Abstract
Health professionals in the emergency departments are often faced with suicidal patients. This article discusses the challenges of suicide risk assessment and the problems of communication between suicidal patients and clinicians. In contrast to somatic disorders, where the natural course of an illness can usually be predicted, a prediction of a patient’s suicide risk is basically an impossible task. Mental disorders are suicide risk factors, which may indicate an increased long-term risk, but they do not help to assess short-term suicide risk. Because suicide and suicidal behaviours are inherently psychological, suicide risk assessment must be patient centred. Therapists and patients should collaboratively find an understanding of the patient’s suicidality, in particular of the triggers of suicidal behaviour. Studies show that narrative interviewing fosters a therapeutic alliance, and is related to a reduction of suicidal thoughts. Suicide risk should be explored collaboratively, with the suicidal person included as an active participant. This approach leads to a shared understanding of the patient’s suicidality and the adequate measures to be taken to ensure the patient’s safety.