What is the appropriate next step when a patient says, 'I feel hopeless/worthless'?

What is the appropriate next step when a patient says, 'I feel hopeless/worthless'?

• A. Tell them to snap out of it
• B. Assess for risk of self-harm, ask do you feel like harming yourself
• C. Change the subject
• D. Encourage them to sleep

Answer: (B)

When someone says they feel hopeless or worthless, the immediate concern is safety and the possibility of suicidal thoughts. The best next step is to assess for self-harm risk by asking directly about thoughts of harming themselves, whether they have a plan, and what means they might have. This direct, nonjudgmental questioning opens a critical safety conversation and helps you determine how urgently the person needs support or intervention. If there are any current thoughts, intent, or a concrete plan, you take appropriate steps right away to ensure safety, which may include safety planning, involving others, and arranging urgent evaluation. If there are no active thoughts or plan, you still document risk, arrange follow-up, and provide support and coping strategies. Options that dismiss the feelings or avoid addressing safety (like telling them to snap out of it, changing the subject, or suggesting sleep) fail to identify and mitigate real risk and do not protect the patient.

When someone says they feel hopeless or worthless, the immediate concern is safety and the possibility of suicidal thoughts. The best next step is to assess for self-harm risk by asking directly about thoughts of harming themselves, whether they have a plan, and what means they might have. This direct, nonjudgmental questioning opens a critical safety conversation and helps you determine how urgently the person needs support or intervention. If there are any current thoughts, intent, or a concrete plan, you take appropriate steps right away to ensure safety, which may include safety planning, involving others, and arranging urgent evaluation. If there are no active thoughts or plan, you still document risk, arrange follow-up, and provide support and coping strategies. Options that dismiss the feelings or avoid addressing safety (like telling them to snap out of it, changing the subject, or suggesting sleep) fail to identify and mitigate real risk and do not protect the patient.