Background Early identification of suicidal ideation would allow more opportunities for intervention and may ultimately reduce risk of suicide. Knowing when patients are likely to voice suicidal thoughts is important, as it may increase confidence of healthcare professionals to have earlier conversations with their patients regarding suicide risk.

Aim To establish the time period between first assessment and recorded suicidal ideation in a patient population.

Methods 385 patients under the care of inpatient and community palliative care teams at St Christopher’s Hospice, Sydenham, were identified to have keyword ‘suicide’ in their electronic patient records (EPR) during the period of April 2015 to March 2016. In these individuals, EPR was reviewed against inclusion criteria and 124 patients were identified to have documented suicidal ideation. Time from first assessment to detection of suicidal thoughts was calculated.

Results 61% of patients with expressed suicidal thoughts (n=76) were male, and mean age of those who voiced suicidal thoughts was 67.4 ± 13.6 years (mean ± SD). 69% (n=86) had a diagnosis of malignancy, and 62% (n=77) had a previous psychiatric history. 15% (n=19) of all patients we identified with suicidal thoughts voiced their suicidal ideation at their first assessment. A further 10% (n=12) voiced these thoughts within the first week of contact, and in 45% (n=55) suicidal thoughts had been detected within the first month.

Conclusions A large proportion of patients expressed their suicidal ideation early in their contact with the hospice-centred palliative care team. As previously established, asking patients about thoughts of suicide does not increase risk of suicide or self-harm (Gould et al., 2005; Eynan et al., 2014). This data provides further encouragement to explore suicidal thoughts in palliative care patients from first contact.