Screening and assessment of suicide risk in oncology

Résumé

The question for anyone involved in such a situation would be: "What went wrong?" The most important missteps were the failure to recognize suicide risk factors in a cancer patient and the failure to adequately explore the patient's thoughts about death and assess his intention to act on his thoughts. Had the professional done so, it might have been discovered that this patient had gone well beyond the exploration of death issues that usually occurs in cancer patients. The patient displayed several important risk factors for suicide in both cancer patients and the general population: a diagnosis of lung cancer, an older male confronting the first anniversary of the death of his spouse, the deaths of multiple other friends, and the perception of being burdensome to family and friends. These issues may have been addressed more openly if the individual had not been a cancer patient. Joiner suggests that clinicians often adopt an älarmist" position in assessing suicide risk. This position tends to be reversed with cancer patients, however, as depression is viewed as a normal response to their diagnosis and prognosis. The assessment guidelines discussed in this chapter are aimed to be neither älarmist" nor "dismissive", but to help clinicians accurately gauge risk of self-harm and suicide and work toward a treatment plan that can meet their patients' needs. The guidelines are followed by the description of a distress screening program that inquires about a patient's thoughts of suicide, suggests guidelines for the follow-up assessment of the patient's risk, and provides an appropriate intervention. (PsycINFO Database Record (c) 2015 APA, all rights reserved) CANCER DÉPISTAGE POTENTIEL-SUICIDAIRE ÉVALUATION-CLINIQUE RECOMMANDATION