Suicide Prevention

 Similar to the previous readings, I tried to explore this week's topic within my field. I know suicide, suicidal thoughts, and self-harming behaviors are very common while someone is incarcerated. I know we say that someone is usually at their lowest point when they come to therapy- well I imagine that being incarcerated is also the lowest point of some people's life. There is a high suicide risk in individuals pretrial and post-conviction. I imagine that the adjustment from living a life of freedom to sitting in a lonely cell awaiting your fate is a pretty hopeless place to be. For some, there really is no way out once they have been convicted. How do we help people see the light at the end of the tunnel when they will never see freedom again? Many of the risk factors listed in the readings apply to many people who are incarcerated- having a psychiatric diagnosis, hopelessness, stressors, lack of social support, increased impulsivity, and substance use. Incarceration becomes the perfect melting pot for suicidal ideation and attempts even if a person has no history. However, wouldn't committing suicide in prison be much more difficult than outside of prison? Apparently not. A study I found (https://econtent.hogrefe.com/doi/epdf/10.1027/0227-5910/a000394) discussed how easy it can be for inmates to commit suicide. The sad part is, something as simple as changing the bedsheets could prevent future suicides yet the changes haven't been made nationwide. In addition, even if the prison has a psychologist or other mental health professionals onsight, they are often overworked and cannot see an inmate immediately following an attempt or before.

 I also found another study that discussed more correctional-specific observations to be aware of for suicide risk (https://research.vu.nl/ws/portalfiles/portal/2253747/Konrad+Crisis+28%283%29+2007+u.pdf). A key observation that stuck out to me was fostering an environment where an inmate would feel comfortable expressing their distress to correctional staff. We know rapport is important between the clinician and the client, but a clinician is not always widely available for the inmate to talk to. How would I, if I was a prison psychologist, help to foster an environment within the prison staff that the inmates would feel comfortable talking to? That is an organizational psychology type of question, but I think that would be important to be aware of if you are working in an environment where the client has many points of contact other than you. The article also mentions the use of manipulation in suicide attempts. Inmates may attempt to self-harm to control their environment one way or another. This would also be an important factor to be aware of within corrections or other settings where clients may have personality disorders. However, death is still an option if someone attempts to self-harm- how do you approach cases where the client is manipulating vs truly suffering? 

What resources are available for clinicians after a client has committed suicide or is self-harming? Where do clinicians draw a line and create boundaries when it comes to clients contacting them? What are the legal implications of having a client commit suicide?