As part of a wider study of young suicide attempters' unmet service needs, a suicidal woman diagnosed as catatonic schizophrenic told her story in a state mental hospital. Her account in this case study revealed much about her life history, suicide career, problems of living, needs for help, and perceptions of relevant systems. The patient's diagnosis and readmissions seemed inappropriate. Regarded as a chronic schizophrenic, she experienced therapeutic nihilism in the hospital and benign neglect in the community. Accepting the expectation of not getting well reinforced helplessness and hopelessness. A proposed model would use parts of the patient's story for preventive intervention regarding suicidal behavior and improving her social competence, social networks, and support systems. A starting point could be her eating disorder, obesity, derogatory self-image, and related substance abuse and psychological problems. Patient perceptions of needs and priorities can help systems involved plan and deliver appropriate services.
