Contenido:

SUICIDAL PERSONALITY

A psychiatric problem is produced when an individual suffers a change in behaviour that becomes intolerable either for himself or for those around him. These changes can be manifested in the things they think, the things they say or in the things they do.

They are complicated situations and in many cases difficult to deal with. Initially they will require MEDICAL ADVICE VIA RADIO and, in the majority of cases, posterior specialised medical attention, which will generally involve the urgent and necessary evacuation or disembarkation of the psychiatric patient.

In practice, when faced with a subject who demonstrates abnormal behaviour, it is important to determine if immediate action is necessary. This applies when:

• They are violent towards themselves, that is to say, they could attempt to injure themselves or commit suicide.
• They are aggressive towards others: violent subject.
• Their consumption or abstention from alcohol or drugs is the reason for their change in behaviour (see Chapter 8.2, ALCOHOL) y (Chapter 8.18, DRUGS).
• They suffer from a neuro-psychiatric illness that produces unexpected fits, for example, epilepsy (see Chapter 8.6, FITS).

In other cases where abnormal behaviour arises, though it is not considered serious, the recommended course of action would be to make observations and monitor the patient over a period of time, as this could be the beginning of a psychiatric disorder that may become aggravated. In these situations it is advisable that someone on board with authority, and who also has the respect of the patient, tries to talk to them to find out about and better evaluate the problem. Always bear in mind that the patient may not be aware that they are behaving in an abnormal way.

We should suspect that a person may try to commit suicide if they begin to show abnormal behaviour and:

• Have Anteriorly attempted suicide.
• Admit to having suicidal impulses or thoughts in a given moment.
• Suffer from DEPRESSION or have suffered similar psychiatric disorders.
• Have feelings of guilt: they believe themselves to be responsible for everything bad that happens on board, in their family, etc.
• Although they do not manifest suicidal ideas, they behave as if they are tempting death (unnecessarily risky behaviour).

Norms of action when dealing with a possible suicidal case

The aim, when the subject is capable of reasoning, is to make him understand that other alternatives exist and that we want to help him.

In general, it is advised:

• Take all threats seriously even though they may appear to be "cries for attention".



• Do not try to convince the patient not to commit suicide but listen, observe and evaluate their mental state. You should speak to them and offer alternatives: medical consultation via radio, disembarkation.



• Deal with them respectfully, in a firm and friendly way. A calm attitude should be adopted. Take them seriously, do not make fun of them and do not treat them as if what they say is foolish.



• The person on board in charge of medical attention should establish personal contact with the subject so that they express their feelings, personal circumstances, etc. This interview should be carried out in private and in the preferred circumstances of the patient.
  
  Speaking about suicide does not put the thought in their heads. It is a mistake to avoid the subject out of fear; in fact, potential suicide cases often feel alleviated when talking about it.
  
  The suicidal risk should be evaluated during this interview. The disembarkation of the crewmember is advisable in the following circumstances, which should be regarded as "high risk":
  
  The subject is deeply depressed.
  
  Alcoholics and drug dependent subjects who show suicidal intentions or behaviour.
  
  Subjects who have persecution deliriums. The patient believes they are being followed, that everyone is against them and wants to harm them.
  
  Those who suffer mandatory hallucinations, that is to say, they think they hear voices or receive messages inciting them to commit suicide.



• Never leave them alone while they are on board. Increase surveillance if they suffer from insomnia and when they suddenly become more excited. A sudden change in mood could be due to them accepting the inevitability of suicide and planning for it.



• As much as possible, keep anything that could be used to self-inflict an injury out of reach (medications, poisons, sharp objects...).