As practice shows, therapists working online have to deal with various crisis situations, including receiving information about patients’ suicidal thoughts. Sometimes the intervention of emergency services and the police doesn’t run smoothly, which one therapist had recently experienced. Thankfully, no tragedy occurred, but it raised suggestions of serious improvement needed in preparing services for such situations. The Ministry of Health reports that work is currently underway to develop standards for dealing with people in suicidal crisis for various groups and institutions. However, changes may be needed much quicker than planned. Emergency and police workers across the country operate according to current regulations.
In recent years, the importance of online therapy has increased. It happens that a therapist, conducting an online session, is conversing with a person who is contemplating suicide. Sometimes the patient is completely alone, having nobody nearby to prevent them from this act. This poses a huge challenge to the therapist. Simply continuing the conversation isn’t enough. The situation needs to be reported to the police and emergency services, usually through mediators.
“Unfortunately, situations wherein patients express suicidal thoughts are not uncommon. It happens both during and after the therapy session. It is crucial for therapists to be prepared to manage such situations and take appropriate actions to ensure patients’ safety. This is something that cannot be fully foreseen in therapy work. Therefore, as specialists, we should always be prepared for such circumstances,” comments Patryk Rzepka, an expert from the psychotherapy platform Risify.pl.
Recently, one therapist had just such a case, and not everything worked as expected. At 15:00, Miss Alexandra informed her Customer Service Office about a crisis situation that occurred during online therapy. The decision was made that the therapist would stay in contact with the client, while the CSO staff would get in touch with the appropriate services. At 15:04, a call was made to 999, giving the patient’s address and phone number. The dispatcher from the ambulance service informed that an ambulance would arrive in ten minutes. At 15:38, the therapist passed on to her superiors that no help had arrived yet. She also added that the police had contacted the patient by phone but had misheard her name.
“Four minutes later, there was another connection to 999. This time, the dispatcher informed that the medical rescue team couldn’t enter the apartment itself. It had to be done by the police. In addition, the dispatcher from the big city handed the matter over to the dispatcher responsible for the county. The dispatcher only had information that the notification had been processed and directed to the command that should know more details. It managed to get through at 15:59 and it turned out that the police intervention happened at a different address and was mislabelled as complete. A patrol from another municipality was then dispatched to the correct place,” informs Patryk Rzepka.
The expert from the Risify.pl psychotherapy platform reports that around 16:10, someone close to the patient arrived. The police officers appeared at her home at 16:33 and talked to her. Continuously, the therapist kept contact with the patient until the officers arrived.
“I think such delays in the actions of the police and emergency services or problems in communication between them shouldn’t take place. In the future, procedures might be introduced that would facilitate faster identification of warning signals and better cooperation between services and therapists. For instance, we conduct regular additional training for therapists in crisis management, which prepares them for situations requiring immediate intervention. This helps us to operate efficiently in such difficult circumstances, but without the appropriate response from the services, our actions often become ineffective,” states the expert from Risify.pl.
The Ministry of Health assures that it does not receive information about situations wherein the patient reports suicidal thoughts to the therapist. At the same time, the ministry mentions the implementation of the National Health Program for 2021-2025. Within its framework, the Institute of Psychiatry and Neurology in Warsaw have been entrusted with the task. This includes (with the participation of suicidologists and public health specialists), updating, disseminating, and monitoring the implementation of standards for dealing with suicide risk behaviors directed at appropriate groups and institutions. Preliminary standards for dealing with people in suicidal crisis have been developed for primary health care, addiction psychotherapists, and medical rescue teams. The final stages of work are currently underway to set standards for dealing with the risk of suicide attempts, among others, for uniformed services (e.g., police), teachers, educational specialists, social workers, and clergy.
“These are key actions aimed at ensuring that all these groups are properly prepared to recognize and respond to suicidal behaviour warning signals. They will contribute to preventing these situations. The Institute of Psychiatry and Neurology is scheduled to submit the developed standards to the Ministry of Health by January 15, 2026. Additionally, training materials and other necessary guidelines for implementation will be created for specific groups,” stresses the Ministry of Health.
Robert Judek, Director of the Provincial Emergency Medical Station in Poznań, draws attention to the act on the State Medical Rescue. Under this Act, the system units provide medical assistance outside the hospital to people in an urgent health threat. It can take different forms, such as a stroke, heart attack, traffic accident, but also a suicide attempt. The Minister of Health approves the plans for the Medical Rescue system under the supervision. Each province develops a plan detailing the provision of rescue services in the region.
“In Krakow, a call usually gets through to the Medical Dispatcher Office, part of the Lesser Poland Voivodship Office. It’s a separate institution, not part of the ambulance station. The dispatcher collects medical interview and other necessary information from the reporter and decides whether to send a medical rescue team. Depending on the situation, they may also direct other services, like the police or fire service, to the scene simultaneously,” explains Joanna Sieradzka, the press spokesperson of the Kraków Ambulance Service.
Robert Judek emphasizes that the leader of a medical rescue team performs medical rescue activities for a person who reports a suicide attempt, according to current knowledge in the field of emergency medicine. Each situation should be assessed individually based on numerous factors, which the medical rescue team will encounter at the scene.
“Upon arrival, the team knocks or rings the apartment or house of the patient and tries to make contact. They have the duty to ask him if he needs help and if he consents to examination and the provision of medical rescue activities, including transport to the hospital. If the patient does not open the door, and it is impossible to contact him, it can be assumed that he is unconscious and in danger to his health and life. Then, forced entry should be considered. The decision on such a solution is always made by the police,” adds Joanna Sieradzka.
The Police Head Command informs that police officers always take prompt actions focused on saving the life and health of those who need it. However, each situation and intervention are different. The circumstances of a particular case determine the need for individual adaptation of the adopted action methods. This can involve cooperation with the State Fire Brigade to break open the door when there is no other way into the apartment and the circumstances indicate a life-threatening situation.
“It’s impossible to define a single, unified method of action in such situations during online therapy. Police negotiators are also directed to the scene of similar events, who have the necessary preparation to engage in conversation with a person in a suicidal crisis. For police officers, the person is always the most important, and only the well-being of such individuals guides the officers,” concludes Asp. Szt. Aleksandra Laskowska from the Police Head Command.
Source: https://managerplus.pl/terapeuci-konieczne-zmiany-w-procedurach-interwencji-policji-i-pogotowia-w-sytuacjach-zagrozenia-samobojczego-40250
