Messages of psychiatric patients who attempted or committed suicide

The stigma attached to suicide, and a qualitative analysis of psychiatric patients' suicide messages that emerged from a study of psychological characteristics and communications of suicidal psychiatric patients, are described. In this retrospective study, the suicide messages from clinical records of 25 suicide completers and a matched cohort of suicide attempters from a Veterans Affairs Medical Center were analyzed. A qualitative method developed by Leenaars in 1992 was used to examine themes in suicide messages. Analysis indicated that clear suicidal messages are sent by most psychiatric patients, and that some useful distinctions exist between messages of completers and attempters. Suicide messages offer worthwhile indicators of suicide that assist clinicians in their therapeutic and preventive roles. The themes of the psychiatric patients' suicide messages included unbearable psychological pain, interpersonal relations, and aggression-rejection. The present study enhances clinicians' recognition of themes in suicide messages and improves the estimation of suicide risk among psychiatric patients.