The treatment in the Danish suicide prevention clinics: a clinician perspective

Abstract

Background: Few qualitative studies have focused on clinicians’ perspectives regarding treatment of suicidal people. Despite limited evidence and imperfect risk-assessment tools, the psychosocial therapy at the Danish suicide prevention clinics has been linked to reductions in numbers of repeated self-harm, deaths by suicide, and other causes. This merits an investigation into how clinicians describe their practice.

Methods: Using a qualitative design, 10 semi-structured interviews were conducted and analyzed to describe the psychosocial therapy.

Results: The practices that the therapists described could be categorized along four dichotomous continuums. These illustrated dilemmas encountered during treatment of suicidal patients: 1) intuitive vs. specific risk assessment, 2) meaningful vs. formal, 3) patient-oriented vs. therapist-oriented and 4) direct vs. indirect approach to suicide prevention.

Conclusions: Treatment in the Danish Suicide Prevention Clinics is characterized by methodological flexibility and diversity and with an emphasis on a patient-oriented approach. Furthermore, clinicians balance knowledge available by switching between a direct and an indirect approach according to the perceived suicide risk. If suicide risk was perceived as high, they would administer a direct approach and if low, an indirect approach. Finally, there seems to be differences as to how effective therapeutic methodologies work in the practice of suicide prevention.

Keywords:

• Suicide
• intervention
• qualitative

Notes

Acknowledgements

This article presents independent research funded by the authors alone and revised by a research supervisor. The authors reported no conflict of interest.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 [15].

2 The ego structure refers to reality testing, impulse control, frustration tolerance, ability to reflect, meaningful and enduring interpersonal relationships, and ability to draw parallels across different settings [15].

Additional information

Notes on contributors

Titia Lahoz

Titia Lahoz, MA Psychology, Centre for Suicide Prevention, Department of Psychiatry, Copenhagen University Hospital, Amager, Denmark.

Jan-Henrik Winsløv

Jan-Henrik Winsløv, MA Psychology, Centre for Suicide Prevention, Department of Psychiatry, Aalborg University Hospital, Denmark.

Rikke Christiansen

Rikke Christiansen, MA Psychology, Centre for Suicide Prevention, Department of Psychiatry, Aalborg University Hospital, Denmark.

Søren Krogh

Søren Krogh, Social Worker, Centre for Suicide Prevention, Odense University Hospital, Denmark.

Per Bjerregaard Knudsen

Per Bjerregaard Knudsen, MA Psychology, Psychoterapeutic Clinic, Department of Psychiatry, Copenhagen University Hospital, Amager, Denmark.

August G. Wang

August G. Wang, MD, DMSc (Medial) Ass. Professor, Centre for Suicide Prevention, Department of Psychiatry, Copenhagen University Hospital, Amager, Denmark.

Annette Erlangsen

Annette Erlangsen, PhD, Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Denmark; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center of Mental Health Research, Australian National University, Canberra, Australia.

Klaus Nielsen

Klaus Nielsen, Professor, Department of Psychology, Aarhus University, Denmark.