TY - JOUR
T1 - Hearing the Suicidal Patient's Emotional Pain
T2 - A Typological Model to Improve Communication
AU - Dunkley, Christine
AU - Borthwick, Alan
AU - Bartlett, Ruth
AU - Dunkley, Laura
AU - Palmer, Stephen
AU - Gleeson, Stefan
AU - Kingdon, David
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Escaping from emotional pain is a recognized driver in suicidal patients' desire to die. Formal scales of emotional pain are rarely used during routine contact between patients and their care team. No study has explored facilitators and inhibitors of emotional pain communication between staff and suicidal patients during regular care. Aims: To identify factors impeding or facilitating emotional pain communication between patients at risk of suicide and mental health professionals. Method: Nine patients with a history of a medically serious suicide attempt and 26 mental health (NHS) staff participated in individualized and focus group interviews, respectively. Results: A typological model was created, describing how patients either speak out or inhibit communication, and professionals may hear the communication or fail to do so. Four permutations are possible: unspoken/unheard, spoken/unheard, spoken/heard, and unspoken/heard. We found 14 subthemes of impediments and facilitators, which include misaligned, alienated and, co-bearing. Limitations: No male patients participated. Conclusion: Numerous factors influence whether emotional pain communication is responded to, missed, or ignored. Patients may try more than one way to communicate. Some patients fear that being able to speak out results in their emotional pain being taken less seriously. Knowledge of this model should improve the care of suicidal patients.
AB - Background: Escaping from emotional pain is a recognized driver in suicidal patients' desire to die. Formal scales of emotional pain are rarely used during routine contact between patients and their care team. No study has explored facilitators and inhibitors of emotional pain communication between staff and suicidal patients during regular care. Aims: To identify factors impeding or facilitating emotional pain communication between patients at risk of suicide and mental health professionals. Method: Nine patients with a history of a medically serious suicide attempt and 26 mental health (NHS) staff participated in individualized and focus group interviews, respectively. Results: A typological model was created, describing how patients either speak out or inhibit communication, and professionals may hear the communication or fail to do so. Four permutations are possible: unspoken/unheard, spoken/unheard, spoken/heard, and unspoken/heard. We found 14 subthemes of impediments and facilitators, which include misaligned, alienated and, co-bearing. Limitations: No male patients participated. Conclusion: Numerous factors influence whether emotional pain communication is responded to, missed, or ignored. Patients may try more than one way to communicate. Some patients fear that being able to speak out results in their emotional pain being taken less seriously. Knowledge of this model should improve the care of suicidal patients.
KW - communication
KW - emotional pain
KW - qualitative
KW - risk
KW - suicide
UR - http://www.scopus.com/inward/record.url?scp=85047503307&partnerID=8YFLogxK
U2 - 10.1027/0227-5910/a000497
DO - 10.1027/0227-5910/a000497
M3 - Journal article
C2 - 29256270
AN - SCOPUS:85047503307
SN - 0227-5910
VL - 39
SP - 267
EP - 274
JO - Crisis: The Journal of Crisis Intervention and Suicide Prevention
JF - Crisis: The Journal of Crisis Intervention and Suicide Prevention
IS - 4
ER -