[zoelow]

Feeling obliged to leave my story here:

Three years ago I made a plan to take my own life. Instead of pushing through I contacted a local suicide hotline, it was completely anonymous. I just talked for a bit, but that little moment helped me to find the courage to talk to a family member and that led me to go into therapy which I completed a few months ago.

Initially I was very scared telling my therapist about being suicidal, exactly sketching those horror scenarios. But when I finally talked about it, nothing happened. I remained into complete control of my own therapy the whole period. It helped me turn my life around and I'm incredibly happy I took the leap of faith to start talking about it.

[candiodari]

Unfortunately, judging by the prevalence of the opposing situation happening in articles (in reputable newspapers too) online, you have essentially been lucky (or never got into a conflict with your therapist).

The odds of someone dying through suicide after a suicide attempt is very small (only 2%), but those odds greatly increase if inpatient treatment is provided, instead of reducing. There is a reason for that, and clearly your experience doesn't provide that reason. The stated reason psychiatrists give for this is that only the very serious cases get committed, but research doesn't back that, and for specific institutions (and you have no control over where you end up) it is definitely not true.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710249/

Suicide after inpatient treatment in a psychiatric facility is actually getting close to enter the top-10 causes of death. Whilst that doesn't directly contradict what you're saying, it comes pretty close.

In the Netherlands, it is now actually true that more than 50% of suicides happen with psychiatric help, which mostly means getting locked up. Given that less than 1.5% of the population ever gets committed (but rising fast, especially for kids), that's pretty incredible.

And in a bunch of published cases it isn't even the case that people were committed for a suicide attempt, but for an outburst that was then diagnosed, for example as autism. Suicide came, years later, after years of treatment, a progressively worsening situation, and months in isolation in such a facility, in one case with the person locked up without his glasses.

[swores]

Is their evidence that psychiatric inpatient treatment is causing high suicide rates among those who leave?

Wouldn't "the system is mostly good at only putting extremely high-risk people into those facilities" cause the same correlation if it were the case?

Would it be surprising if "people leaving any general hospital" were more likely to die of whatever they had been there for than "people who didn't need to go to hospital"?

[candiodari]

Yes, in the sense that due to the funding situation of such facilities a bunch of people get refused entry (or because of "complex" problems. E.g. suicidal + addicted? No help for you). So you can study the group that gets helped and the group that doesn't and compare them.

Of course the criticism is that they only take the worst problems (even though refusing "complex" cases obviously contradicts that more than a little bit in my opinion). Likewise other studies that assess the ability of professionals to predict who will commit suicide keep coming with very disappointing results, so frankly, I find it hard to believe they could select the serious cases even if they fully intend to do so.

But the group that gets help has a bigger suicide rate compared to the group that doesn't. Quite a bit bigger. So it depends what you believe.

1) do you believe the criticism that they are able to select serious cases (but are unable to prove that in studies specifically checking that) ? Then it is unknown how effective their treatments are, and until they quantise "seriousness" it is impossible to check how effective they are.

2) do you believe the selection process is mostly random and the criticism is invalid? Then the treatments are counterproductive and they cause suicide. That does not (necessarily) mean they mistreat patients. For example, often the inability to leave gets blamed for job, family, and generally the future prospects to evaporate, which in turn causes suicide, which seems to me to find support in the observation that it's most often just after treatment ends that the actual successful suicide happens. The treatment causes suicide, but not directly.

We should make the exceptions that there are plenty of studies about specific institutions where abuse of patients does happen and it is definitely the institution itself that causes suicide.

[ricardobayes]

Nice one mate, so happy for you. This must have been incredibly difficult to work through.

[1cvmask]

Thanks for posting that for the world to hear.