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  • Q&A with Australian Health Practitioners

    How can I care for my older sibling following a suicide attempt?

    Related Topics
    Depression Mental Health Suicide Prevention
    My sister spent 4 days in a mental health unit following a suicide attempt. They discharged her into the care of my mum and me along with her two young children. The hospital gave no advice on the type of support she needs and how to keep her safe.
    We have never done this before and just want to know if there's particular practical things you can do at home to help with the recovery process.
    She has depression and anxiety and has been started on anti-depressants upon being discharged.
    Thank you
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  • michelleanne

    HealthShare Member

    Hi 

    Sure. She is 34, there has been a quite strong history of mental illness in my family on my father's side (mainly severe depression and my father has Asperger's). It is quite difficult to say how anyone ‘becomes’ depressed i think it is a gradual progression and so many different factors.
    She has struggled with depression and anxiety on and off since her first child was born 14 years ago. Just reccently there is relationship problems, financial difficulties and bevarioural difficulties with her son. It has been informally said that she had a ‘breakdown’.
    It is hard to say what she feels at any moment but her mood as been quite up and down since leaving hospital and she constantly says she is taking it ‘day by day’.
    I guess my question was asking about ways to support someone who is overwhelmed by life at the moment but still help them to feel like they have some power and autonomy in their life.
    Also even simple things like how to spot signs that a person may be suicidal again and what to do. You can't watch over a grown adult 24/7 that could be more of a hindrence than help.
    I just think when someone goes into hospital to have an operation they come out with notes for their carers about looking after the person whilst they are not 100%, preventing secondary infections, exercises to help healing process etc 
    Why can't there be a similar post hospital admission advice?
    Thanks for your help

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    Damien Haines

    Clinical Psychologist, Psychologist

    Damien Haines is a registered Clinical Psychologist who brings a warm and empathetic approach to therapy. He emphasises engagement in the world and encourages clients … View Profile

    Hi MichelleAnn

    It sounds like you feel quite overwhelmed by these recent events, and quite unsupported by the mental health unit your sister attended.

    Having worked in private psychiatric hospitals I would suggest the following immediately after discharge. (Ideally these things would have been done by the hospital/clinic). Have a suicide prevention plan with your sister. It is important to be as open about this as possible. Included in this plan should be the following:

    1. Knowing what her plan would be if she felt that way again. If possible remove those items or monitor them. eg if pills you dispense them, she doesn't. Sharps are a bit trickier, but razors are an obvious one to remove (this is all just for now, not forever).
    2. Have a list of phone numbers by the home phone and in hers and your mobile. Obviously 000 and LifeLine (13 11 14). Also add her GP, Community Mental Health Team, Psychiatrist, Psychologist, Support groups such as GROW (www.grow.net.au), the local hospitals mental health unit. I would also add in her friends and families numbers. The family and friends numbers are there for social support, NOT for suicide prevention. ie she feels lonely and calls someone to just chat to, not about her problems, just stuff.
    3. Encourage (it is all you can do) her to engage with a psychologist (http://www.psychology.org.au/FindaPsychologist) and/or a psychiatrist. Get her a list of names and tell her that you will take her to one, though she should call them first to see if they “gel” (as an example).
    4. Encourage her to be somewhat social (she may only be able to call someone or be with people for up to 30 minutes at a time). Encourage activity and eating well (lots of complex carbs, and foods with tryptophan - dairy, soy, poultry, bananas). All these things aid in serotonin production which will help to stabilise her mood especially if she is on antidepressants.
    5. Encourage her to do small tasks. eg if you are doing some washing ask her to help hang it up and give her praise for her efforts. Incorporate her as much as possible, make her feel useful and needed.
    6. Be honest with her. Tell her that if you guys get worried you will be calling 000.
    7. Try not to nag/harass - encourage her.
    8. Look after yourselves. Take time out to enjoy/experience your life as well. If you guys burn out no-one gets better.
    I realise that much of this may sound generic, however, the bottom-line is you cannot make someone do anything. But you can let them know that they are cared for, that they matter, that they have purpose, and that they need help that you cannot provide.

    I look forward to hearing about the progress of your sister. I hope she is able to re-engage and improve, especially for her children's sake.

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    michelleanne

    HealthShare Member

    Thanks Damien
    That was of great help! I was beginning to think annonymous wasn't going to respond  after asking for more info and i was feeling a bit disappointed in this network. I undertstand what it is and isn't but i did identify i was looking for some pratical advice/support even if it were from a non-professional but someone who has been/is there.
    It was disappointing to see her to leave my parents house 2 days after being discharged but again her choice and Easter factored in it, the youngest wanted to be at her home for Easter bunny. There just isn't the support there.
    There are little unhealthy behaviours she hasn't changed although almost completely giving up alcohol (which was a big factor in the attempt) has been a good step. Although she tells me yesterday ‘this isn’t forever you know'. 
    Generic is great! No one has mentioned a list of support and intervention numbers by the phone like you suggested and i know that no one did a plan with her 
    She is finding it really difficult to get to see a public psychologist and isn't willing/able to pay privately. the 6 sessions through medicare is really insuficient and some distance to travel but we're making do with that for now.
        The hospital visited her once ‘in the community’ and called once and that was it. There has been no further follow up to see how she is going with medication (or if she even got a script) and seeking out counselling.
    Her teenage son is still acting out, violent, distant giving her significant trouble and this worries us. The whole family is trying to help there.

    I might print out your advice, write up a few points we can work on and I'll sit down with her she does listen to my advice having been there myself to a lesser extent (never hospitalised but major depressive disorder over a number of years) and she knows I love her A LOT!

