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Words Matter

Why Words Matter

It is important to pay attention to the language that we use when we talk about suicide with patients, family, friends, or the public. Language can convey criticism, shame, or fear of talking about suicide. Language could subtly convey that suicide is, in some way, a desirable outcome. Or, language can be clear and matter-of-fact and can help others to feel more comfortable talking about a difficult topic.

In the context of clinical documentation, clear language can facilitate communication with other providers. Further, because patients can have access to clinical documentation, we want to avoid critical language in notes as well.

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Language to Use

Suicide ideation or thoughts about suicide. This refers to thoughts about wanting to be dead or about killing oneself. Use: “a person with suicide ideation” rather than “suicide ideator.”

  • Suicide attempt. This refers to potentially self-injurious behavior associated with some level of intent to die as a result of the act. Sometimes patients may be unclear about their level of intent to die. If a patient is unclear about intent, or if the injury is clearly not lethal but the patient believes it could have been lethal, a behavior is still labeled as a suicide attempt.
  • Self-injurious behavior with intent to die that results in death. This can be referred to as “death by suicide.”

  • Non-suicidal self-injury. Deliberate, non-accidental, injury to body tissue without suicidal intent. This may include cutting or burning.

Language to Avoid

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Do not use words or phrases that are pejorative, have vague unclear meaning, are euphemisms, or imply in some way that suicide is desirable. Do not ask questions that imply a “right” answer.

  • Avoid:
    • Successful suicide
    • Successful attempt
    • Failed attempt
    • Committed suicide
    • Nonfatal suicide
    • Suicidality
    • Parasuicide
    • Suicide gesture
    • Suicide threat
    • Manipulative act
    • “Passive” ideation
    • Cutting, cutter, or mutilator
  • Avoid:
    • “Patient denies risk,” and “Patient contracts for safety.”
  • Avoid asking:
    • “Are you safe?”
    • “You’re not suicidal, right?”

 

Helpful Resources

  • Uniform definitions of terms related to suicide and self-directed violence, please see this CDC document: Learn More >>
  • A brief essay on trauma-informed language when talking about suicide: Learn More >>
  •  Survey results of people affected by suicide – about the language they prefer: Learn More >>
  • For information for journalists about how to write about suicide: Learn More >>

The Providence Center 24-hour Behavioral Health Emergency Line

Providence Center crisis clinicians provide 24/7 telephone assistance for adults and children in crisis.

They also provide consultation services and crisis evaluations. 

Call (401) 274-7111
This information was developed by the Care New England Suicide Prevention Workgroup, which includes membership across Care New England operating units.