When young people want to die
Dealing with suicidal children and adolescents is an emotionally stressful and extremely difficult situation for emergency physicians: In addition to physical care, the doctor must be able to assess the vital risk and initiate further psychological crisis intervention.
Suicidality - one of the leading causes of death in adolescents
After accidental death, suicide is the second leading cause of death among young people. In male adolescents, suicides occur at a frequency of 1.9-24.4 / 100,000. The number is significantly lower for girls (1-9.5 / 100,000). However, they are more likely to attempt suicide than boys. The latter are around 10 times as common as suicides. Children and adolescents commit suicide attempts impulsively and at short notice. In most cases, the triggers are relationship conflicts and separations - occasions that may seem minor from the outside.
The emergency doctor as a switchman
When admitting young people at risk of suicide, the emergency doctor has the task of laying the foundation for successful problem solving in addition to physical stabilization. Although he cannot offer any solutions on site, he can convey the meaning of further clarification and name a series of steps that can lead to solutions. The young person must be helped to distance himself from thoughts of suicide in order to be able to develop long-term prospects for the future and the ability to solve problems independently. The first step is to establish a conversation with the young person, followed by discussions with the parents. The emergency doctor then accompanies the patient to a suitable clinic in order to initiate further crisis intervention and therapy.
Don't be afraid of clear words
In order to develop a constructive relationship with the suicidal adolescent, one should familiarize oneself with a few basic rules for conducting a conversation: Meet the patient in a neutral, accepting position, introduce yourself by name and conduct the conversation while seated. Clearly address the suicide attempt, the motivation, the exact course of events and the current psychosocial stress - both to the young person and to the parents. Diagnostically, it is important to determine not only the physical but also psychological findings and assess the future risk of suicide. Evidence of depression can be found e.g. B. determine by asking about future orientation. If the adolescent patient has nothing to say about future plans, interests, or hobbies, this is a red flag. Simultaneously, facial expressions, gestures, the external impression or the mood can provide clues. The original article 'Suicidality of children and adolescents' was published in the journal 'Emergency & Rescue Medicine', issue 03/2005, on May 31, 2005. Author (s): Prof. Dr. R. Frank, Institute and Polyclinic for Child and Adolescent Psychiatry and Psychotherapy at the Ludwig Maximilians University in Munich. Author of this topic of the week: Joachim Coch