- •Passive suicidal ideation (SI) is described in the literature as death ideation, ranging from believing life is not worth living to thoughts of, or desire for, death.
- •Nurse practitioners in primary care settings are front-liners to screen, evaluate, and manage older adult patients suffering from passive suicidal ideation.
- •The response and ongoing management of individuals with SI depend on determining their risk level.
This case study presents the diagnosis and treatment of an older adult with depression and passive suicide ideation (SI). While treating depressed patients at risk for suicide, family nurse practitioners must stay grounded in patient data related to medications, ideally using the patient’s psychiatric condition (ie, depression with suicidal risk) as the separate and appropriate target of clinical intervention, and discuss the risks and benefits of medications targeting both conditions with the patient. The response and ongoing management of individuals with passive SI depend on determining their risk level.
Abbreviations:SI (suicide ideation), PCPs (primary care providers)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The Journal for Nurse Practitioners
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Suicide mortality in the United States, 2000–2020.NCHS Data Brief. 2022; : 1-8
- Provider opinions of the acceptability of Ask Suicide-Screening Questions (ASQ) Tool and the ASQ Brief Suicide Safety Assessment (BSSA) for universal suicide risk screening in community healthcare: Potential barriers and necessary elements for future implementation.J Behav Health Serv Res. 2022; 49: 346-363
- Clinical pathway for suicide risk screening in adult primary care settings: special recommendations.J Acad Consult Liaison Psychiatry. 2022; 63: 497-510
- Assessing suicidality in real time: a psychometric evaluation of self-report items for the assessment of suicidal ideation and its proximal risk factors using ecological momentary assessments.J Abnorm Psychol. 2018; 127: 758-769
- Personality and suicidal behavior in old age: a systematic literature review.Front Psychiatry. 2018; 9: 128
- Suicide risk in primary care: identification and management in older adults.Curr Psychiatry Rep. 2014; 16: 1-8
- Practical suicide-risk management for the busy primary care physician.Paper presented at Mayo Clinic Proceedings. 2011;
- Primary care assessment of patients at risk for suicide.JAAPA. 2015; 28: 35-39
- COVID-19: the implications for suicide in older adults.Int Psychogeriatr. 2020; 32: 1225-1230
- Suicide attempts among adults denying active suicidal ideation: an examination of the relationship between suicidal thought content and suicidal behavior.J Clin Psychol. 2022; 78: 1103-1117
- Characterizing the phenomenology of passive suicidal ideation: a systematic review and meta-analysis of its prevalence, psychiatric comorbidity, correlates, and comparisons with active suicidal ideation.Psychol Med. 2020; 50: 367-383
- Mental health distress in homebound older adults: importance of the aging network.Aging Ment Health. 2021; 25: 1580-1584
- The impact of the COVID-19 pandemic on suicide rates.QJM Int J Med. 2020; 113: 707-712
- Universal suicide risk screening: views of rural adults on acceptability and implementation in primary care.Gen Hosp Psychiatry. 2021; 71: 102-107
- Older adult suicides: What you should know and what you can do.Home Healthc Now. 2020; 38: 124-130
- Attitudes, practices, and barriers to adolescent suicide and mental health screening: a survey of Pennsylvania primary care providers.J Prim Care Commun Health. 2012; 3: 29-35
Davis M, Siegel J, Becker-Haimes EM, et al. Identifying common and unique barriers and facilitators to implementing evidence-based practices for suicide prevention across primary care and specialty mental health settings. Arch Suicide Res. 2021 October 15:1-23.
- Patient health questionnaire depression scale as a suicide screening instrument in depressed primary care patients: a cross-sectional study.Prim Care Companion CNS Disord. 2011; 1327081
- Identification of suicidal ideation and prevention of suicidal behaviour in the elderly.Drugs Aging. 2002; 19: 11-24
- Older adults.in: Stahl’s Handbooks: Suicide Prevention. Cambridge Univesity Press, 2021: 245-253
- Understanding vulnerability to late-life suicide.Curr Psychiatry Rep. 2021; 23: 1-9
- Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Spplications.Cambridge University Press, 2013
- Internet-based CBT for patients with depressive disorders in primary and psychiatric care: is it effective and does comorbidity affect outcome?.Internet Interv. 2020; 19100303
- The development of a brief psychodynamic protocol for depression: dynamic interpersonal therapy (DIT).Psychoanal Psychother. 2010; 24: 329-346
- Veteran suicide risk reduction: a recommendation for practice.J Nurse Pract. 2021; 17: 579-581
Reimund Serafica, PhD, PMHNP-BC is an associate professor at the School of Nursing, University of Nevada, Las Vegas, NV and can be contacted at [email protected]; Benito Calderon, MD is with Calderon Medical Group, Las Vegas, NV Timothy Grigsby, PhD is an assistant professor at the School of Public Health, University of Nevada, Las Vegas NV.
In compliance with standard ethical guidelines, the author reports no relationships with business or industry that would pose a conflict of interest.
Published online: February 03, 2023
© 2022 Elsevier Inc. All rights reserved.