scholarly journals Suicide risk: structured professional judgement

2005 ◽  
Vol 11 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Joe Bouch ◽  
John James Marshall
Keyword(s):  
Risk Factors ◽  
Suicide Risk ◽  
Evidence Base ◽  
Suicide Risk Assessment ◽  
Case Histories ◽  
Risk Recognition ◽  
Suicide Risk Factors ◽  
Risk Assessment And Management ◽  
Professional Judgement

Patient risk factors for suicide are well known to psychiatrists, yet the availability of clinically useful, routine and systematic methods for risk recognition are limited. This article outlines the structured professional judgement approach to suicide risk assessment and management. This method combines psychiatric assessment and formulation with the evidence base for suicide risk factors. Structured professional judgement is contrasted with actuarial and clinical judgement approaches. A categorisation of risk factors is presented, with four groups described – static, stable, dynamic and future. Case histories illustrate long-term high risk contrasted with sudden and unpredictable onset of suicidality.

Enhancing suicide risk assessment: a novel visual metaphor learning tool

2016 ◽  
Vol 24 (6) ◽  
pp. 608-614 ◽  
Author(s):  
Mohsen Alyami ◽  
Hussain Alyami ◽  
Frederick Sundram ◽  
Gary Cheung ◽  
Beverly A Haarhoff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Suicide Risk ◽  
Teaching And Learning ◽  
Clinical Skill ◽  
Visual Metaphor ◽  
Suicide Risk Assessment ◽  
Load Theory ◽  
Suicide Risk Factors ◽  
Memory And Recall

Objective: Suicide risk assessment is variably taught and learnt by health professionals. The literature indicates that training programs of this fundamental competency need to be enhanced. To facilitate teaching and learning of this core clinical skill, we propose a novel visual metaphor in order to conceptualize suicide risk factors. The design of the proposed visual metaphor was informed by the Cognitive Load Theory to enhance deep learning of the various suicide risk factors. Conclusion: The visual metaphor depicting suicide risk factors can potentially improve memory and recall. It activates prior knowledge and is based on educational theory informed design principles.

The Suicide Risk Assessment and Management Manual (S-RAMM) Validation Study 1

2009 ◽  
Vol 26 (2) ◽  
pp. 54-58 ◽  
Author(s):  
Atif Ijaz ◽  
Alexia Papaconstantinou ◽  
Helen O'Neill ◽  
Harry G Kennedy
Keyword(s):  
Risk Assessment ◽  
Internal Consistency ◽  
Validation Study ◽  
Suicide Risk ◽  
Suicide Risk Assessment ◽  
Rater Reliability ◽  
Cronbach's Alpha ◽  
Cohen's Kappa ◽  
Risk Assessment And Management ◽  
Professional Judgement

AbstractObjective:There are validated tools for structured professional judgement of risk of violence, but few for risk of suicide. The Suicide Risk Assessment and Management Manual (S-RAMM) is a new structured professional judgement tool closely modelled on the HCR-20. This is the first validation study for the S-RAMM. We measured inter-rater reliability, internal consistency, concurrent validity with another validated risk instrument (HCR-20) and with a measure of psychopathology (PANSS). We tested whether the tool could distinguish between groups of patients clinically assessed as at varying levels of risk of suicide or self harm.Method:Two researchers jointly interviewed 25 current in-patients for inter-rater reliability (Cohen's kappa) and internal consistency (Cronbach's alpha) and interviewed 81 of 83 current in-patients to assess whether the mean scores for different wards were significantly different (using ANOVA). Two other researchers made independent ratings of the HCR-20 and PANSS.Results:Inter-rater reliability was acceptable for all items (Cohen's kappa >0.5 for all but three items) and all sub-scale and total scores (Spearman correlations all >0.8). Internal consistency was high, (Cronbach's alpha all sub-scales >0.6). Scores stratified significantly with high scores for admission and intensive care units and progressively lower scores in rehabilitation and predischarge units. The HCR-20 historical and S-RAMM background scores did not correlate but the dynamic sub-scales correlated significantly. PANSS scores also correlated significantly with S-RAMM scores.Conclusion:The S-RAMM has better than minimum acceptable characteristics for use as a clinical or research tool. Prospective studies of sensitivity and specificity are now required.

