Suicidality, or an idea of suicide commitment, appears to be one of the side effects and features of schizophrenia. Almost half of the patients contemplate about it and at least one fourth of schizophrenia patients have tried to take their own lives (“Ongoing assessments”, 1999).
As Meerwijk et al. (2010, p. 66) point out, a very important aspect of schizophrenia treatment in the relationship to suicidality is the involvement of mental nurses in verbal communication with the patients discussing their addictive thoughts about suicide commitment and not letting the feeling of isolation catch them up. Therefore, in order to improve nursing competences, an effective set of care actions was summarized in a special guideline that offered the evaluation of risks and choosing of the prevention method for the suicidally inclined patients. The specially classified materials from the literature databases and reviews for the last 20 years were taken as the foundation.
During the research, the nurses were supplied with conversation templates to use them as references in personal communication with patients and identifying the possible risks according to the scale system provided. The main idea was to let the patient express own opinion freely and be accepted by the nurse. It was also highly recommended to keep in touch with the patients regularly, keep track of their progress and assist them in versatile kinds of complications (Meerwijk et al., 2010, p. 67).
In order to obtain the highly efficient results concerning the suicide-addicted schizophrenia patients, a pilot study has taken place in Netherlands gathering professional nurses with the experience of more than 10 years in the field, Meerwijk et al. (2010, p. 65) inform. Two interviews and a questionnaire helped to summarize the results and present the findings. The new techniques of working with the patients proved to have positive effects but did not significantly help in making patients discuss their addictive intentions freely. No risk in managing suicide was reported but not always the coordinated plan of intervention was followed. Besides, no improvement in the communication between the nurse and the patient was noticed.
Therefore, I would personally cast doubt on the relevance of some results within the research because not all interviewed participants followed the concept of research precisely. And here are some arguments supporting my statement. At first, “suicide risk continues throughout the lifespan of the individual with schizophrenia”, Harkavy-Friedman and Nelson (1997, p. 371) conclude. Therefore, abstaining from interventions does not seem to be a solution for all patients. At second, according to Meerwijk et al. (2010, p. 72), there is no evidence that the discussions of suicide with patients could surely trigger thoughts about it. At third, it is quite hard to define whether the patient is suicide addictive or not (“Ongoing assessments”, 1999). However, nurses did not intervene much when they felt the patient was feeling well. Finally, the symptoms of suicidality may not come in sight for the first five years of schizophrenia development (“Ongoing assessments”, 1999). This is another argument that insists on the inaccuracy of nurses’ actions in the relationship to certain patients.
In order to disclose a topic in a more accurate way, let me add some complementary data standing for another suicidality reason analysis. It is reported that the schizophrenia patients depending on alcohol, drugs, or similar substances are much more likely to be subjected to suicidality than those who are not addicted to anything from the aforementioned. In the research by Kamali et. al (2000), 41 per cent of patients analyzed informed about having suicidal inclinations. Almost half of those patients were misusing substances on a regular basis, and consequently this means that these were the people potentially exposed to suicidality. In such cases, the treatment of the patients could incorporate other means rather than simply involving mental nurses with the necessity of permanent verbal communication.
As a conclusion, I would like to mention that schizophrenia is not the only disease in which ethical and personal approaches play almost as dominant role as the medical treatment. The guideline for nursing care of suicidal patients can be considered as a part of treatment itself and should not be viewed as an instruction useful only for the nurses with the lack of experience in this role. In the research by Meerwijk et al. (2010), it is obvious that old techniques do not always prove to be effective in the long run, so the acceptance of changes and innovations is the way of evolutionary development, which is impossible without similar experiments.