Clinicians acknowledge awkwardness and lack of skills in assessing suicidal symptoms. This requires increased education, screening for psycho-existential symptoms, and the therapeutic targeting of key symptoms. Assessment of hopelessness, pointlessness, low morale, entrapment, anhedonia, loss of control, loss of roles, and the wish to die prove extremely helpful in recognising a suicidal patient. Use of a screening tool for psycho-existential symptoms aids this recognition and empowers referral for treatment. Communication skills training increases each clinician’s skill and provides a strategic sequence to explore symptoms that mediate suicidal thinking. Network analysis research to identify core symptoms suggests that hopelessness, pointlessness, and entrapment are key therapeutic targets to assuage suicidal thinking. Meaning-centered therapy helps to restore purpose and value to life, cognitive-behavioural therapy reframes pessimism and catastrophising, supportive therapy provides hope and accompaniment, while psychotropics treat clinical depression. There is both a clinical responsibility and an ethical imperative to treat suicidality effectively.


invited commentary, cancer, demoralization, hopelessness, screening, suicidality

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