The Suicide Risk Assessment and Management Manual (S-RAMM) Validation Study II

2009 ◽  
Vol 26 (3) ◽  
pp. 107-113 ◽  
Author(s):  
John Fagan ◽  
Atif Ijaz ◽  
Alexia Papaconstantinou ◽  
Aideen Lynch ◽  
Helen O'Neill ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Validation Study ◽  
Suicide Risk ◽  
Area Under The Curve ◽  
Suicide Risk Assessment ◽  
Global Function ◽  
Self Harm ◽  
Risk Assessment And Management ◽  
Professional Judgement ◽  
Better Than

AbstractObjectives:Structured professional judgement is now the most widely accepted approach to clinical risk assessment and risk management. The Suicide Risk Assessment and Management Manual (S-RAMM) is a new structured professional judgement tool closely modelled on the HCR-20. This is the first prospective validation study for this instrument.Methods:Two post-membership registrars jointly interviewed 81 of 83 current inpatients to rate the S-RAMM. Two assistant psychologists independently rated the HCR-20, GAF and PANSS. All incidents of self-harm, attempted suicide, suicide and violence to others were collated from hospital reporting of critical incidents over the next six months supplemented by examination of other records.Results:For combined self-harm and suicide outcomes, the S-RAMM total score using the receiver operating characteristic had an area under the curve AUC=0.89, (95% CI 0.79 to 0.99). The S-RAMM performed as well for the prediction of self-harm and suicide as the HCR-20 did for violence, and better than measures of mental state (PANSS total score) and global function (GAF).Conclusions:The S-RAMM has better than minimum acceptable characteristics for use as a clinical or research tool for suicide risk assessment, and performs almost as well as the HCR-20 does for violence. Further prospective studies are now required, in other populations.

Diagnostic scales for suicide risk assessment

2020 ◽  
pp. 67-79
Author(s):  
L. Gelda ◽  
L. Nesterovich
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Medical Research ◽  
Suicide Risk ◽  
General Medicine ◽  
Diagnostic Tools ◽  
Suicide Risk Assessment ◽  
Research And Practice ◽  
Psychometric Instruments ◽  
High Incidence

The problem of adequate diagnostic tools use for suicide risk assessment т medical research and practice is of extreme importance because of the high incidence of suicide in the population of psychotic patients and the high vulnerability of the latter to the known risk factors. The article provides ап overview of the existing psychometric instruments (scales) used to assess the risk of suicide in psychiatry as well as in general medicine.

Suicide risk assessment in a large public mental health service: do suicide risk classifications identify those at risk?

2021 ◽  
pp. 103985622098403
Author(s):  
Marianne Wyder ◽  
Manaan Kar Ray ◽  
Samara Russell ◽  
Kieran Kinsella ◽  
David Crompton ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Assessment ◽  
High Risk ◽  
Suicide Risk ◽  
Public Mental Health ◽  
Assessment Tools ◽  
Suicide Risk Assessment ◽  
Public Mental Health Service ◽  
Risk Assessment Tools

Introduction: Risk assessment tools are routinely used to identify patients at high risk. There is increasing evidence that these tools may not be sufficiently accurate to determine the risk of suicide of people, particularly those being treated in community mental health settings. Methods: An outcome analysis for case serials of people who died by suicide between January 2014 and December 2016 and had contact with a public mental health service within 31 days prior to their death. Results: Of the 68 people who had contact, 70.5% had a formal risk assessment. Seventy-five per cent were classified as low risk of suicide. None were identified as being at high risk. While individual risk factors were identified, these did not allow to differentiate between patients classified as low or medium. Discussion: Risk categorisation contributes little to patient safety. Given the dynamic nature of suicide risk, a risk assessment should focus on modifiable risk factors and safety planning rather than risk prediction. Conclusion: The prediction value of suicide risk assessment tools is limited. The risk classifications of high, medium or low could become the basis of denying necessary treatment to many and delivering unnecessary treatment to some and should not be used for care allocation.

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