Secondary Suicide Prevention as Neuro-Rehabilitation
Author(s): Valach Ladislav
Neuro-rehabilitation and suicide prevention used to be linked together mostly as preventing suicidality in neuro-rehabilitation patients after, e.g., brain injury. However, we propose that the recent changes in neuro-rehabilitation, on the one hand, and in the suicide conceptualization, on the other, suggest the possibility of using some of the principles of neuro-rehabilitation in suicide prevention. The changes in neuro-rehabilitation include the integration of cognitive processes in motor processes [1, 2] and stressing the bottom-up in contrast to top-down procedures suggested by cognitive behavioral therapy. The changes in suicide conceptualization include the view of suicide as a distorted goal-directed action. The secondary suicide prevention procedure linked equally to neuro-rehabilitation as to psychotherapy is a consequent conceptualization of this process as a joint goal-directed action and project, using the video self-confrontation as an action experiencing procedure including mentalizing  and the video-self-confrontation with the integration of alternative action and action steps to revise the target actions and project . Finally, a reminder in the form of a postal nudge to follow the joint life-enhancing project rounds up the secondary suicide preventive procedure. The development of professional and scientific disciplines, as well as treatment and health services is driven by their contribution to the target aims, but it also is a social process with its own institutions and professional identities that sometimes hinder a cross disciplinary fertilization. We would like to suggest that we should consider enriching the secondary suicide prevention by neuro-rehabilitation. This cross-fertilization becomes meaningful when we acknowledge the changes in each discipline. Thus, we briefly outline some of the changes in neuro-rehabilitation, in the suicide conceptualization, and in secondary suicide prevention before summarizing the secondary suicide prevention procedure encompassing some of the neuro-rehabilitation views.