A discourse analysis of suicide ideation assessment among first year health professional students enrolled in a communications course

Abstract

Background: Suicide risk assessments require a complex set of skills around a sensitive matter which can be difficult for providers. Aim: Research investigating communication techniques and the language choices used to assess for suicide ideation is limited. Methods: We analyzed 121 video-recorded and transcribed final exams from a communication skills course for first year health professional students to identify patterns and variation in the language choices made to assess for suicidal ideation in standardized patients exhibiting symptoms of depression.  Results: We found that 66 of the 121 (55%) interviews included a suicide assessment. We noted key patterns and variation around when the assessments took place (while exploring depressive symptoms or as a topic shift), how they were prefaced (with ubiquity statements, normalization statements, or expressions of care and concern), and how the question itself was structured (with a negative preference structure, in a non-polar format, or ambiguously). Conclusions: Assessing for suicide is a delicate task for both patients and providers, both of whom may be reluctant to engage around the topic. Utilizing normalization statements as well as statements of care and concern is a good approach to assess suicide idation while exploring depressive symptoms.