Checklist before discharging an adolescent who has attempted suicide Before discharging a patient from the emergency room or crisis centre always

• Check that firearms and lethal medications have been secured or removed

• Check that there is a supportive person at home

• Check that a follow-up appointment has been scheduled

Acute psychiatric inpatient care should be reserved for patients for whom intensive surveillance and intervention are considered essential—as in the presence of active suicidal ideation and intent or when the youngster is unable to commit to not carrying out a suicidal act, when the youth is unpredictable, impulsive, agitated, or psychotic, or if there is a lack of support and supervision in the home. There is no evidence that exposure to other suicidal psychiatric inpatients increases the risk of suicidal behaviour. Determining when a patient is ready for discharge from the hospital or crisis centre will usually include an evaluation of the severity of existing suicidal ideation and intent. Implicit coercions (e.g. telling patients that discharge will be delayed until they can state that they are not suicidal) should be avoided.

Treatment compliance may be improved by offering definite, closely spaced, follow-up appointments, being flexible in arranging appointments if a crisis should arise, and reminding the family and patient by telephone or note about the next appointment. If an appointment is missed, the patient and parent should be contacted. Hopeless and depressed children and adolescents, who may be not be able to commit to a lengthy treatment process, may be better engaged by offering short-term treatment plans with defined intervention goals. While offering confidentiality for some issues, it is essential that the clinician communicate to the patient that, if they feel that suicidal thinking or behaviour is imminent, such information will be shared with the parents.

Break Free From Passive Aggression

Break Free From Passive Aggression

This guide is meant to be of use for anyone who is keen on developing a better understanding of PAB, to help/support concerned people to discover various methods for helping others, also, to serve passive aggressive people as a tool for self-help.

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