Discussing the Topic of Suicidal Thoughts and Ideations

min read

Discussing suicidal thoughts and ideations with patients can be a daunting task. Suicide is a major public heath dilemma. It is one of the world’s most preventable leading causes of death. In recent years, treatment and prevention have been viewed primarily as a responsibility of mental health professionals; many people present symptoms and characteristics to their primary care physicians first.

Suicidal ideations are often misunderstood. Patients who express thoughts of or exhibit behaviors of ending their lives are often looking to escape the psychological strains they are experiencing. 

Consider the following questions for patients that may be at risk. 

Over the past two weeks, have you been bothered by:

  • Little interest or pleasure in going about your daily routine?
  • Feeling lonely, hopeless, depressed?
  • Have you felt any desire to harm yourself or others?

Next steps 

It is always better to do something rather than nothing when you have a patient that is considering harming themselves or others. If suicide ideations and thoughts have been expressed, the next steps should be to document this interaction and inform your patient of your duty to warn. Comfort your patient by letting them know that you hear them. In order to determine the level of care needed and to gain more insight to the depths of their situation a risk assessment is necessary.

If direct in-person questions are not comfortable for you, you could include them in the form of a written questionnaire. This allows you to bring up this topic with patients by incorporating self harm assessments and questionnaires as part of your  standard intake or appointment process.  

Adding three to five  questions on the subject of depression, anxiety, and suicidal thoughts could lead to an early intervention for an at-risk patient.

Clear Warning Signs

While every person who expresses thoughts of suicide will not make an attempt on their lives. Every threat should be taken seriously. Here are  signs that indicate need for require further evaluation and added support:

  • Unbearable physical/psychological pains
  • Extended periods of depression
  • Expressed feeling of hopelessness or having no reason to live
  • Feeling trapped or alone
  • Extreme mood swings

Ethical and legal responsibilities

After initial conversations or assessments, if the patient is determined to be at risk you should inform them of your "duty to warn" responsibility. Ethically and by law, if they present a threat to their life or someone else's it must be noted and reported. At this point you may share with your patient that you will determine the immediate and necessary steps to take.


Next Steps:

Determine your patient’s risk level and decide which resources you feel will benefit the patient most.


Low Risk Assessments 

Typically low risk patients should be connected with a licensed mental health provider through your custom url. 

SonderMind will streamline the process of direct personalized care for your patient. Average time from beginning process to first appointment is seven days. Urgent cases can typically be seen in 48 hours. 

Higher Risk Assessments

If your patient is in immediate danger to themself or someone else and determined to be high risk, the patient may need to be admitted to your local hospital for immediate treatment.

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