Viewpoint: Toward Involvement of Caregivers in Suicide Prevention Strategies; Ethical Issues and Perspectives

Suicide prevention research faces specific challenges related to characteristics of suicide attempts and attempters (Wasserman, 2004). Suicide attempters have been described as poorly adhering to intensive treatment over time, and delivery of interventions in the emergency department can be difficult, where psychiatric staff availability is often limited or absent. The post-discharge period constitutes a critical challenge for emergency and mental health care services both in the short and long terms (Hunt et al., 2009). Given these issues, there has been growing interest in assessing the efficacy of post discharge intervention after a suicide attempt. For example, brief contact interventions (BCIs) are low resources interventions seeking to maintain long-term contact with patients after a suicide attempt (Milner et al., 2015). These interventions intent to reinforce the health care networking around the patient but only rely on mental health and emergency services. Depression, drug misuse, family and social situations are well established suicide risk factors (Zalsman et al., 2016). Recent findings also showed the correlation between sleep disturbances and suicidality from a clinical point of view (Pompili et al., 2013). Including protective factors in suicide risk management might be of great interest. However, prevention strategies often exclude form the preventative procedure an essential preventative component of patients social network: the caregiver (Mann et al., 2005). Indeed, studies showed the potential positive impacts of caregivers in the management of important suicide risk factors as depression (Joling et al., 2012), and social isolation (Chatterjee et al., 2014).