A plea for the understanding of the suicidal mind

Although suicide is a major public health issue worldwide, both mental health professionals and lay-people struggle to cope with suicide. Part of the problem comes from the myths, obsolete paradigms, and stigma associated with suicide that results in anxiety and fear. However, most suicidal individuals want to live even when facing serious suicidal stress. Clinicians are, therefore, called upon to unlock the suicidal mind, relieve the suffering, and pay attention to the unmet needs of these individuals. There are so many unmet needs in individuals at risk of suicide. Too often, the medical model is imposed as a treatment plan. Therapists are more likely to treat the psychiatric disorder and, therefore, assume that this treatment also reduces suicide risk. In this way, the “one fits for all” model precludes understanding the suicidal mind, with its unique characteristics for each subject. Furthermore, there are still no agreed-upon models for managing patients accessing the emergency room and, besides, there is still no data on patient adherence to prevention programs at follow-up. One of the central elements of caring for people at risk of suicide lies in the ability to formulate the question, “What is like to be suicidal?”. To answer this question, the therapist must necessarily leave his formal position and try to identify himself with the subject in crisis. It is an exercise that is not necessarily easy but for which you can train. Throughout this chapter, the reader is helped to understand the suicidal mind to facilitate this action. This essay focuses on some of the unmet needs of suicidal patients and points to some key elements for clinicians in the management of suicidal individuals. The concept of mental pain as the main ingredient of suicide is used to explore some of the most prominent features of the suicidal mind.