    Thanks for your help I'll keep you updated

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    Damien Haines

    Clinical Psychologist, Psychologist

    Damien Haines is a registered Clinical Psychologist who brings a warm and empathetic approach to therapy. He emphasises engagement in the world and encourages clients … View Profile

    If you are comfortable giving your location or that of your sisters (not address just suburb or town etc) then I or others may be able to provide or suggest resoirces that are locally available for your sister.

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  • michelleanne

    HealthShare Member

    She lives in the Lake Macquarie area (between Newcastle and Central Coast its a big area). Perhaps its a matter of GPs not knowing what is on offer for their patients or preferring to go through GP access/medicare local. There is one service that I have used that is good but with a 3 month wait. I guess anywhere is difficult for needing something at fairly short notice. It gets overwhelming.

    Thank you Damien :) 

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    Damien Haines

    Clinical Psychologist, Psychologist

    Damien Haines is a registered Clinical Psychologist who brings a warm and empathetic approach to therapy. He emphasises engagement in the world and encourages clients … View Profile

    Hi Michelle Anne

    Here is a lost of links I have found that may be of help for you and your sistser.

    http://www.grow.net.au/index.php/grow-in-your-state/grow-nsw under Regional and you should find Lake Macquarie. Grow is a community based support group for people with a mental health issue. It is future focused and aimed at reducing symptoms rather than a forum to talk about your woes. It's free.

    Macquarie Hospital http://www.nscchealth.nsw.gov.au/services/003700642.shtml#TopOfPage They have in patient and out patient services. Out patient include supprt and day programmes.

    Others include

    http://www.ccarafmi.org.au/images/ccmhservices.pdf

    http://www.nscchealth.nsw.gov.au/areas/ccahs/healthaccessplan/pdf/hap_mental.pdf


    ARAFMI for yourself

    http://www.ccarafmi.org.au/ (carers of those who have a mental disorder)

    Also add in the links I provided before regarding psychologists. I didn;t look at Newcastle services, but I would imagine that they would have additional services.

    I would also suggest (if your sister has private insurance including extras for mental health) looking at private hospitals up there as they also provide day programs and are usually less “distressing” than public hospital systems. However, I cannot comment on the services up there as I have not used them so the public facilities may be great.

    I hope that this is of help

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    Millie Simic

    Arts Therapist

    I am an art therapist in private practice after graduating from the University of Queensland’s (School of Medicine), Masters of Mental Health-Art Therapy program.Since graduation … View Profile

    Let me say firstly that I can hear a very sympathetic, heroic and compassionate sister who cares deeply about her sibling, I commend you so much for that.

    I have read some of the excellent practical answers that have been written for you regarding the care of your sister and I thought I would write to you about you.

    Trying to keep someone we love alive is traumatic and harrowing and we can lose our own life (metaphorically speaking) always worrying and feeling responsible for that person. I am wondering if you would consider some support from a therapeutic professional yourself so that you can expel the trauma you yourself hold in your mind and body.

    I am an arts psychotherapist and I feel the old cliché ‘a picture paints a thousand words’ is very apt. Drawing, painting or sculpturing our fears and hopes can be very confronting, therapeutic and inspiring and also gives us a voice.

    I recommend reading as well. Different authors, over the years have written very interesting books for carers caring for loved ones with depression. Some authors have actually experienced depression and have written their story and state what they needed from loved ones during that time, read as much as you can.

    Balance you’re life with as much pleasantness as possible and take care of yourself so that you can care for your older sibling as a wonderful role model. I wish you all the best on this journey.

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  • michelleanne

    HealthShare Member

    Hi Millie

    Thank you very much for your kind words. I'm not sure if I'm heroic but definitely my actions and concern come from a place of great love for my only sister. I do believe sisters have a special unspoken bond between them thats why it is so imperative for me for my own reassurance that I do all I can within my own capacity to help her.

    In an ironic sense of luck I was seeing a clinical psychologist regularly before my sister's suicide attempt and still am. I too have struggled with similar demons and as I said there's a strong history of mental illness on my father's side. My mother's parents died young so I'm not sure about that side. But one half of your genetic makeup is more than enough I imagine!!

    I'm very much into creative writing and drawing. Funnily enough I've only really found the darkest times of my life to be my muse; the words come quickly and easily when I'm struggling with a lot of difficult emotions and life situations.

    Although my sister's attempt was almost 6 months ago now I'm still worried about her. She is taking regular medication as far as I know, hasn't received any form of therapy and has a rather unhealthy view of alcohol and its uses. That's what concerns me the most. I wouldn't say she has alcoholism but it is definitely a crux for her at extremely difficult times and played a major part in leading up to her attempt. For me it feels like a warning sign whenever I see it but I know I need to exercise some self control and not hover over her or act as though I'm on the lookout. That can be stressful I'm sure.

    Occassionally maybe for my own peace of mind I gently advise her to take it easy and look after herself when she goes home and have once expressed to her my great concern that I don't want to see her back at that hospital again.

    EVerybody still hurts but I think we're healing. I still worry for her and occasionally for me but I keep seeing my therapist and doing some of those things you have suggested. In therapy I'm working on ACT and I've really got into mindfulness.
    I've read a few of Russ Harris' books and I'm also learning how to read for fun.
    My neices and nephews (I have 3 of each) definitely bring a lot of pleasantness and joy in my life when I see them.

    Thank you for your kind words Millie. Especially pertinent on a day like today…R U OK DAY? :)

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