Suicidal behavior at the beginning of the mental disorders: despair vs hope

In the comments, the discussion of organizational and clinical-social problems of identifying and managing patients in the debut of mental disorders (e.g., schizophrenia) was continued and the need for the development of special (target) therapeutic and prophylactic programs based on the multidisciplinary team biopsychosocial approach as an evidence-based antisuicidal (protective) factor. The programs include a long (≥ 1 year) pharmacotherapy (drugs of choice with an optimal risk / benefit ratio, e.g., atypical antipsychotics and antidepressants of the new generation) and psychosocial work with patients and their families involving self-help groups and the peer support of trained volunteers with successful experience in overcoming the disease and crisis conditions. It is necessary to monitor the risk of suicidal behavior, depression, and clinical efficacy at consistent stages of treatment and prevention on a routine basis.