Lockup Doc

(The following is a fictional vignette based on thousands of real patient encounters. Any resemblance to an actual person is purely coincidental.)

The heavy door slammed with an echo he’d never forget. He thought he could trust her, but he had been proven wrong. He should’ve known not to trust anybody in prison. In fact, throughout most of his life he’d known only a few people he ever could trust. Naked, cold, humiliated and feeling as though he had been violated again, “David” now wanted to die more than ever. He didn’t care how; it didn’t matter if it hurt. He just needed to end it all. But, he would soon realize that it would be nearly impossible to do. Nearly ever imaginable method of suicide had been removed from him. He was now “safe” in the eyes of the prison, but he sunk into a deeper depression.

It was David’s first time in prison. He had spent a few days in jail prior to his current age of 22, but it was remarkable that he hadn’t gotten himself into more trouble. His father was a career criminal who had repeatedly emotionally, physically, and sexually abused him as he was growing up. David had grown up far too fast. He had had few boundaries and rules and almost no adult supervision in his younger years. He started smoking cigarettes at age 10, started drinking at 12, and was using marijuana regularly by 13.

Despite having the deck stacked against him, David was Read more…

Suicide is an absolutely horrible phenomenon. It destroys families and forever leaves survivors on an elusive search for why it happened. Suicide is often viewed as a very selfish act, yet I believe that in many cases those who do it truly cannot endure the emotional pain any longer and believe that they are out of options. When I was a young adult, an extended family member committed suicide. During my career I have lost a small number of patients to suicide as well. These were all very tragic experiences.

In the United States, mental health professionals have a legal responsibility to take action when our patients appear to be at risk for harming themselves. It is not possible for us to accurately predict when a person is going to commit suicide, but we are expected to assess for and document suicide risk factors. If necessary, we may have to call police or take other action to have patients involuntarily admitted to an inpatient psychiatric unit. Read more…