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Prescribe an anti-depressant medication and allow her to return home
0%
0/23
Explain to her that she will have to be hospitalized as she is an acute threat to herself
87%
20/23
Refer her to a psychiatrist
4%
1/23
Tell her parents about the situation and allow them to handle it as a family
Prescribe an anti-psychotic medication
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This patient is an acute threat to herself and must be hospitalized, either voluntarily or involuntarily. Patients who are suicidal must be stabilized and treated in a hospital. This patient has many signs and symptoms of depression and is actively suicidal. Suicide is the third leading cause of death between the ages of 15-24 and should be taken very seriously. She has multiple risk factors for suicide, including history of depression and white race. Although females more often attempt suicide, males are more likely to succeed. Other risk factors for suicide are: age older than 45, previous attempts, substance abuse, rational thoughts, chronic illness, an organized plan or access to weapons, lack of a spouse, lack of social support, and low socioeconomic class. Norris and Clark discuss the practice of evaluating and treating the suicidal patient. They recommend questioning high-risk patients about suicidal intent, as it has been shown to improve outcomes. They discuss the treatment of the suicidal patient in both the inpatient and outpatient setting. In the short term, patients must be stabilized in a safe environment. Those at a lower risk, such as patients with no active plans and good support, may be treated as outpatients. Those at high risk, such as patients with plans for suicide or access to lethal methods, must be admitted for inpatient treatment. Ougrin et al. review the efficacy of psychosocial and social therapeutic interventions in reducing both suicide and self-harm in adolescents. They compared 19 randomized controlled trials spanning 2,176 patients and found those treated with psychosocial and social therapeutic interventions had a lower rate of self-harm relative to the control group. In particular, they found that dialectical behavior therapy, cognitive-behavioral therapy, and mentalization-based therapy had the biggest therapeutic effect. Incorrect answers: Answer 1, 3-5: This patient is actively suicidal and has a plan, thus she must be admitted to the hospital for treatment and stabilization. None of the other answer choices are appropriate in a patient who is an acute threat to themselves.
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