Ewha Law School

Jungwoo Kang

Nearly 800,000 people die by suicide each year, and one dies by suicide every 40 seconds. Suicide is the second leading cause of death among 10s and 20s. The need for effective intervention services has become greater over time. However, researches show many patients experiencing clinically based treatments or services find the medical professionals’ help unsatisfactory and inappropriate.

Even though current suicide policies and services emphasize the importance of appropriate and continuing care for people who harm themselves, there are a list of barriers found to provide satisfactory suicide prevention services.

One common reason for the unsatisfactory reviews was the attitudes of the staffs. Studies show close to 50% of clinicians showed hostile attitudes to those who committed non-fatal suicide or self-harm, and most of them was left without any psychosocial assessment. Those who had positive reviews had interactions with the staffs such as sharing the distress feelings or treatment planning, but those were very exceptional cases. Other reasons mentioned were the stigma associated with seeking such medical treatments, negative previous experience, accessibility and the thoughts that such clinical services are not beneficial. It is notable that those unsatisfied service users tend not to seek another medical help in case of subsequent suicidal behaviour.

Given that suicide is a very complex issue, the systemic, institutional and observation-led approach of the current medical management should be changed to one which is long-term oriented and interactive with the personal needs of individual patients. In fact, a growing number of medical professionals suggest alternative models of more humanistic and caring manner.

Fitzpatrick and River point out that a humanistic approach might be much more helpful for suicidal people despite potential worries. The humanistic model of engagement stresses interactions with the people in need. it does not abandon the need for systemic techniques to manage complex symptoms, but goes beyond that and asks health experts to establish relationships with them. The relationships can be built on a mutual understanding of suicidal behaviours in the context of the patients’ life.

Moreover, Fitzpatrick and River provide some cases of non-medical models of care. Researches indicate suicidal patients prefer to manage their problems outside of the medical settings. Some authors highlight informal and community-based suicide prevention supports are more suitable for, in particular, young patients. Fitzpatrick and River give the Maytree Suicide Respite Centre’s befriending model as a good example of such support. The main aim of Maytree is to create trusting and necessary spaces for whoever in need where they can discuss their stories. The policy allows guests to stay for up to four nights and they have to follow the house rules while staying. Many visitors left positive review of the place and said they had helpful experiences.

References

Hunter C, Chantler K, Kapur N, Cooper J. Service user perspectives on psychosocial assessment following self-harm and its impact on further help-seeking: a qualitative study. J Affect Disord. 2013;145(3):315–323.

Saunders KEA, Hawton K, Fortune S, Farrell S. Attitudes and knowledge of clinical staff regarding people who self-harm: a systematic review. J Affect Disord. 2012;139(3):205–216.

Scott J. Fitzpatrick and Jo River. Beyond the Medical Model: Future Directions for Suicide Intervention Services. International Journal of Health Services. 2017;48(1):189-203.

Taylor TL, Hawton K, Fortune S, Kapur N. Attitudes towards clinical services among people who self-harm: Systematic review. Br J Psychiatry. 2009;194(2):104–110.