Assessing Suicidality: Experiences of Healthcare Professionals and Developing a Professional Consensus for People with Post-Stroke Aphasia

McCann, Kellsey Ellen (2026) Assessing Suicidality: Experiences of Healthcare Professionals and Developing a Professional Consensus for People with Post-Stroke Aphasia. Doctoral thesis, University of East Anglia.

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Abstract

Background: Healthcare professionals have a duty of care to detect and assess suicidality, which is recognised to be a global health problem. However, relatively little is known about their subjective experience of suicide risk assessment. In certain situations, such as when stroke affects communication in post-stroke aphasia, the risk of suicide may be increased but there is uncertainty about how to approach risk screening and assessment. Professionals often feel underconfident, undertrained and unsupported to address communication needs, leaving stroke survivors with aphasia at risk of being missed by routine assessment.

Method: A systematic review and meta-synthesis were completed to understand the experiences of healthcare professionals completing suicide risk assessment. A Delphi study was undertaken to develop a professional consensus on the most useful methods to detect and assess suicide risk in stroke survivors with aphasia.

Results: Thirteen reports of 12 studies were reviewed and synthesised. Four themes emerged; 1) Assessing Suicide Risk is a Challenging Experience, 2) Relying on Experience and Intuition to Guide Assessment, 3) Navigating the Gaps Between Guidance and Practice and 4) Systemic Factors Influence Approaches to Assessment. Twenty experienced stroke professionals completed a three-round Delphi study, reaching a strong consensus on many aspects of detecting and assessing suicide risk in stroke survivors with aphasia. On some issues, consensus could not be reached, such as the use of specific standardised mood measures in this context.

Conclusions: Assessing suicidality is a challenging experience, with healthcare professionals reporting reliance on intuition, and barriers to risk assessment, reinforcing a need for further research and clinical resource dedicated to supporting those conducting suicide risk assessment. This portfolio presents the first professional consensus on detection and assessment of suicide risk in stroke survivors with aphasia, advocating a multi-faceted approach integrating joint professional working, supported interview techniques, and family involvement.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	11 Nov 2026 09:54
Last Modified:	11 Nov 2026 09:54
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105061
DOI:

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