Videoconferencing for Family Therapy with Suicidal Older Adults Offers Post-Pandemic Opportunities

Hannah Heintz, BA

McLean Hospital
Videoconferencing for Family Therapy with Suicidal Older Adults Offers Post-Pandemic Opportunities

Scientific Abstract

Background: Early data suggest that elder suicide has increased during the pandemic due to high rates of social disconnectedness, desensitization by the media, and feelings of expendability. Treatment of suicidal older adults in inpatient settings must therefore address suicidality in a manner that reflects these dynamics.

Methods: We describe the use of videoconferenced family therapy for a suicidal individual nearing discharge from inpatient treatment. In this case, a 70-year-old man with MDD worsened by pandemic-related social isolation was hospitalized several times for a series of suicide attempts by overdose, receiving multiple medication trials and ECT. The unit’s restricted visitor policy led the treatment team to offer a Zoom family meeting prior to discharge, attended by the patient, his wife, and 3 children across several time zones.

Results: The videoconference platform offered several unique opportunities not possible on a phone conversation or in-person meeting. First, participants were able to see each other’s faces unmasked. Second, as his children reside internationally, attending an in-person meeting was not feasible. This virtual gathering facilitated the sharing of worry and despair in addition to compassion and hope. Afterwards, the patient called the meeting a “powerful experience”; he expressed pride at watching his children articulate themselves, compassion for his wife’s anxiety, and appreciation that all would be shattered by another attempt. He was discharged home a week after the meeting, and his depression and suicidality remitted for the 3 months post discharge.

Conclusions: The use of videoconferenced family therapy offers opportunity post-pandemic to facilitate reparative work with hospitalized suicidal individuals. Connecting face-to-face and unmasked with family members who would have otherwise been unable to attend in person provides opportunities to share powerful affect states, assess the patient’s proximity to baseline, and contribute to crisis planning. If more widely adopted, videoconferenced family meetings post-suicide attempt may mitigate risk and offer therapeutic potential for both patients and families.

Live Zoom Session – April 21st

research Areas

Authors

Hannah Heintz, BA, Alexis Freedberg, MD, Rahel Bosson, MD

Principal Investigator

Alexis Freedberg, MD