Background: Patients in suicidal processes describe ambivalence about living or dying, and that there are feelings of loneliness, shame and failure, and longing for someone to truly see and understand. When encountering hospital emergency care, the experiences range from hostility to gentleness. However, a positive relationship is understood as part of recovery. 

It can be challenging for ambulance clinicians to encounter patients in suicidal processes, and suicidal ideation is not necessarily considered to be within the scope of their responsibility. Ambulance clinicians encounter patients in all stages of the suicidal process, and they could have responsibility in preventing future suicide. Nevertheless, there is scarce research on how patients experience this encounter and what meaning it has to them.

Aim: The aim of the study was to elucidate meanings of encountering ambulance clinicians whilst being in a suicidal process.

Method: A qualitative inductive design was used. Fifteen individual interviews were conducted with eight participants with experience of encountering ambulance clinicians whilst being in a suicidal process. The interviews were transcribed and the data was analysed using phenomenological hermeneutics.

Ethical considerations: The study was approved by the Swedish Ethical Review Authority.

Results: Preliminary findings presents three themes. Being under ambulance clinicians’ authority which means to be inferior in the power balance to the clinicians. However, the power balance is highlighted through body language, tone or focusing on diagnosis, but it could also be balanced through a personal and empathic encounter. Being unsure of one’s own value where one keeps up a façade to protect both one’s vulnerability but also to avoid putting one’s burden upon the clinicians. Being a problem to solve, and not a person in need of help, is elucidated when the clinicians use impeaching language. Regaining hope in moments of togetherness where the brief relationship with the clinicians can rise hope when one is seen as a unique person. Having an everyday conversation reminds of human community. An opportunity to share one’s story and to be supported in approaching what is distressful, arises when clinicians have an understanding attitude.

Conclusions: Encountering ambulance clinicians means to be inferior. Clinicians’ communication highlights the power imbalance and can increase feelings of loneliness and being a burden. But there is also in the clinicians’ power to equalize the imbalance, to convey hope and remind of human community. Thus, the encounter could be the start of the patients’ recovery.