scholarly journals Assessment of Suicide Risks During the First Week Immediately After Discharge From Psychiatric Inpatient Facility

2021 ◽  
Vol 12 ◽  
Author(s):  
Trine Madsen ◽  
Eybjørg Egilsdottir ◽  
Chanette Damgaard ◽  
Annette Erlangsen ◽  
Merete Nordentoft
Keyword(s):  
Risk Assessment ◽  
Suicide Risk ◽  
Psychiatric Inpatient ◽  
Elevated Risk ◽  
Suicidal Risk ◽  
Suicide Risk Assessment ◽  
Patient Will ◽  
History Of ◽  
Reason For Admission

Background: The suicide rate in first week after psychiatric discharge is alarmingly high. Although a risk assessment prior to discharge is standard praxis, it can be difficult to take into consideration the obstacles that patient will meet once discharged. A follow-up-visit during the first week after discharge is an opportunity to reevaluate whether a person may be at risk of suicide.Aim: To determine how many patients, of those who were assessed, were evaluated to be at elevated risk of suicide during the first week after psychiatric discharge and secondarily to identify predictors of this and predictors for receiving a follow-up visit during first week after discharge.Methods: All patients discharged between March 1st 2018 to January 17th 2019 were offered a home visit including a systematic risk assessment. Socio-demographics and clinical variables were obtained from medical records and logistic regression analyses were used to identify predictors of a higher suicide risk assessment as well as receiving a follow-up visit.Results: Information from 1905 discharges were included. Of these, 1,052 were seen in follow-up meetings. Risk assessments was conducted in a total of 567 discharge procedures, of which 28 (5%) had an elevated risk of suicide. A history of suicide attempt, suicide risk having been the reason for admission, a first diagnosis of a psychiatric disorder was associated with an elevated risk of suicide after discharge.Conclusion: Follow-up visits could serve as an important tool to identify people whose suicidal risk were overlooked at discharge or exposed to severe stressors after discharge.

A review of suicide risk assessment instruments and approaches

2015 ◽  
Vol 5 (5) ◽  
pp. 216-223 ◽  
Author(s):  
Megan Lotito ◽  
Emmeline Cook
Keyword(s):  
Risk Assessment ◽  
Suicide Risk ◽  
Assessment Instruments ◽  
Suicide Risk Assessment ◽  
Simple Task ◽  
Clinical Interviews ◽  
Number Of Factors ◽  
Assessment Measure ◽  
Patient Will ◽  
Commit Suicide

Abstract Introduction: Conducting an accurate suicide risk assessment (SRA) is no simple task as there are a number of factors that influence an individual's level of suicidality and his/her willingness to share this information. Therefore, it is imperative that practitioners adopt a systematic approach to conducting and documenting the foreseeability that a patient will commit suicide. Methods PubMed was used to search for articles published in MEDLINE journals using the following keywords: suicide, risk assessment, measure, scale. Randomized trials and pilot, proof-of-concept publications investigating the use of specific SRA measurements were included in the review. The scales are described based on the prevailing opinions in psychiatry from the American Psychiatric Association's Textbook of Suicide Assessment and Management (2nd ed., 2012). Results Although various SRA scales exist, experts in the field have repeatedly concluded that there is not any one scale that can predict who will commit suicide to any useful degree. However, when used along with the clinical interview, standardized suicide risk factor components of clinical and research scales remain crucial to gaining information often omitted by patients regarding thoughts and preparation for suicide. A summary of the most widely cited scales and approaches used in SRA is provided. Discussion SRA remains a challenge largely due to the fact that suicidal behavior is multifactorial. As a result, risk formulation is a process that should involve both standardized measures and detailed clinical interviews repeated over time.

scholarly journals The Importance of Suicide Risk Formulation in Schizophrenia

2021 ◽  
Vol 12 ◽  
Author(s):  
Isabella Berardelli ◽  
Elena Rogante ◽  
Salvatore Sarubbi ◽  
Denise Erbuto ◽  
David Lester ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Suicide Risk ◽  
Patient Specific ◽  
Suicidal Risk ◽  
Suicide Risk Assessment ◽  
Prevention Strategies ◽  
Specific Group ◽  
Choice Of Treatment ◽  
Psychological Risk

