The management of the presuicidal, suicidal, and postsuicidal patient.

Abstract

Between 200,000 and 350,000 Americans attempt suicide each year; about 40,000 succeed. The rate of suicide is rising, particularly in young people in urban areas. Physicians are increasingly challenged to understand the irrational "magical thinking" of the person who attempts suicide; to recognize the warning "cry for help" that the potential suicide usually makes to his physician, family, or friends; and to respond sympathetically and compassionately to his attempts to resolve what, to him, are overwhelming and insoluble problems. Most suicidal patients admitted to a hospital are poisoned by an overdose of drugs. Management consists of identification of the poison, decontamination of the victim, induction of diuresis, and, in the comatose patient, scrupulous attention to respiratory care, including ventilation, oxygenation, and tracheobronchial toilet. With skilled medical management most suicidal patients recover from drug overdose, but the hazard of repeated suicidal attempts is very great. There must not be a disdainful, scornful, or condemning attitude toward these unfortunate human beings. An enlightened and sympathetic approach by a wise physician will relieve great anguish and save many lives.