What is a social worker's main concern during the first interview with a very depressed patient?

In initial interviews with a very depressed patient, the primary concern is to determine suicidal intent. This concern stems from the fact that depression can significantly increase the risk of suicidal thoughts and behaviors. Social workers have a duty to ensure the safety of their clients, and assessing for any suicidal ideation or intent is crucial in this context.

By determining whether the patient is having thoughts of self-harm, the social worker can better understand the severity of the depression and the immediate risks involved. This assessment helps to inform the approach to treatment and safety planning, ensuring that the patient is supported in a way that addresses their most pressing needs right from the outset. Safety is a foundational element in mental health care, and addressing suicidal intent is often the first step in building a therapeutic alliance and trust with the client.

While exploring the patient's history, discussing treatment options, and assessing family support are all important components of a comprehensive assessment, they are secondary to the immediate need to ensure the patient’s safety from harm.