- Disclaimer
- Recommended citation
- Acknowledgements
- Introduction - Suicide prevention and first aid
- Early detection of risk – Suicide and the relationship with mental disorders
- Talking about suicide and mental health issues
- Suicide prevention – Risk assessment in general practice
- Suicide prevention – Ongoing care for patients and self-care for GPs
- Suicide prevention and first aid resource tool kit
- Disclaimer
- Recommended citation
- Acknowledgements
- Introduction - Suicide prevention and first aid
- Early detection of risk – Suicide and the relationship with mental disorders
- Talking about suicide and mental health issues
- Suicide prevention – Risk assessment in general practice
- Suicide prevention – Ongoing care for patients and self-care for GPs
- Suicide prevention and first aid resource tool kit
Beginning a conversation about suicide
Research shows that the relationship between the GP and the patient can often be one of the most important factors in reducing self-harm ideation – for example, the GP demonstrating empathy and a willingness to discuss emotional concerns.18
Make reassuring statements like:
‘It’s my job to make sure you’re doing OK. I have some concerns that things might not be going so well for you at the moment. Is it OK if we have a bit of a chat about how you are?’
Sometimes it can be daunting asking difficult questions about suicide and mental illness for fear of prying, upsetting the person, stigmatising your patients9 or putting ideas in their head. However, the first step to supporting people considering suicide is to begin a conversation about it. By being calm, non-judgemental and empathetic, a GP provides an opportunity for a client to discuss their suicidal thoughts. They can be encouraged to tell their story, outline their stresses, provide information about their history, and describe their current suicidal thoughts.
While everyone has their own personal communication style, being direct when asking about suicide is imperative. Information about the frequency and intensity of the suicidal thinking, history of suicidal behaviour, current plans, overall mental state, and level of support will inform the overall level of risk and the subsequent management plan required.
Some example questions are highlighted below.
What to ask
- Do you ever feel like giving up?
- How does your future seem to you?
- Does your life ever seem so bad that you wish to die?
- How often do you have these thoughts? How intense are they?
- Have you made any plans? If so, what have you been thinking about?
- How close have you come to doing something?
- What stops you from doing something?
References
- Lampe L, Fritz K, Boyce P, et al. Psychiatrists and GPs: Diagnostic decision making, personality profiles and attitudes toward depression and anxiety. Australas Psychiatry 2013;21(3):231–37.
- Almeida OP, Pirkis J, Kerse N, et al. A randomised trial to reduce the prevalence of depression and self-harm behavior in older primary care patients. Ann Fam Med 2012;10(4):347–56.