Construction of suicidal ideation in medical records

Abstract

In this paper we are interested in exploring discursive transformation of patients’ stories of suicidal ideation into medical discourses. In other words, we focus on how the narrated experience of suicidal thoughts made during the psychiatric assessment interview is recorded in the patients’ medical record. Our data come from recordings of psychiatric interviews, as well as the doctors’ notes in the medical records made after the interviews, collected in psychiatric hospitals in Poland. Assuming a constructionist view of discourse, we demonstrate that lived experience of suicide ideation resulting in stories of a complex and homogeneous group of “thoughts” is reduced to brief statements of fact of presence/existence. Exploration of the relationship between the interviews and the notes suggest a stark imposition of the medical gaze upon them. We end with arguments that discursive practices relegating lived experience from the focus of clinical practice deprives it of information which is meaningful and clinically significant.