Suicide is a cause of early mortality in nearly 5% of patients with schizophrenia, and 25–50% of patients with schizophrenia attempt suicide in their lifetime. Evidence points to numerous individual, clinical, social, and psychological risk factors for suicide in patients with schizophrenia. Although recognizing suicidal risk factors in schizophrenia is extremely important in suicidal risk assessment, we have recently witnessed a change in suicide risk management that shifts the focus from suicide risk assessment to suicide risk formulation. Suicide risk formulation is dependent on the data gathered in the suicide risk assessment and assigns a level of suicide risk that is indispensable for the choice of treatment and the management of patients with a high suicidal risk. In this article, we extend the suicide risk formulation model to patients with schizophrenia. Suicide risk formulation results from four different areas that help clinicians collect as much information as possible for the management of suicidal risk. The four distinct judgments comprise risk status (the risk relating to the specific group to which the patient belongs), risk state (the risk for the person compared with his baseline or another reference point in the course of his life), available resources (on whom the person can count during a crisis) and foreseeable events (which can exacerbate the crisis). In schizophrenia, the suicide risk formulation model allows the clinician to evaluate in depth the clinical context of the patient, the patient's own history and patient-specific opportunities for better choosing and applying suicide prevention strategies.

The death-implicit association test and suicide attempts: a systematic review and meta-analysis of discriminative and prospective utility

2021 ◽  
pp. 1-10
Author(s):  
Maya N. Sohn ◽  
Carly A. McMorris ◽  
Signe Bray ◽  
Alexander McGirr
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicidal Behaviour ◽  
Implicit Association Test ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Association Test ◽  
Implicit Association ◽  
Suicide Risk Assessment ◽  
History Of

Abstract Suicide risk assessment involves integrating patient disclosure of suicidal ideation and non-specific risk factors such as family history, past suicidal behaviour, and psychiatric symptoms. A death version of the implicit association test (D-IAT) has been developed to provide an objective measure of the degree to which the self is affiliated with life or death. However, this has inconsistently been associated with past and future suicidal behaviour. Here, we systematically review and quantitatively synthesize the literature examining the D-IAT and suicide attempts. We searched psychINFO, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception until 9 February 2021 to identify publications reporting D-IAT scores and suicide attempts (PROSPERO; CRD42020194394). Using random-effects models, we calculated standardized mean differences (SMD) and odds ratios (ORs) for retrospective suicide attempts. We then calculated ORs for future suicide attempts. ORs were dichotomized using a cutoff of zero representing equipoise between self-association with life and death. Eighteen studies met our inclusion criteria (n = 9551). The pooled SMD revealed higher D-IAT scores in individuals with a history of suicide attempt (SMD = 0.25, 95% CI 0.15 to 0.35); however, subgroup analyses demonstrated heterogeneity with acute care settings having lower effect sizes than community settings. Dichotomized D-IAT scores discriminated those with a history of suicide attempt from those without (OR 1.38 95% CI 1.01 to 1.89) and predicted suicide attempt over a six-month follow-up period (OR 2.99 95% CI 1.45 to 6.18; six studies, n = 781). The D-IAT may have a supplementary role in suicide risk assessment; however, determination of acute suicide risk and related clinical decisions should not be based solely on D-IAT performance.

What is commonly missed in the suicidal risk assessments in the emergency room?

2017 ◽  
Vol 41 (S1) ◽  
pp. S562-S562
Author(s):  
N. Alavi ◽  
T. Reshetukha ◽  
E. Prost ◽  
A. Kristen ◽  
D. Groll
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Emergency Medicine ◽  
Emergency Room ◽  
Educational Intervention ◽  
Suicide Risk ◽  
Chart Review ◽  
Risk Assessments ◽  
Suicidal Risk ◽  
Suicide Risk Assessment

IntroductionSuicidal behaviour remains the most common reason for presentation to the emergency rooms. In spite of identifiable risk factors, suicide remains essentially unpredictable by current tools and assessments. Moreover, some factors may not be included consistently in the suicidal risk assessments in the emergency room by either emergency medicine physicians or psychiatrists.MethodStep 1 involved the administration of a survey on the importance of suicide predictors for assessment between psychiatry and emergency medicine specialties. In step 2 a chart review of psychiatric emergency room patients in Kingston, Canada was conducted to determine suicide predictor documentation rates. In step 3, based on the result of the first 2 steps a suicide risk assessment tool (Suicide RAP [Risk Assessment Prompt]) was developed and presented to both teams. A second patient chart review was conducted to determine the effectiveness of the educational intervention and suicide RAP in suicide risk assessment.ResultsSignificant differences were found in the rating of importance and the documentation rates of suicide predictors between the two specialties. Several predictors deemed important, have low documentation rates. Thirty of the suicide predictors showed increased rates of documentation after the educational intervention and the presentation of the suicide RAP.ConclusionThough a surfeit of information regarding patient risk factors for suicide is available, clinicians and mental health professionals face difficulties in integrating and applying this information to individuals. Based on the result of this study suicide RAP and educational intervention could be helpful in improving the suicidal risk assessment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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