Asking about self-harm and suicide in primary care

Share this post

We’ve been reading a very useful report about the sensitive topic of asking about suicide and self-harm when a patient is in primary care. You can read the full report from Ford et al here and we have pulled out some of the key points below.

1. When asking about self-harm or suicide, the wording of the clinician’s question is very frequently framed for a “no” response.

For example, they may ask, “You’re not having any thoughts of harming yourself or suicide or anything like that?” This can make it difficult for service users to answer “yes”.

2. The wording of the question can affect not only the service user’s immediate response (i.e. “no” versus “yes”), but the trajectory of the entire interaction.

For example, when service users answer negatively – even when their negative response is delayed, hesitant, or ambiguous – clinicians tend not to pursue further discussion on the topic.

3. Service users who answer “yes” when asked about thoughts of self-harm or suicide often downplay the seriousness of their thoughts.

It’s unclear why this is, but it is likely related to both the negative framing of the clinicians’ questions and/or the stigma associated with self-harm and suicide.

4. Clinicians often focus their questions on the risk assessment of actions and behaviours.

The level of distress caused by thoughts of self-harm is not typically addressed or acknowledged.

More news to explore

Young adults sitting on a wall
Storm News

Loneliness and self-harm in adolescents during lockdown serious concerns about a student’s safety or mental health

September saw the publication of the results of a survey of 10,000 secondary school pupils. The OxWell School Survey is a repeated cross-sectional, self-report survey on children and adolescents’ mental health and well-being, commencing in 2019. The 2020 survey was completed during June-July either on school premises or from home due to partial school closures during the first COVID-19 UK national lockdown.

Read More »
Young Adult walking through Library
Storm News

Universities to involve trusted contacts when there are serious concerns about a student’s safety or mental health

Universities UK (UUK), in partnership with PAPYRUS Prevention of Young Suicide, has published recommendations calling on universities to be more proactive in preventing student suicides. Suicides in student populations is relatively rare, as with any death by suicide it has a large impact. The new guidance sets out how and when universities should involve families, carers, and trusted others when there are serious concerns about the safety or mental health of a student.

Read More »
STORM Skills Training logo - Suicide prevention training for the frontline
Striving towards a more collaborative and inclusive approach to suicide prevention.

Join the STORM® Community

Subscribe to receive our quarterly newsletter and other occasional updates straight to your inbox.

View our Privacy Policy

© 2020 STORM® Skills Training CIC (Company number 07726889)