MHM Magazine

Patients who have tried to take their lives through, for example overdose, or who are struggling with suicidal thoughts are most-often not always priority in a trauma-filled (or medical emergencies) Emergency Centre (EC) or ambulance. This comes from personal nursing experience as well as being such a patient myself. First line healthcare providers (HCPs) (referring to emergency care providers, nurses, and doctors) are extremely important in dealing with such patients as secondary trauma is uncalled for (and further suicide must be prevented). The most important goal in medically managing patients who have attempted to take their life or are who seeking assistance due to suicidal ideation/threat/attempt is to provide a physical and psychological safe space, treat self-inflicted medical problem and further prevent any more complications (such as further self-hurt). Nurses are often first in contact with patients arriving in ECs, especially where an effective triage system is place. The South African Triage Scale (2017) states clearly that patients who have taken an overdose or have been poisoned are triaged orange/very urgent (unless any of the ‘red’ criteria apply) and must be treated within 10 minutes. Emergency medical care providers and emergency care doctors are also first line responders and so this article is applicable to them as well. Other systems though, allow receptionists to be on the receiving end of new patients and although not ideal, receptionists should also be given some guidelines on identifying and dealing with patients who are in psychiatric distress. This guideline however will focus on the behavioural or psychosocial management of such patients (these may be patients who have already self-inflicted harm or those who seek assistance due to suicidal ideation/threat/attempt). Such patients may be suffering from a range of psychiatric disorders such as major depression or depression due to bipolar disorder or post-natal depression, anxiety disorders, PTSD (post-traumatic stress disorder), schizophrenia, substance abuse and/or personality disorders. My own experience (and I am also guilty) and experience of some South African emergency nurses and other healthcare providers shows that they sometimes struggle to show the necessary empathy in managing suicidal patients. There may be several reasons for this, such as: • Little or no training in psychiatric emergencies • Copying colleagues’ poor management of such emergencies • No general psychiatry training • Necessary prioritisation of patients with physical problems (e.g., ‘red’ patients) and general busyness of the EC • General blunting to such ‘difficult’ or ‘non-emergency’ patients (especially non-overdose patients) may unfortunately be another reason for a lack of empathy Unfortunately there is also the Jean Augustyn Former professional emergency nurse and educator HEALTHCARE PROVIDERS’ PSYCHOSOCIAL ROLE IN RECEIVING AND MANAGING SUICIDAL PATIENTS Issue 5 | 2023 | MENTAL HEALTH MATTERS | 27 MHM