Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Guiding Principles/Assumptions in the Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour.
  • ‘Stigma of suicide’ can be defined as a negative attitude based on prejudice and misinformation that is triggered by a suicide or suicidal ideation or behaviour. Suicide, and suicidal ideation and behaviour is sometimes, but not always, linked to a mental illness. The presence of stigma is problematic because it leads to ongoing discrimination and marginalization with detrimental effects for clients, families and communities of people, including decreased self-esteem, increased isolation and vulnerability and, in the presence of a mental illness, a higher probability of relapse.
  • Suicide is an abrupt ending to life and the most extreme way in which people respond to overwhelming distress. The nurse needs to understand this from the perspective of the client and approach these actions in a non-judgmental and non-blaming way.
  • Nurses have a significant role in intervening when individuals express suicidal ideation and behaviour.
  • The goal of intervention is to reduce the risk of suicidal ideation and behaviour, and to promote the safety of the client, staff and others. Nurses cannot stop every death by suicide. Suicide is complex, and prevention cannot rest solely in the hands of a small group of people.
  • Establishment of a therapeutic relationship is fundamental to this work.
  • Excellence in relational practice takes into consideration issues of difference and cultural safety.
  • There are significant psychological and potentially physical impacts on the nurse when providing care for adults at risk for suicidal ideation and behaviour. The work environment must provide adequate supports for the nurse.
  • In treatment planning, the nurse considers factors that support mental health and wellbeing, keeping in mind determinants of health, including social and cultural factors. It is important to support internal strengths and self-esteem, and the development of emotional coping and life skills needed for stress management.
  • Safe, effective care is best achieved when nurses work in collaboration with the interdisciplinary team and client, family and community.
  • Documentation is a standard of nursing practice and is an integral part of the assessment and care of clients at risk for suicidal ideation and behaviour.