Constructing the Interview

Given the patient’s presenting symptoms and history, the interview should be conducted in a private, non-threatening environment. The goal is to establish rapport and gather essential information without causing undue distress.

The interview should focus on several key areas:

• Patient history: Detailed information about the patient’s weight loss, including onset, rate, and associated symptoms.
• Psychiatric history: Exploration of personal and family history of depression, anxiety, or other mental health conditions.
• Social history: Inquiry about recent life events, including job loss, relationship changes, and financial stressors.
• Coping mechanisms: Understanding how the patient has been managing stress and coping with challenges.
• Suicide risk assessment: Direct, but sensitive questioning about suicidal thoughts, plans, and intent.

It is crucial to use open-ended questions to encourage the patient to share their experiences and feelings. Active listening and empathetic responses are essential to build trust and rapport.

Measures to Take

The information gathered during the interview indicates a patient at increased risk for depression and suicide. Therefore, immediate and comprehensive measures are necessary:

• Safety assessment: Prioritize the patient’s safety by conducting a thorough suicide risk assessment. This includes determining the presence of suicidal ideation, plans, and intent. If there is an imminent risk, immediate intervention, such as hospitalization, may be necessary.
• Collaboration: Involve the mental health team to conduct a comprehensive psychiatric evaluation. This collaboration ensures a coordinated approach to the patient’s care.
• Support system: Assess the patient’s support system and involve family or friends in the care plan if appropriate.
• Education and counseling: Provide the patient with information about depression, suicide prevention, and available resources. Offer counseling or therapy referrals.
• Medication management: If indicated, initiate or adjust antidepressant medication in collaboration with the mental health team.
• Close monitoring: Frequent monitoring of the patient’s mood, behavior, and vital signs is essential.

By taking a comprehensive approach that addresses the patient’s physical and mental health needs, it is possible to reduce the risk of suicide and improve overall well-being.