Table 7 Exemplifying quotes related to personalised approaches to alleviate emotional pressure

Patients

To feel safe from myself, I needed to get out of that psychosis where I believed that I was bound to kill myself because I had let everything and everyone down. Because I did not truly want to kill myself…I lost my sense of self, my motor control, my sight and my concentration during the psychosis. I thought this was what my life had become…

It was hopeless when I was very psychotic. I could not attend to any of what they [HCP] said, and I didn’t say anything to them. I was afraid to be locked inside forever. The most important thing for me right then was that they let my parents visit with me on the seclusion unit daily. That’s when I realised someone loved me. But also getting the medication, and the seclusion were important for me in the first phase, I guess

(Male, psychotic symptoms, locked ward, sample 2)

Healthcare Professionals

If you talk with the patient about suicidality in every conversation, then you can tick off the list that you have done it and it calms the therapist down. But I doubt that it will calm the patient. Suicidality is a symptom the patient has. Previously we would transfer a patient to the locked wards if they were suicidal, but now we explore their grief and understand phenomenologically what lies behind the suicidality for each individual…Through gaining insight, the patient finds other ways to express their emotions… We do not simply detach ourselves from the suicidal behaviour or medicate it away… This therapy [interpersonal therapy] is always about individual processes. They get the same structural parts of the treatment, but what they need is very individual

(Male psychologist, 15 years of experience, locked ward, sample 3)