Suicidal Ideation in the Palliative Care Patient: Considerations for Health Care Practice

Abstract

For the clinician who works in a palliative health care setting, the suicidal ideation of palliative care patients is a challenge. How are patients with a life-limiting illness who wish to hasten their death, and who express this suicidal ideation, understood in the context of Palliative Care? The present article is a systematic literature review of published research to determine how this issue has been addressed in palliative care and the implications for social work practice. Because suicidal ideation and depression tend to be undertreated in the medically ill, the article examines whether there may, indeed, be barriers in the psychosocial environment of care for palliative patients. Attention was paid to determine how suicidal ideation has been variously interpreted and whether it has been linked to hopelessness. Of the relevant studies, which were primarily from leading services in the field, there is little evidence of approaches to suicidal ideation in palliative care to improve mental health outcomes for patients.

Keywords:

• Suicidal Ideation
• Hopelessness
• Palliative Care

Acknowledgements

This paper was made possible by a Palliative Care Clinical Research Fellowship under Associate Professor Richard Chye, Area Director of Palliative Care, Eastern Sydney. The author acknowledges the Sacred Heart Palliative Care Service, St Vincents’ Hospital Sydney, the Palliative Care Social Workers, and the patients and families they serve. The author is grateful to the reviewers for their thoughtful comments and also thanks Dr Lindsey Napier, Faculty of Education and Social Work, The University of Sydney, for her ongoing support.