Teaching evidence-based approaches to suicide risk assessment and prevention that enhance psychiatric training

ABSTRACTSuicide risk assessment is now a core competency requirement in the residency training of psychiatrists.The purpose of suicide risk assessment is to identify modifiable or treatable acute, high-risk suicide factors, and available protective factors that inform patient treatment and safety management.The standard of care varies according to state statutory definitions. Heretofore, most states adopted an average physician or “ordinarily employed standard.” Currently, more states are adopting a “reasonable, prudent physician” standard. No single source or authority defines the standard of care for suicide risk assessment. Evidence-based psychiatry can inform clinicians' suicide risk assessments. Carefully documented risk assessments will assist the courts in evaluating clinicians' decision-making process.

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The Men’s Mental Health Perspective on Adolescent Suicide in the COVID-19 Era

Acta Neuropsychiatrica ◽

10.1017/neu.2021.10 ◽

2021 ◽

pp. 1-11

Author(s):

Timothy Rice ◽

Leo Sher

Keyword(s):

Risk Assessment ◽

Substance Use ◽

Suicide Risk ◽

Adolescent Suicide ◽

Suicide Risk Assessment ◽

Social Distancing ◽

Adolescent Women ◽

Risk Assessment And Prevention ◽

Male Specific ◽

Adolescent Suicide Risk

Abstract Objective: The COVID-19 pandemic has drastically changed society and introduced many new factors to consider in adolescent suicide risk assessment and prevention. One complexity that warrants consideration is the male-specific impacts of the pandemic within adolescence. Methods: A review of the relevant literature. Results: Matters of social distancing, virtual education, and substance use may impact adolescent men in fashions that raise their suicide risk more significantly relative to adolescent women. Social distancing may impact adolescents’ friendships and generate a regression back to the nuclear family; qualities of male adolescents’ friendships and of masculinity suggest that these impacts may be more severe in adolescent men and may directly raise suicide risk. Virtual schooling yields educational and social setbacks; losses of team sports, male mentors, and the implications of diminished educational advancement may more adversely affect adolescent men and raise risk. Substance use has increased in the pandemic, particularly among adolescent men. There are direct associations with suicide risk as well as indirectly through increased parental conflict and punishment. Conclusion: As adolescent men die by suicide at significantly elevated rates relative to adolescent women, a male-specific consideration of these impacts is indicated to address adolescent suicide in our current era. Recommendations are made for integrating these considerations into updated adolescent suicide risk assessment and prevention efforts.

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Mental Health Professionals' Suicide Risk Assessment and Management Practices

Crisis ◽

10.1027/0227-5910/a000478 ◽

2018 ◽

Vol 39 (1) ◽

pp. 55-64 ◽

Cited By ~ 13

Author(s):

Jared F. Roush ◽

Sarah L. Brown ◽

Danielle R. Jahn ◽

Sean M. Mitchell ◽

Nathanael J. Taylor ◽

...

Keyword(s):

Mental Health ◽

Risk Assessment ◽

Mental Health Professionals ◽

Health Professionals ◽

Suicide Risk ◽

Management Practices ◽

Self Report ◽

Evidence Based ◽

Suicide Risk Assessment ◽

Risk Assessment And Management

Abstract. Background: Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. Aims: The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Method: Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Results: Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. Limitations: The study utilized a cross-sectional design and self-report questionnaires. Conclusion: Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

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