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Outpatient Treatment for Suicidal Ideation and Self-Harm

Suicide is the tenth leading cause of death in the US. It claims nearly 44,000 lives annually. Still, it may be challenging to understand suicide or know what to do if someone is thinking about it, especially if you’ve never personally been affected by it before.

Treatment at a suicide treatment center is essential to getting help and feeling better, regardless of whether you experience suicidal ideation or self-harm. Inpatient treatment offers relief for those in a crisis, while outpatient treatment is helpful for those who aren’t in an emergency situation. 

If you or a loved one lives with mental illness, it’s vital to establish which treatment is best and prevent ideation or harm from escalating.

Understanding Suicidal Ideation and Self-Harm

Suicidal ideation is the technical term for having thoughts or ideas of ending your own life. Passive suicidal ideation is having suicidal thoughts without actually going through with them. Active suicidal ideation is when the concept of suicide turns into actively making plans to die by suicide.

The reasons for suicidal thoughts vary. Some factors can put people at greater risk of suicidal ideation, from gender and ethnicity issues to underlying mental health concerns. Julie D. Eberwein, executive director at Integrative Life Center, noted that multiple factors contribute to thoughts of suicide, including the below.

Contributing factors to suicidal ideation include:

  • Age
  • Race
  • Ethnicity
  • Gender
  • Socioeconomic status 
  • Mental health issues
  • Substance use problems
  • Medical conditions
  • Grief and loss
  • Low self-esteem
  • Relationship problems
  • Employment difficulties
  • Family conflicts 

Signs of suicidal ideation may include:

  • Panic attacks
  • Disruption in sleep or eating habits
  • Poor hygiene
  • Feelings of hopelessness and helplessness
  • Elevated irritability or agitation
  • Mood swings
  • Reckless behavior
  • Social isolation
  • Substance use
  • Self-injury

Self-harm or self-injury involves intentional damage to one’s body. The harm can be carried out in various ways, most often via cutting, although burns, scratching, and self-hitting are other recognizable methods. 

Common signs of self-harming behavior include:

  • Scars
  • Excessive wounds (i.e., burns, scratches, bruises, scars)
  • Long sleeves or pants to mask the harm
  • Claims of accidental injury
  • Interpersonal relationship difficulty
  • Mood swings
  • Reckless behavior
  • Feelings of hopelessness, helplessness, or worthlessness

The Relationship Between Suicidal Ideation and Self-Harm

Both suicidal ideation and self-harm share similar signs, symptoms, and causes. Both indicate underlying concerns such as ongoing mental illnesses like depression, post-traumatic stress disorder, or anxiety. Self-harm lacks suicidal intent, yet long-term struggles often coincide with disorders that result in suicidal ideation.

Dr. Julie D. Eberwein, Executive Director at Integrative Life Center, said, “Different functions and motivations underlie self-harm and suicidal thoughts and behaviors.”

“There can be different factors or motivations related to suicidal behavior and self-harm, but the one defining feature of the suicide attempt is at least some desire to die,” she stated. 

Signs That It’s Time to Seek Suicidal Ideation Treatment

Regardless of the cause, suicidal ideation and self-harm aren’t something to ignore. If you or a loved one are showing signs of either of these issues, it’s critical to discuss and get emergency help immediately.

Seek treatment when a person displays:

  • Expressing hopelessness
  • Withdrawal from social connections
  • Severe emotional distress
  • Irregular sleep patterns
  • Lack of personal care (appearance and hygiene)
  • Lost interest in hobbies 
  • Changes in diet
  • Lack of energy and motivation
  • Increased irritability or agitation
  • Dangerous or self-destructive behaviors
  • Increased substance use
  • Physical self-harm

More imminent suicide warning signs are:

  • Threatening suicide 
  • Often talking about death or dying
  • Making a plan of how to die
  • Accessing a way to end life
  • Saying goodbyes
  • Giving away valued possessions

Active ideation is a more immediate and urgent risk than passive ideation. But both types of suicidal thoughts can have major negative effects on your everyday life. Passive ideation can also turn into active ideation if left untreated. “Anyone experiencing suicidal thoughts should seek mental health care immediately,” Julie said. “If there is an imminent risk of harm, contact mobile crisis services or the local emergency room.”

Self-Harm and Suicidal Ideation Treatment Options for People in Need

Many treatment options exist for people in severe distress who are considering suicide or harming themselves. Emergency care is necessary if the person is in danger. If the person isn’t in immediate danger, seeking treatment is a good idea.

The first step in treatment for suicidal thoughts is assessing for underlying mental health disorders. Mood disorders, including depression, bipolar disorder, and anxiety, are strongly linked to suicidal ideation — especially if left untreated. Depression treatment and suicide treatment work best when combined into one customized holistic care plan.

