[Treatment plan for female adolescents in the grip of chronic suicidality]. / Behandelbeleid bij vrouwelijke adolescenten gegijzeld door chronische suïcidaliteit.

BACKGROUND: A psychological autopsy study (Mérelle e.a. 2020) demonstrates a subgroup of female adolescents with chronic suicidal behavior and severe internalizing problems. AIM: To describe characteristics of the suicidal process and the challenges experienced in providing mental health care for this subgroup. METHOD: A case description and review of literature. RESULTS: The persistent suicidal threat and the following despair of the patient and its parents are forcing care providers into an impasse: the primary focus of treatment is to guarantee the patient's safety, whereby the treatment of underlying problems is underexposed. Based on expert knowledge we make recommendations including autonomy-promoting treatment policy, treating suicidality as a transdiagnostic phenomenon, creating a multidisciplinary network of care providers and making chronic suicidality tolerable for care providers. CONCLUSION: We propose preliminary practical recommendations in our quest for optimal mental health care for chronic suicidal adolescents.

[The best intervention for depression is early detection and prevention in youth]. / De beste behandeling voor depressie is vroegsignalering en preventie bij jeugdigen.

Background A more preventive and proactive approach in youth mental health care can contribute to reduce the severity of psychological problems in young people and help to reduce the risk on treatment resistance. Aim To show opportunities to organize youth mental health care more proactively. Method Discuss new approaches based on existing literature and examples from clinical practice. Results It is essential that young people receive treatment that is appropriate for the severity of their problems. Early detection and prevention can be systematically carried out in collaboration with public health service and schools. In addition, it is imperative that young people receive appropriate (specialized) mental health care based on their prognosis. Conclusion Committing to the right care at the right time is essential to prevent the development of co-morbidities, stagnation in development tasks and therapy resistance. Tijdschrift voor psychiatrie 63(2021)2, 111-114.