper in the next couple of days. However, five minutes later, they called again and said, that something might have happened that disconnected us and if I could tranfer them again. Needless to say, many people attempt suicide only for the attention. I believe in the US a person can only be held against their will for a psychiatric observation for 72 hours.

Didn't the Roman emperor Hadrian declare suicide a capital offense?

Does attempting suicide "for attention" make it any less serious?

That alone tells me that the person in question is in serious need of help.

People who commit suicde, Crawlie, may be, in your opinion, selfish but, trust me, they can think of nothing except ending their own pain. Someone who is suicidal is obviously not thinking rationally, therefore they're not thinking about their families.

I have a friend who attempted suicide by taking a bottle of pills. She was alone, she called her father, her father called 911(he lives 2 hours away) and then her parents blamed her friends and denied that she had a problem. It was horrible. She went to counseling twice a week for about a month and that was it. She acted like it never even happened.

@ER
Yes

All attempted suicides require professional help before they become successful suicides.

Just like any other mental disorder, depression is a disease. If it progresses far enough you can no longer be responsible for your actions.

Selfishness has nothing to do with anything, would you call a schizophrenic selfish?

I read somewhere that throwing yourself under a rush hour train is a way that at least you know you brought witnesses to the pain that drove you to kill yourself.

Not very clear English there; tired, innit.

Whether the person is doing it for maximum publicity or not,t he act is selfish - sometimes intentionally so, more often not. But it is certainly selfish

My initial thought was that this guy just wanted to be out for a while and did not really intend on going all the way. I could think of a few better ways of taking oneself out. He did write a note to his girlfriend which was found and taken away by the police before she had a chance to read it. I am really purturbed though that he is allowed to be with the children again after he did this in the presence of one of them.

Saw one a couple of years ago on (under) the U2 at Hauptbahnhof, the main chunk you couldnt even tell it was human, looked like something you would see hanging in a butcher shop except redder and wetter, saw the arm though with some shirt and a watch on it. Pissed everyone off too.

Had a lot of mates make that final decision back in school, not in a selfish way though, normally firearms or pills, the first time was a bit shocking, but eventually you just end up feeling good about being one of the survivors. Life tests us somewhat, and we obviously all dont have what it takes to pass. With 5 billion of us putting pressure on the planet and each other a small amount of lemming-like behaviour is pretty natural I think.

Maybe e just wanted a clean start...

Just because someone attempts suicide does not mean that they are depressed. To be clincally depressed you require a list of many symptoms over a long period of time. In fact one of the problems with treating depressed people medically is that you bring them a bit out of the depression, where they now have enough motivation to committ suicide. Many depressed people are too "lethargic" to actually attempt suicide. I also believe the people who "attempted" suicide and go on to living a long time afterwards is much much higher than people who attempt and then kill themselves. Classic example of a reverse syllogism "All Johns are men, but not all men are Johns".

Would you consider attempting suicide and suicidal ideation normal then? Both are symptoms of depression and you only have to experience these symptoms for a 2 week period to be diagnosed with major depression.

No not all suicidal attempts are by depressives but depression is the number 1 cause of suicide.

It is also strange that over 90% of suicide "victims" have two hands. Correlation does not mean causation.


Yes. It is normal. Many individuals (16.9% of teenagers have considered it in the last last) have thought about it and considered it during their lifetime.

can you clarify that statement for me, I don't understand what you mean.


Thinking about and doing are two very different things.

Meaning that just because people are depressed does not mean they will commit suicide. Eventhough it is not classified as clinical depression over 30% of people will admit to being depressed during the last year at some point. People who commit suicide may be depressed, may be angry, may be bored, may be selfish, may be vengeful, may be a lot of things. The hands example is a spurious correlation which has nothing to do with suicide to draw attention to your point that depression "causes" suicide is just as fallacious.

That was only used to address your question. But on a more serious level. There are different gradations of this suicidal ideation. There is a clear distinction between someone placing a shotgun in their mouth and pulling the trigger vs. someone taking twelve aspirin or eating soap and calling 911 immediately. The aspirin and soap are closer to the person who only has ideation than the person who actually kills themselves.

I'm not implying that there is a 100% correlation or causation between depression and suicide but to say they are not related surprises me. You have access to the Journals you must know there is a correlation.


So person #2 should not be considered a threat to themselves because they weren't using a gun? As I said before, most people are not successful on their first attempt. Maybe they're not as serious about it the first few times but to ignore it completely or write it off as attention seeking is very dangerous assumption.

