title: [Suicidality and alcohol abuse].
abstract: This article describes the role played by a patient's mental competency in the assessment and treatment of patients who are under the influence of alcohol and expressing suicidal thoughts. The factors that should be taken into consideration in the assessment of suicidality are not always clear: somatic complications or possible discharge from the emergency room. The treating physician at the emergency department should evaluate the mental competency. The risk of suicide should also be assessed by a psychiatrist. In order to make the right decisions about treatment and mental competency, the key concepts of proportionality, effectiveness and subsidiarity in the assessment of mental competency are crucial. These concepts require a personalized, multidisciplinary approach and result in unique decisions which may differ from case to case. In the assessment and treatment of patients under the influence of alcohol who are suicidal and do not want to have a proper medical evaluation, communication between the emergency physician, internist and psychiatrist is crucial to optimize both evaluation and treatment. In this context, tasks and responsibilities should be clearly defined in order to minimize the risk of errors and complications.
authors.affiliation: Tergooi, afd. Psychiatrie, Hilversum.
authors.forename: Joeri K
authors.initials: JK
authors.lastname: Tijdink
authors.forename: Yvo M
authors.initials: YM
authors.lastname: Smulders
authors.forename: Monique C H I
authors.initials: MC
authors.lastname: Biesaart
authors.forename: Christiaan H
authors.initials: CH
authors.lastname: Vinkers
mesh_terms: D000328:Adult; D000437:Alcoholism; D003299:Cooperative Behavior; D003419:Crisis Intervention / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008603:Mental Health; D010348:Patient Care Team; D011570:Psychiatry; D018570:Risk Assessment; D059020:Suicidal Ideation