Comprehensive exams for Mental Health Q 170
Jun has been hospitalized for major depression and suicidal ideation. Which of the following statements indicates to the nurse that the client is improving?
A. “I’m of no use to anyone anymore.”
B. “I know my kids don’t need me anymore since they’re grown.”
C. “I couldn’t kill myself because I don’t want to go to hell.”
D. “I don’t think about killing myself as much as I used to.”
Correct Answer: D. “I don’t think about killing myself as much as I used to.”
The statement “I don’t think about killing myself as much as I used to.” indicates a lessening of suicidal ideation and improvement in the client’s condition. Suicidal ideation is highly linked to completed suicide. Some inexperienced clinicians have difficulty asking this question. They fear the inquiry may be too intrusive or that they may provide the person with an idea of suicide. In reality, patients appreciate the question as evidence of the clinician’s concern. A positive response requires further inquiry.
Option A: Determine what the patient believes his or her suicide would achieve. This suggests how seriously the person has been considering suicide and the reason for death. For example, some believe that their suicide would provide a way for family or friends to realize their emotional distress.
Option B: Others see their death as a relief from their own psychic pain. Still others believe that their death would provide a heavenly reunion with a departed loved one. In any scenario, the clinician has another gauge of the seriousness of the planning. A clear and complete evaluation and clinical interview provide the information upon which to base a suicide intervention. Although risk factors offer major indications of the suicide danger, nothing can substitute for a focused patient inquiry.
Option C: A host of thoughts and behaviors are associated with self-destructive acts. Although many assume that people who talk about suicide will not follow through with it, the opposite is true; a threat of suicide can lead to the completed act, and suicidal ideation is highly correlated with suicidal behaviors.