How do mental health professionals deal with uncertainty in suicide risk assessment?

IntroductionSuicide risk-assessment forms a significant part of the workload of mental health professionals (MHPs). There is much research regarding efficacy of different methods/scales of suicide risk-assessment, and effects of formal training on risk-assessment. To date, there is little investigation into how approach to risk-assessment varies amongst professionals on an individual level, or how MHPs react when confronted by lack of information.ObjectiveThis study evaluated how MHPs respond to uncertainty when assessing suicide risk.Methods720 MHPs were given 10 clinical scenarios and asked to assess suicide risk in each case. The scenarios were a mixture of high, medium and low risk cases. In addition, there were scenarios where information provided was incomplete or ambiguous. Subjects graded suicide risk-severity from 1–10 (1 = low, 10 = high).ResultsThe simple scenarios produced a predictable consensus of opinion amongst MHPs. The ambiguous scenario produced three distinct response peaks (Fig. 1) at low, medium, and high risk.Fig. 1[Fig 1]ConclusionsAmbiguous suicide risk separates MHPs into three responder groups:1.‘don’t know’2.more cautious, assumes higher risk3.less cautious, assumes lower risk.This has implications for suicide risk training. Further research is required to fully understand why individuals respond in different ways to suicide risk scenarios.