Thursday, December 16, 2010

ALERT: Pain and Suicide Attempts in the Hospital or Emergency Setting

The holidays bring with it the added risk of suicide attempts for an increased number of people.  Suicide deaths rise during the holiday season, and this is a fact of which we may all be aware, but tend not to recognize until an attempt is made by someone we care about.

It's widely recognized that suicide is a risk for depressed and psychiatric patients.  What is not recognized and probably highly under-reported is that it is a serious risk for severe and chronic pain patients, outside of a psychiatric diagnosis or setting.

An article in US Department of Health and Human Services mentions a Joint Commission alert telling doctors that it is not just psychiatric patients that commit suicide in the hospital setting, but those in pain as well.  The article states that of 827 (voluntarily reported) in-hospital suicides, a large number - 25% of them - were in non-psychiatric settings.

Making these non-psychiatric patients different are their presenting complaints and diagnosis.  The medical team concentrates on the physical aspects they can control - fever, hydration, etc - and miss important assessment of the patient's mental and emotional symptoms related to their distress.

Living with daily pain is a physical and mental battle. Patients with chronic pain can become exhausted, and feelings of hopelessness which begets desperation, begin to pervade.  If the pain becomes too severe, or if the patient sees no end to their pain, they often feel that life is unbearable because their past experience has taught them this fact.

Photo copyright 2008 Ellen Schnakenberg: starving horse 

They are trapped, and escape from pain becomes the focus of their thoughts, yet they may not talk about it.  If their pain remains undertreated - or they are denied the medication they need - they are at significant risk for suicide.  If their pain is severe enough, or their desperation is profound, these patients may not wait until they get home to attempt suicide.

The article also discusses the specific symptoms and signs someone in chronic pain may come to the hospital complaining of: "irritability, agitation, complaints of unrelenting pain, refusing visitors or medications and requesting early discharge, the commission noted. Dementia, chronic pain or illness, end-stage cancer, acute signs of depression and drug or alcohol intoxication may also heighten suicide risk."

Desperate people will find a way to do desperate things.

Caretakers, friends and family members of chronic pain patients need to be aware of the above signs and symptoms so they can alert doctors and remind them that they have reason to worry about their loved one.  Protect them by being sure your loved one is getting the pain relief and care that is needed.  Understand that pain DOES kill. Don't be afraid to seek a second opinion, or third or fourth if that's what's necessary.  These patients are not drug seeking addicts.  They are seeking relief from their tormentor - their pain.  If they are denied relief from this tormentor, many will find their own ways, leaving friends and family to pick up what they have left behind them...

Comment by Amy K on December 16, 2010 at 9:18pm
I can't wait to share this post in many different communities, particularly at Una Vita Bella my new network for those with chronic pain and mental health challenges. Pain is a major contributor to depression, suicidal thoughts, and suicide attempts, plain and simple and can't be ignored. Pain can kill, like you said.
I have shared this before, but the pain almost killed me as I was led to a suicide attempt myself after a diagnosis and extreme pain due to fibromyalgia. I am one of these people you talk about here and I am proof that it is a real issue.
I truly hope we can continue to reach others with this message and your post that reminds caretakers, professionals, activists and those suffering with pain themselves that awareness of this is so very important, literally vital.

Thank You Ellen! Feel free to post this yourself at Una Vita Bella - The Community as well. Also, would love to see this mentioned in the fibromyalgia group here, I can write a discucssion and link to it, if you would like?
Comment by Ellen S on December 17, 2010 at 11:30am
Amy - done!  If you can start a discussion about it, I think it's an important subject, especially in light of the fact that Fibromyalgia is so often misunderstood and simply not taken seriously, leaving patients to feel helpless and hopeless.  If you don't have a chance soon, I will try to step over there and write something too.  This is important stuff <3
Comment by Amy K on December 17, 2010 at 10:17pm
I'll make sure to post about it in the Fibromyalgia group and thank you so much for sharing it at Una Vita Bella!

No comments: