How do you approach assessing and managing a patient who expresses active suicidal thoughts but is ambivalent about hospitalization?

Specialty-Specific

Purpose

This question digs into your understanding of suicide risk and how you handle tough situations where a patient's safety is at stake but they’re unsure about getting help. Interviewers want to see if you can balance empathy with the need to act decisively.

Tips

  • Start by emphasizing that active suicidal thoughts are a medical emergency that needs immediate action.
  • Outline a clear risk assessment process, covering intent, plan, means, lethality, and both risk and protective factors.
  • Engage empathetically with the patient, acknowledging their fears while explaining the importance of safety and the rationale for any interventions.

Common mistakes

  • Don't downplay the seriousness of suicidal thoughts or the patient's ambivalence.
  • Avoid focusing only on patient autonomy without addressing immediate safety concerns.
  • Don't hesitate to involve supervisors or crisis teams; this isn't a situation to handle alone.