an upsetting chat

An upsetting chat

Nathaan Demers ‏@Doc_Demers 3h3 hours ago
We need protocols in primary care regarding MH & suicidal ideation. We flag pt records for med conditions- lets do the same for MH. #spsm

I came across this statement while going through the SPSM chat that goes on every Sunday on Twitter. What I find upsetting is that these suicide preventionists don’t realize that suicide and suicidal thinking are time limited. People who think of this in time of extreme distress are not going to think about it down the line. Now if they make an attempt, that is a different matter.

The way I see it, you can let the medical providers know that the patient has mental health issues. I am for that. But telling them they have suicidal ideation that won’t go on like pneumonia is just foolish. Sure you can document that the person had ideation but for what? So that some idiot insurance policy can deny claims because they were going through a tough patch and wanted to get out of it? To me, that is just perpetuating the stigma of suicide. If the patient attempted suicide, then that is cause for concern because the best indicator that we have right now is survived attempts leading to a death by suicide.

This isn’t the first chat that has called for the medical providers and mental health professionals to be working together. But once you place it in the patient’s chart, it’s there forever. You can’t erase it. More thought needs to go into this before I feel comfortable about my own thoughts going into my medical record. We’re not talking about a deathly reaction to penicillin. Those kind of things should of course be documented at every medical visit.

But passing suicidal thoughts that were thought of last week or last month or even ten years ago? Everyone has these thoughts. Not all go through with them. It’s the attempts that should be documented not the ideas if we want to save a life. Granted patients might be ashamed or embarrassed to bring up a failed attempt but it should be asked about. And again, this should all be done with dignity and respect and compassion. It shouldn’t be hurried and passed over once talked about. It should also be respected about the time. If the patient is currently have these thoughts they should be addressed. If it happened ten years ago and the patient is stable, then in my opinion, it should be documented but not be hounded and beaten to death. The crisis is over and dealt with. It’s what is going on now in the patient’s life that should matter, not the long ago past.

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