During an assessment in the emergency department, a patient with a history of depression casually mentions that 'things would be easier for everyone if I wasn't around anymore.' Which of the following responses by the nurse demonstrates the best approach to further assess the patient's risk for suicide?
Assess the patient for current substance use as it often coexists with suicidal thoughts
Ask the patient, 'Do you have thoughts of harming yourself or suicide?'
Inform the patient that such thoughts are common and advise them to stay positive
Immediately contact a psychiatrist, as this statement infers a high risk for suicidal ideation
The correct response is to ask the patient directly about suicidal thoughts. Direct and open-ended questions such as inquiring whether the patient has thoughts of self-harm or suicide allows for an honest dialogue and a clear assessment of the patient's mental state. Avoiding the subject, being judgmental, or speaking in euphemisms may suppress important information. While contacting a psychiatrist and assessing for substance use are important, they should come after clarifying the patient's self-harming intentions.
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Mental Health Emergencies
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