Patient safety and person-centeredness in healthcare for patients with suicidal behavior

Abstract

Ensuring patient safety is a cornerstone of high-quality care for individuals experiencing suicidal behavior. Traditionally focused on risk reduction, safety efforts may unintentionally erode trust when overly security-driven. Research highlights the importance of involving patients and relatives in care planning, yet the role of person-centered care in suicide prevention remains underexplored. The overall aim of this thesis was to examine healthcare utilization and explore the potential for person-centeredness in healthcare for patients with suicidal behavior. Studies I and II focus on healthcare utilization, analyzing adverse events and visit patterns related to patients with suicidal behavior. Studies III and IV explore patient and relative perspectives on person-centered care during suicidal crises. Findings show suicidality as a fluctuating, long-term condition requiring flexible care (Studies I–IV). Study I reveals that adverse events stem from systemic issues rather than isolated failures. Study II finds that patients in mental healthcare with a history of suicide attempts have distinct care needs compared to those without such a history. Studies III and IV highlight that patients and relatives see themselves as key contributors but rarely have opportunities to collaborate. The focus on acute crisis management often excludes them, with patients deemed either too well for support or too unwell for shared decision-making. Participants call for care models balancing long-term planning with proactive safety measures to detect escalating suicidality early while promoting self-care and involvement from relatives. This thesis underscores the intersection of patient safety and person-centered care, advocating for a multidimensional approach that integrates person-centeredness into both clinical practice and healthcare system design to ensure safer, more responsive care for patients with suicidal behavior.