Hospitalization of the Suicidal Patient
GENERAL CONSIDERATIONS Safety is usually foremost in the mind of the clinician who treats a suicidal patient. However, when the physical safety of the patient preoccupies the therapist, he or she may lose sight of other important aspects of treatment (e.g., reality testing in psychotic patients, analysis of defenses in neurotic patients, pathological personality styles and interpersonal relationships, or the prescription of medication where indicated). Nevertheless, the principal reason for hospital admission, with few exceptions, is to protect against suicide. When should a patient be admitted to a psychiatric unit? What negotiations are involved in arranging voluntary and involuntary admissions? What are the available resources, and how are they best used? These questions are examined from three perspectives: (a) issues related to the patient, (b) issues related to the therapist, and (c) issues related to the interaction between the patient and the therapist.