Víctor Pérez Sola, president of the SEPB.
The progress in the implementation process of the telephone prevention, early detection and attention to suicidal behavior has been very well received by Psychiatry. However, the first details of its implementation revealed in Medical Writing by the deputy director of health of the Red Cross, an organization to which Health has delegated the development of 024, have left a bittersweet taste to the specialty by do not count on psychiatrists as members of the team of professionals who will support the helpline and which will be led by Psychology.
“This type of device they benefit from having a multidisciplinary team behind them. It is very difficult to have very well-trained professionals, and there are a series of functions such as a good diagnosis or specific psychotherapy that can only be undertaken with all the quality guarantees psychiatrists or clinical psychologists”, claims the president of the Spanish Society of Biological Psychiatry (SEPB), Víctor Pérez Sola, who qualifies as “error” nor have psychiatrists on the anti-suicide phone.
The suicide expert gives the example of the model defined in neighboring countries such as France or the Netherlands, which have been successfully offering this telephone service for years. “In them there are multidisciplinary teams because there are things that can do better a psychologist, a nurse, a social worker or a psychiatrist. The psychologists often lead these teams, but yes, they must be trained and have the capacity to be decisive. The important thing here is to provide a solution to those people who need help”, explains Pérez Sola.
The justification for the need for a multidisciplinary team lies in the fact that in suicide “not all patients are the same”. “Some come through mental illness and there the most appropriate is the psychiatrist, but others are social situations. For example, there is a clear relationship between evictions and suicides. Here a social worker would be more useful than a psychiatrist”, explains the specialist.
Two fundamental issues in the anti-suicide telephone
For the president of the SEPB, suicide hotline It must meet two fundamental questions. The first consists of taking special “care” in carrying out a “correct” assessment of suicide risk. “For this, the staff has to be trained or be people who are used to carrying out these evaluations. At the moment, in the National Health System (SNS), those who meet this profile are the hospital emergency psychiatristssince that’s where people with a high risk of suicide end up”, details the specialist.
Other appropriate professionals to assess risk would be clinical psychologists. “In the case of psychologists, if they have to do a treatment or a diagnosis should be clinical psychologists. The complicated thing is that there are currently very few on the market”, explains Pérez Sola. Given the absence of these professionals in the Spanish labor market, the specialist considers that if correct training in suicide is guaranteed, it might be delegated to other health professionals.
The second question goes through a “very good” coordination with the regional systems. “They can call you when they are regarding to take some pills. At that moment, what you have to do is locate him, convince him to let himself be helped and activate the health system”, explains Pérez Sola. An autonomous health system that would receive the alert from a state system. “On the phone you cannot assess a high-risk person. You will have to move a health service. Therefore, you must have a very well-oiled system so that there is coordination with the regional system”, details Sola.
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