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Journal Article

Citation

Xanthopoulou P, Ryan M, Lomas M, McCabe R. Crisis 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, International Association for Suicide Prevention, Publisher Hogrefe Publishing)

DOI

10.1027/0227-5910/a000786

PMID

unavailable

Abstract

BACKGROUND: In the United Kingdom, suicide risk is assessed in the emergency department (ED) in a face-to-face assessment with psychiatric liaison practitioners. This study aimed to explore patient experiences of psychosocial assessment after presenting with self-harm/suicidality.

METHOD: A total of 28 patients were interviewed within 2 weeks of ED attendance for self-harm/suicidality. Interviews were transcribed and analyzed using inductive thematic analysis.

RESULTS: People described two different experiences. A therapeutic interaction was about the "person" and made people feel their life mattered and instilled hope for the future. This was characterized by: unscripted conversation; warmth promoting disclosure; psychological exploration of feelings; validation of distress; and a coproduced care plan. A formulaic assessment was about the "risk" and made people feel their life did not matter and hopeless about the future. This was characterized by: feeling judged and not worthy of help; a focus on risk and form filling; a trivial treatment plan; and loss of trust in services. Limitations: Our study comprised a single ED and used a non-diverse sample.

CONCLUSION: Psychosocial assessment in the ED impacts on hope for people in crisis. A focus on therapeutic communication that is about the person, as well as the risk, improves patient experience, decreases distress, and instills hope that life is worth living.


Language: en

Keywords

emergency department; suicide; self-harm; liaison psychiatry; psychosocial assessment

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