An Exploration of Suicidal Ideation Presentations to Health services

Background: Suicidal ideation is a prominent presentation across mental health services. Presentations are both very complex and individual to each person. Services are under increased pressure to provide assessment and intervention for people experiencing suicidal ideation. Aims: This thesis explored suicidal ideation as a presentation to general emergency health services and mental health services. Method: Two related studies were completed. The first, a systematic review reporting on hospital presenting suicidal ideation. The systematic review of 27 relevant studies reports on the characteristics, medical history and medical treatment of people presenting to hospital with suicidal ideation. The second is comprised of a file audit including presentations to a mental health emergency service for the calendar year 2020 followed by explorative qualitative interviews with 10 service users presenting to mental health services for assessment of suicidal ideation. Results: The systematic review highlights the variability in presentations of suicidal behaviour and the limitations in relation to inconsistent assessment and treatment approaches. The file audit of the mental health service revealed the average age of presentations was 35.4, the gender split was 48.6% Male to 51.3% Female, the most prominent presenting complaint was low mood and suicidal ideation, 17% of people presenting with intermittent risk, 79% amount of people were directed to CMHT for further support and EUPD was the most common diagnosis given. The interview data identified five major themes with subthemes within them. 1. Complex presenting needs, 2. Interactions with staff, 3. Emotional experience of attending the service, 4. A missing piece – psychology or talk therapy, 5. Service limitations and recommendations. Conclusion: Evidence suggests there is a desire for additional services for people with suicidal ideation, specifically psychological therapies and trauma informed assessment and intervention. Future research could examine the role of suicide specific interventions in assessment and treatment of suicidality.