Malingering or True Suicidal Intent?

Mar 05, 2017

“Dance is the most ephemeral of arts. It is inscribed on air, not on paper, canvas, or stone. Except when captured by a movie or video camera, a work lasts no longer than the performance. . . . To the dancer, the end of a perfect line of movement marks the end of a beauty never to be precisely recaptured. The beauty of dance lies in part in this poignancy – an existence so fleeting that it seems, paradoxically, to transcend time.”

Yi-Fu Tuan, Geographer and Writer
from “Passing Strange and Wonderful

Malingering or True Suicidal Intent?

TISA Description of the Problem: There are various arenas in which a client may malinger suicidal intent, as when trying to get admission into a hospital to avoid a court appearance or secondary to homelessness. Malingered suicidal intent can pose a problem in prison assessments. At times an inmate may, for very good reasons, want to be admitted to the infirmary under the guise of being suicidal. For instance, such a situation may arise if the inmate is trying to avoid an impending assault in their current location. In the following very practical tip from Robert Houle, a question is described that may be used to help us to unravel whether or not voiced suicidal ideation is being feigned or represents “the real thing”.

Tip: It is not uncommon for me to encounter a situation in which it is not clear whether or not an inmate is malingering suicidal ideation, because he or she needs “to escape” a bad situation. I have found the following question to be helpful at these times:

Clinician: If one thing could change, or happen, that would make you not suicidal, what would it be?

TISA Follow-up: The above question is deceptively direct, but decidedly effective. It is its directness that probably creates a sense of safety for the client with the interviewer. This sense of safety paves the way for a frank discussion about what is really “going down”.

Tip provided by:

Robert Houle
State of Michigan, Department of Corrections
Ionia, Michigan