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Hospital Leadership and the Chronically Suicidal Adult
 
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Code: DJ 10.2 (4) Thompson
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Erik Thompson, MA
Chronic suicidality is one of the most taxing problems in the mental health care field. Leading researchers have noted that the standard treatment for acute suicidality is counterproductive in cases of chronic suicidality, which calls for a different approach toward hospital admission and discharge criteria. The issue of who takes responsibility for another’s safety is at the heart of this policy discussion. In this single-subject case experiment, Bowen theory guided the modification of hospital admission and discharge criteria for one chronically suicidal individual, allowing the patient access to the hospital for any reason but clarifying the hospital’s accountability in order to heighten the patient’s own responsibility for her safety. Measured in terms of crisis-bed days, responsibility increased with decreased crisis-bed usage. Bowen theory predicts that a shift in the level of self-definition of a significant party in a relationship system will evoke a “change back” move. Events consistent with this prediction emerged during the experiment, involving behavior that appeared dangerous but was instead revealed to be a deceptive display.

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