Recognizing risk, bearing responsibility: Physicians’ perspectives on suicide risk documentation in healthcare settings undergoing changes

This article explores Lithuanian physicians' experiences with documenting suicide risk following 2023 regulations mandating the registration of suicide-related diagnoses and referrals for psychosocial assessment. Based on qualitative interviews with 16 non-psychiatrist physicians from outpatient, inpatient, and emergency settings, the study identified four themes. (1) The need to learn to talk about suicide reveals doctors' discomfort, lack of training, and patients' reluctance to disclose suicidal thoughts. (2) The decision to record the diagnosis is subjective, shaped by personal judgment, stigma, and fear of negative consequences. (3) Procedure as a barrier or enabler highlights unclear protocols and fear of legal repercussions. (4) Not my domain reflects physicians' tendency to delegate suicide risk assessment to unavailable mental health professionals. The study concludes that legal mandates are insufficient without systemic support-clear guidelines, accessible training, and improved mental health resources are essential to enable physicians outside mental health to effectively engage in suicide prevention.