Management of suicidality in stroke patients with and without aphasia-a national survey among healthcare professionals in Sweden.

Abstract

Investigating how stroke healthcare professionals manage suicidality in stroke patients with and without aphasia. A cross-sectional survey of 981 professionals in Sweden was conducted. Nearly 60% of respondents had encountered suicidality in stroke patients without aphasia, while 40% had encountered it in patients with aphasia. SLPs were more likely to meet patients with aphasia and suicidality. Routine screening was rare, while 40% reported that suicidality was assessed when needed. Psychologists, physicians, and social workers were seen as responsible for assessments, with 13% of respondents feeling it was their responsibility to assess suicidality. Less than half of those felt competent to assess patients with aphasia. Aphasia was viewed as a barrier to assessment. Uncertainty was widespread regarding intervention, particularly in patients with aphasia, and there were concerns about the competence to handle such cases when referred to psychiatry. Free-text responses highlighted a perceived lack of competence, tools, and routine procedures for handling suicidality in aphasia, alongside calls for more mental health professionals and better interprofessional collaboration regarding suicidality in stroke rehabilitation. Management of suicidality in stroke patients, particularly with aphasia, is surrounded by uncertainty. Greater competence in suicidality, aphasia-friendly communication, and improved interdisciplinary efforts are needed.