Citation

Perczel-Forintos D, Zinner-Gérecz, Naszvadi E. Psychiatr. Hung. 2020; 35(4): 448-462.

Copyright

(Copyright © 2020, Magyar Pszichiatriai Tarsasag)

DOI

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PMID

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Abstract

The prevention of suicide and self-harm are of particular importance in psychiatric practice handling ade - quate diagnostic procedures. Despite its decreasing tendency, suicide risk is still a serious problem facing our health care system. From the second half of the 20th century, verbal or written agreements that were intended to forestall sui - ci dal behavior became part of suicide prevention protocol. Today, we refer to them as "suicide prevention contracts" or "no-suicide contracts". Despite the fact that these agreements are becoming more and more common in medical care, there is still no general agreement among health care providers on the indication, form or other aspects of these con - tracts. However, contracting in these situations requires delicate discretion. At the outpatient psychotherapy service of the Clinical Psychology Department, Semmelweis University we have been using this tool in the last 20 years in the management of patients in suicidal crisis. In this article the establishment of contracts in clinical use and its indica - tions are described as well as some special issues like suicidality in adolescence. We also discuss the presumed positive effects of contracting, and demonstrate the use of no-suicide contracts in clinical practice by presenting selected cases.

Language: hu