Your patient is a 40-year-old male who is threatening suicide. What should you ask or say to this patient?

Asking a patient if they have given any thought to how they might end their life is crucial for several reasons. This question helps to assess the immediacy and specificity of their suicidal thoughts, which is vital in determining the level of risk and the appropriate medical intervention. It opens the door for the patient to share their feelings and intentions without judgment, allowing for a more in-depth understanding of their mental state.

This inquiry can lead to critical insights into the patient's plan, means, and timeframe, which are important factors in evaluating the seriousness of their suicidal ideation. It also conveys to the patient that their feelings are being taken seriously and that the responder is equipped to engage in a deeper dialogue about their mental health needs.

In contrast, other responses may not effectively promote communication or address the patient's immediate needs. Asking why they feel a certain way might come across as confrontational or dismissive, which could inhibit open dialogue. Suggesting that the patient should talk to someone else could minimize their current distress, making them feel unsupported. Stating that it's not worth it and bringing family into the conversation can induce guilt or shame rather than providing the empathic support the patient may require at that moment.