Construction of suicidal ideation in medical records

Suicide Risk and Emotional Responses to Thoughts of Death: The Response to Morbid Ideations Questionnaire

BACKGROUND

There is need for deeper understanding of the processes by which suicidal thoughts lead to action. Examination of morbid ideation and the emotional sequelae of such ideation that may feed suicide ideation (SI) and attempts (SA) have been limited.

METHOD

Adult psychiatric outpatients (N = 385) were administered the Response to Morbid Ideation Questionnaire (RMI-Q) and measures of SI, suicidal thoughts and behaviors (STB), and other psychiatric symptom severity. We examined (1) incidence and prevalence in mentation of morbid ideations and emotional responses to these ideations, (2) differences in emotional responses between individuals of varying levels of suicide history, and (3) the relationships of different types of morbid ideations and emotional responses with concurrent SI and symptom severity.

RESULTS

Morbid ideation was reported by 87.5% of participants and associated with lifetime and concurrent levels of SI/STB. Calm/relieved emotional responses were associated with lifetime and concurrent levels of SI/STB, while negative-valence responses to morbid ideations were associated with concurrent severity of psychopathology.

CONCLUSIONS

Our results suggest that the role of morbid ideation and its emotional sequelae in the development of suicidal motivation and action deserves further attention and may be a treatment target for suicide risk reduction.

The construction of people in suicide prevention documents

Suicide is a significant issue worldwide and despite comprehensive prevention activities, suicide stigma remains. To explore this issue, we used critical discourse analysis to examine how Australian suicide prevention documents (n = 8) constructed people living with thoughts of suicide. We found that risk and biomedical discourses dominated, with people experiencing suicide ideation constructed as dangerous, different, lacking coping skills, and burdensome. We propose that future suicide prevention activities address potentially stigmatizing language, broaden support and advocacy options, and meaningfully include people with lived experience of suicidal ideation or behavior in the development of policy and interventions.