Suicidal Behavior and Difficulty of Patients, as Perceived by Community Mental Health Nurses

Mark Van Veen, Bauke Koekkoek, Margot Kloos, Arjan W. Braam

Research output: Contribution to journalArticleAcademicpeer-review


Background: Mental health professionals who work in community mental health services play an important role in treating patients after attempted suicide or deliberate self-injury. When such behaviors are interpreted negatively, patients may be seen as difficult, which may lead to ineffective treatment and mutual misunderstanding. Objective: The goal of this study was to assess the association between the grading of suicidality and perceived difficulty. We hypothesized that a higher grading of suicidality is associated with increased perceived difficulty. Methods: We analyzed cross-sectional data from 176 patients who participated in 2 cohort studies: 92 patients in the MATCH-cohort study and 84 patients in the Interpersonal Community Psychiatric Treatment (ICPT) study. The dependent variable was perceived difficulty, as measured by the Difficult Doctor-Patient Relationship Questionnaire (DDPRQ) and the Difficulty Single-item (DSI), a single item measuring the difficulty of the patient as perceived by the professional. Grading of suicidality was considered as the independent variable. Multiple linear and logistic regression was performed. Results: We found a significant association between perceived difficulty (DDPRQ) and high gradings of suicidality (B: 3.96; SE: 1.44; β: 0.21; P=0.006), increasing age (B: 0.09; SE: 0.03; β: 0.22; P
Original languageEnglish
Pages (from-to)113-121
Number of pages9
JournalJournal of Psychiatric Practice
Issue number2
Publication statusPublished - Mar 2023


  • mental health professional
  • perceived difficulty
  • self-injury
  • suicidal behavior
  • suicidality
  • suicide risk

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