Recent clinical encounters for suicidal thoughts and behaviours: Disclosure, assessment, missed opportunities, and...

Many individuals who die by suicide have contact with healthcare services in the months preceding their death, making these interactions critical opportunities for identification, intervention, and support. However, little is known about how individuals experiencing suicidal thoughts and behaviours (STBs) perceive recent clinical encounters, including how these experiences are discussed and managed.

Australian adults (N = 266; M_age = 32.9; range = 18-71 years) who had experienced STBs and consulted with a mental health professional within the past two weeks completed an online survey examining suicide-related enquiry, disclosure experiences, clinician responses, and satisfaction.

Psychologists were the most commonly consulted clinicians (49.2%), and 90.8% reported having seen the same clinician previously. Although 95.7% of participants considered discussing their STBs at least somewhat important, only 67.9% reported discussing these experiences with clinicians. Among those who did not discuss STBs, 50.0% reported that they had not been asked. Participants also reported that clinicians more frequently enquired about general emotional wellbeing (80.6%) than directly about STBs (55.3%). Among participants who did discuss STBs, 52.1% reported withholding information, while 46.2% reported feeling hesitant to disclose. Safety planning (36.9%) and follow-up (37.4%) were reported infrequently despite being viewed as important and helpful. Nevertheless, 75.4% reported being satisfied with their recent interactions.

Despite generally positive experiences with these interactions, the findings highlight opportunities to strengthen suicide prevention by creating opportunities to discuss STBs beyond initial clinical encounters, supporting disclosure through compassionate care, and ensuring that suicide-specific care is provided where appropriate following identification.