My 17-yr-old niece got it right the first time - with a gun. Poor girl was always a prodigy and shown off as a great singer and musician and was never taught that it is totally ok for her to ask for help verbally, that she does not have to face all of her problems alone. She had told her friends that she would kill herself, but none of them spoke to an adult about it (she probably told them not to).
On topic (German): Any stay in a psychiatric clinic has to be primarily voluntary. If you are a danger to yourself or others you can be held until there is a court order confirming your commitment (within 24 hours). But it's the doctors who decide how dangerous you are. Perhaps they didn't take the suicidical intent too seriously in this case. I should think the children's mother would be the one to have the suicide candidate removed, but that's just a personal opinion.

ER there are more definite correlates than depression. For example this paper tries to find some better reasons as my point is that many people feel depressed to the same degree as people who kill themselves. You can not select on this point alone.

Review article
Personality traits as correlates of suicidal ideation, suicide attempts, and suicide completions: a systematic review
Acta Psychiatrica Scandinavica
Volume 113 Page 180 - March 2006
doi:10.1111/j.1600-0447.2005.00702.x
Volume 113 Issue 3

Summations
• Evidence to date suggests that hopelessness and neuroticism, and to a lesser extent, extroversion may
eventually be useful in screening for risk for suicidal behaviors.
• Further studies are needed on aggression, impulsivity, anger, irritability, hostility, and anxiety,
particularly in relation to suicidal ideation and suicide completions.

people have different reasons for suicide- some are depressed, some see no way out of the situation (job loss, loss of home, or a broken heart), some out of spite (my ex boyfriends mom did herself in, she didn't want the ex husband to get anything- was a nasty divorce, with lots of money and property, so she killed herself and left everything to the one son), some cannot fight anymore and don't have the power to continue. These people do it for reason's of their own, and its not selfish.
Sometimes its a cry for help, but sometimes, you cry and nobody is listening!

Or sometimes it is schizophrenia, as ER said.
They have no control over their own mind and do it to escape the demons in their head.

In the UK if you try to top yourself you have to get past an interview with the shrink. You have two choices, basically:

• you say that it was a cry for help and you'll never do it again - in which case you're free to go (but the "cry for help" remains unheeded)
• or you say that you're really depressed, don't see any point to life, you'll probably do it again, in which case you get locked up in the loony bin.

This probably explains the "cry for help" statistics.

Dunno about here in Germany, though.

I thought Germany was the looney bin that GB sent their suicide attempters to??

you could be right, actually
that could explain all the "weirdos" on TT

Yes it is selfish but not necessarily intentional. However, it is a very selfish act which may "solve" one problem but cause many others for those who are left to deal with it (the never-ending questions that follow)

I'm sure the people who do it don't see it as selfish at the time, Crawlie. It's probably a case of no longer wanting to inflict yourself on the people around you, you being the worthless piece of shit that you are*...
Then you try it once and see the effect it has on the people around you. You might not understand how your loved ones could be so devastated at the prospect of losing you (you being the worthless piece of shit that you are*), but you don't want to inflict that kind of pain on them ever again. Hence the low "reoffending" rates for those who don't succeed first time around.

* the suicide attempter, not you, Crawlie

With clinical depression comes an increased frequencyof suicidal thoughts (ideation?)...not necessarily an increase in attempts.
The second major problem is alcohol abuse/dependency.

Now that the sun is out, there will probably be a spike in the suicide figures as those who really have the intention will find they also have the energy as well.

Or it could be that they realise that they're such losers that they can't even get topping themselves right??

I guess it depends on how big the problems to be solved with suicide are. The mother of the guy involved said yesterday that it would have been better for everybody concerned, had he been successfull given the numerous issues they have had to deal with involving him over the years. By the way this guy apparently has a history of borderline personality disorder that causes him to do all kinds of strange things, but he refuses to get himself treated.

Jesus Christ, I bet that cheered him up no end.
WTF?

@Timmeh - interesting theory, never thought of that before

Big clues in the mother's attitude there methinks. Plus, there is no treatment for BPD.

I heard that masturbation is really someone acting out seppuku on themselves over and over and over again...

@brokenm: I think you are thinking of bukake Except I can never reach my face, my stomach usually ends up with the full brunt instead.

That's the difference between a half-assed attempt and success.