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Suicidality

A person’s suicidal thoughts or depressive tendencies can also play a role in the campus environment. It is not our aim to provide an exhaustive analysis on the topic of “suicidality;” this is best left to the experts in the field. Instead, we wish to demonstrate possible initial responses for you if, for example, you are confronted with a suicidal crisis in the course of your work as an academic adviser.

  • Definition

    The term suicidality comprises the overall range of

    • Suicidal Thoughts:

    Thoughts of wanting to take one’s own life.

    • Suicide Plan:

    Formulating a specific method by which one wants to end his or her life.

    • Suicide Attempt:

    Action that is performed with the intent of dying but that does not have a lethal outcome.

    • Suicide:

    Deliberately ending one’s own life.

    Distinctions are also drawn between

    Latent Suicidality:

    • The suicidal thoughts a person utters are prevalent (some of the time); but there is no concrete, impending intention to act on them, nor are there related preparations.
    • The person is still capable of distancing himself or herself from suicidal thoughts and images.
    • The person has the capability of accepting alternative options at finding a solution.

    Acute Suicidality:

    • The suicidal thoughts the person has been uttering are dominant and accompanied by the concrete and/or impending intent to follow through (suicide plan).
    • The person has concrete plans on how to proceed, a method, a time and location for the suicidal act.
    • The person is no longer capable of distancing himself or herself from his or her suicidal thoughts; and a suicidal act cannot be ruled out for the immediate future.

    Often it is not possible to draw a clear distinction between latent and acute suicidality; there may be a gradual transition between the two. The higher the probability of acute suicidality, the more urgent and crucial is the need for assistance.

  • Recommendations for Action

    People who are afflicted by suicidal thoughts or who have actual suicide plans, typically feel their burden lifted, if they are actively approached about these thoughts. If you feel a person you know is having suicidal thoughts, ask questions. Questions for addressing suicidality:

    • Suicidality: “Have you ever thought about taking your own life?”
    • Preparation: “Are you consciously thinking about it, or do such thoughts unintentionally creep into you mind?” “Are you already thinking about how you want to go about doing it?”
    • Announcements: “Have you already discussed your intentions with someone?”
    • Closing in: “Have you become less interested in things, or have you withdrawn from social contacts compared to before?”
     

    There is no one-solution-fits-all approach for dealing with people who want to take their own life or who threaten to do so. Examine your own capability for decisive action in this context; understand that you will not be expected to be a medical services provider. Your function is that of a layperson. Moreover, you do not have the power to prevent somebody from committing suicide and you are not responsible if they follow through.

    Attempt to motivate the person who is having suicidal thoughts to seek professional help.

    Assessing the risk:

    NO ACUTE RISK
    Communicating offers of assistance
    e.g., socio-psychiatric service for students (PBS), telephone hotline, student societies,

    ACUTE RISK
    Emergency plan
    Primary care provider, Clinic for Psychiatry and Psychotherapy, emergency room

    If you suspect a person is at risk for committing suicide, help this person to get help. Perhaps it may make sense to contact a specialist for an examination together with the person at risk.

    In cases of acute suicidality, after having obtained the consent of the person at risk, alert the Clinic for Psychiatry and Psychotherapy and/or Emergency Response Physician/Emergency Services (112).

    If the person at risk reports a concrete suicidal intent and a suicide plan, or if such a person cannot distance himself or herself from such an intent or plan while also rejecting all offers of help, you must weigh your actions. If you decide that the risk is acute, you may have to take steps that include violating your duty of confidentiality (provided the person at risk is withholding consent). If in doubt, call Emergency Response Physician/Emergency Services (112); or, if the person at risk has run away, call the police (110)

    As a principle, always exercise your own judgment and document your decision by outlining your actions. If possible, always obtain consent from the person at risk; or, if this is not possible, consult a relevant contact person. If necessary, notify other university institutions (e.g., the dean’s office).

  • Assessing the Suicide Risk

    Ten warning signs

    • statement of wanting to die or of wanting to take one’s own life
    • increased substance use
    • expression of futility
    • signs of fearfulness (including changes in sleeping habits)
    • expressing the sensation of being trapped
    • feelings of hopelessness
    • social withdrawal
    • uncustomary expressions of anger and rage
    • inconsiderate behavior
    • signs of mood changes

    Four extended warning signals

    • concrete information regarding the implementation, selection and procurement of the means for committing suicide
    • previous suicide attempts
    • insufficient distance to any previous suicide attempts
    • mental disturbance or illness
  • Emergency Plan for Persons with Acute Risk

    PERSON ACCEPTS HELP

    Refer the person to a doctor

    Inquire:
    “Why don’t you go see a doctor?”
    “Who is your primary care provider?”
    “Shall we phone the doctor together?”
    “Do you want me to find a doctor who is close by? That way you can go there immediately.”

    As an alternative, you may want to prevail upon the person to present themselves at the Clinic for Psychiatry and Psychotherapy:
    “You will find contact persons in the psychiatric outpatient department who can help/protect you.”

    Notify the drop-in center as soon as the person at risk is on his/her way there; request confirmation of their arrival. Stay close to a phone!


    PERSON REFUSES VOLUNTARY ACCEPTANCE OF HELP

    Notify the Emergency Response Physician/Emergency Services 112

    • information for the emergency call
    • personal information
    • name of the person at risk
    • whereabouts of the person at risk
    • condition
    • contact information of the person at risk
    • personal availability

    If you do not know the whereabouts of the person at risk (e.g., if he or she ran away during a counseling session):
    Call the police 110


    Document all your decisions and, if necessary, notify other university institutions (e.g., the dean’s office).

Emergency Numbers / Counseling Centers

Clinic for Psychiatry and Psychotherapy
Institutional Outpatient Clinic/Polyclinic
Rudolf-Bultmann-Straße 8
35039 Marburg
Opening hours
Mon.-Thu. 8:00 a.m. – 4:30 p.m.
Friday: 8:00 a.m. – 2:30 p.m.
Telephone: 06421/58-65239
Fax: 06421/58-67099
Reception: 06421/5865200

Emergency room at UKGM (University Clinic Gießen/Marburg)
Doctors on call: 116117

Vitos Clinic for Psychiatry and Psychotherapy
Cappeler Str. 98
35039 Marburg
Telephone: 06421/4041

Psychotherapeutic Counseling Center for Students
General consultation without an appointment

Telephone counseling service
0800/111 0 111
0800/111 0 222
116 123

Socio-psychiatric service at the Marburg-Biedenkopf health department

List of psychotherapists and therapists in Marburg and the surrounding area

 



Source information for address content:
Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie Universitätsklinikum Ulm (Hrsg.) (2010): Wahrnehmung von und Umgang mit Gefährdungspotentialen in der Beratung von Studierenden. Eine praktische Orientierungshilfe für Beraterinnen und Berater, Ulm 2010
Stadt Bielefeld, Amt für Schule, Regionale Schulberatungsstelle; Stadt Bielefeld, Büro für Integrierte Sozialplanung und Prävention; Klinikum Lippe, Kinder- und Jugendpsychiatrie (Hrsg.) (2017): Handlungsleitfaden Umgang mit suizidalen Krisen und Suizidprävention an Bielefelder Schulen, Bielefeld 2017