Severe Suicidality

Severe suicidality refers to the presence of acute or persistent suicidal ideation, intent, or behavior associated with significant risk of self-harm. It may occur in the context of mood disorders, psychotic disorders, substance use, trauma-related conditions, or other severe psychiatric or medical illnesses. Severe suicidality requires timely, comprehensive, and coordinated intervention to ensure patient safety and stabilize symptoms.

Patients with severe suicidality may present with:

  • Active suicidal ideation with intent or plan
  • Recent suicide attempts or escalating self-harm behaviors
  • Persistent suicidal thoughts despite ongoing treatment
  • Severe depressive, mixed, psychotic, or agitated states
  • Impaired judgment, hopelessness, or inability to engage in safety planning

Our Approach to Severe Suicidality

At the UTHealth Houston Center for Interventional Psychiatry, severe suicidality is managed as a clinical emergency requiring rapid assessment and decisive intervention. Care is guided by a matched-care framework that prioritizes safety, accurate diagnosis, and timely access to effective treatments.

Evaluation includes:

  • Comprehensive suicide risk assessment
  • Review of psychiatric history, prior treatment response, and recent stressors
  • Assessment of medical and psychiatric comorbidities
  • Determination of the most appropriate level of care to ensure safety

Patients with acute or high-risk suicidality are typically treated in inpatient psychiatric settings, where continuous monitoring and intensive intervention are available. Level-of-care decisions are reassessed frequently as clinical status evolves.

Treatment Options

Treatment for severe suicidality is individualized and may include:

  • Intensive medication management targeting underlying psychiatric illness
  • Psychotherapeutic interventions focused on crisis stabilization and safety
  • Interventional and rapid-acting treatments, when clinically indicated, including:
    • Electroconvulsive Therapy (ECT)
    • Ketamine- or esketamine-based treatments

These interventions may be considered when rapid symptom reduction is critical or when standard approaches have been insufficient.

Continuity and Risk Reduction

Following stabilization, care emphasizes ongoing risk assessment, continuity of treatment, and relapse prevention. Patients may transition to partial hospitalization, intensive outpatient, or outpatient services with structured follow-up and safety planning.

Through comprehensive evaluation, evidence-based treatment, and coordinated care across levels of service, the Center seeks to reduce suicide risk and support recovery for individuals experiencing severe suicidality.