section_path: Prevention/Treatment of mental illness
section_name: Treatment of mental illness
paragraph_text: Treatment of mental illness
  
  In those with mental health problems, a number of treatments may reduce the risk of suicide. Those who are actively suicidal may be admitted to psychiatric care either voluntarily or involuntarily. Possessions that may be used to harm oneself are typically removed. Some clinicians get patients to sign suicide prevention contracts where they agree to not harm themselves if released. However, evidence does not support a significant effect from this practice. If a person is at low risk, outpatient mental health treatment may be arranged. Short-term hospitalization has not been found to be more effective than community care for improving outcomes in those with borderline personality disorder who are chronically suicidal.
  
  There is tentative evidence that psychotherapy, specifically dialectical behaviour therapy, reduces suicidality in adolescents as well as in those with borderline personality disorder. It may also be useful in decreasing suicide attempts in adults at high risk.
  
  There is controversy around the benefit-versus-harm of antidepressants. In young persons, some antidepressants, such as SSRIs, appear to increase the risk of suicidality from 25 per 1000 to 40 per 1000. In older persons, however, they may decrease the risk. Lithium appears effective at lowering the risk in those with bipolar disorder and major depression to nearly the same levels as that of the general population. Clozapine may decrease the thoughts of suicide in some people with schizophrenia. Ketamine, which is a dissociative anaesthetic, seems to lower the rate of suicidal ideation. In the United States, health professionals are legally required to take reasonable steps to try to prevent suicide.