NCJ Number
193561
Date Published
2001
Length
7 pages
Annotation
Twenty open-ended interviews with crisis interveners, police officers, and crisis negotiators who have responded to suicides in progress provided information on specific behaviors observed or heard that portended an imminent suicide attempt.
Abstract
Symptoms of hyper-vigilance were commonly observed. Rather than responding positively to the presence of caring potential rescuers, the person at risk of imminent suicide remains convinced that life forces are arrayed against him or her, warranting a self-destructive intent. As the last physical manifestation before the suicide attempt, the patient undergoes a detectable, but not always pronounced, change in respiratory rate. No persuasion to deter the suicide is possible after this occurs. Immediate strong verbal or physical intervention is required to prevent the suicide attempt. Patients who intend to commit suicide by jumping from a high place will typically count down or up in developing a cadence that takes them to the point of jumping. This may involve a rocking motion that culminates in the jump. This article presents four brief case studies as examples of these behaviors. In recognizing behaviors that immediately precede a suicide attempt, crisis interveners can assess danger either before engagement with the patient, at the point of approaching the patient, or during the process of the intervention. This knowledge can be applied when deciding upon a change of tactics that will break the patient's momentum toward the suicide attempt; for example, crisis negotiators from numerous police departments have reported that when they could hear the suicidal patient start hyperventilating during the intervention, they would respond by yelling at the patient, thus breaking the intensity of his or her concentration on the suicide attempt. This knowledge can also be useful in deciding when to use deadly force to save the life of a hostage held by a person intent on homicide-suicide.