Mental health treatments for suicidal ideation and self-harm include:

  • Dialectical Behavior Therapy (DBT). This form of talk therapy helps people with a variety of disorders, including those related to trauma, depression, and anxiety.
  • Attachment-Based Family Therapy (ABFT). This family therapy focuses on improving the parent/child relationship and other relationships in the family. 
  • Multisystemic Therapy-Psychiatric (MST-Psych). This therapy helps patients with addiction or mental health issues by addressing those issues in multiple settings at once, including school or work environments.
  • Integrated Cognitive Behavioral Therapy (I-CBT). This therapy focuses on changing thought patterns behind behaviors to help people manage anxiety disorders and depression symptoms. It can also be helpful for those with substance use issues.
  • Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). A type of psychotherapy that helps alter thought patterns to treat PTSD in adults who have experienced trauma.
  • Trauma-Informed Therapy. Helps you acknowledge and overcome traumatic experiences that may contribute to mental health issues and suicidal thoughts.
  • Experiential Therapies. Art, music, and equine therapies, along with other experiential treatments, can work in conjunction with the above modalities to help treat suicidal thoughts.

Compassionate engagement in suicide treatment is critical, according to Julie. “Once engaged, it is imperative that trust is fostered so that the therapeutic relationship can be experienced by the individual as valued, supported, seen, and heard,” she said. “This foundation will allow the individual to engage in interventions that increase protective factors and reduce risk factors.” 

Supporting a Loved One Who has Suicidal Thoughts

The first step in supporting a loved one who may be having suicidal thoughts is encouraging them to talk about their feelings. If you’re unsure of what your loved one is going through, it’s vital to ask them directly if they:

  • Are having suicidal thoughts/ideas
  • Have a suicide plan 
  • Have access to lethal means

“You have to have the confidence that asking these direct questions will not increase the person’s suicidal thoughts,” Julie said. “It will give you information that indicates how strongly the person has thought about killing themselves.” 

Julie noted that if you think the person might harm themself, do not leave them alone. Instead, remove any potentially lethal items from the vicinity and seek professional help immediately.

If your loved one doesn’t have immediate plans of suicide, ​​it’s still crucial to offer support. You should find the right help as soon as possible.

Other ways to support a loved one with suicidal thoughts are:

  • Educate yourself with these suicide prevention resources
  • Recognize warning signs of the worsening condition
  • Know the risk factors for suicide
  • Be aware of any self-harm clues
  • Be there for them
  • Help create a low-stress environment
  • Encourage them to talk to you about their feelings
  • Let them know that support is available
  • Help them find treatment

Maintaining an approach rooted in care and compassion is of critical importance when supporting a loved one experiencing thoughts of suicide, Julie said. 

When talking with your loved one about suicide, be patient, listen compassionately, and try to empathize with them. Let them know that you care and you are there to support them no matter what. Don’t victim-blame, judge, or make negative or unhelpful comments that might make them feel worse. Respect and reassurance are key.

Is Outpatient Treatment for Suicidal Thoughts the Right Fit?

Seeking a suicide treatment center should include some reflection on the type of treatment you or a loved one needs. Inpatient and outpatient treatments offer a variety of benefits.

“​​Identifying and working with a qualified outpatient therapist is the best treatment option when there is little or no risk of imminent harm to self and no previous suicide attempts,” Julie stated. “The therapist can further assess the risk level and determine if more intensive services are indicated. If a higher level of care is necessary, the therapist can work with the individual to recommend the most beneficial programming.” 

When considering an outpatient program, make sure the person agrees that they need help and are willing to work toward recovery. Treatment only works when the person is ready and willing to heal.

When looking for a treatment center, look for a well-trained staff that focuses on trauma-informed care. Unresolved trauma frequently is the root cause of mental health issues.

Finding the Right Suicide Treatment Center

Finding the right treatment center is a challenging task, largely because of the vast amount of resources out there and the overwhelming need when you’re in that situation. As a result, it’s important to narrow your scope and find reputable, reliable resources to help you with your search. It can be difficult, but speaking with a reputable center makes all the difference. 

With that said, if you or a loved one are having thoughts of suicide, Integrative Life Center’s suicide treatment program may be the most ideal option. 

At ILC, we start with a medical assessment that helps determine what type of interventions might best serve you. We believe there is no one-size-fits-all treatment for suicidal thoughts. Every person and situation is different.

Our professional counselors and therapists create specifically-tailored treatment plans to treat suicidal ideation and co-occurring disorders. We can help you regain control of your thoughts and life once again through our heart-centered approach experienced through a combination of integrative and holistic therapies.

Contact Integrative Life Center today to start discussing your options.

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