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Assessing Suicide Risk: What is Commonly Missed in the Emergency Room?

ALAVI, NAZANIN MD; RESHETUKHA, TARAS MD; PROST, ERIC MD; ANTONIAK, KRISTEN; GROLL, DIANNE PhD

Journal of Psychiatric Practice: March 2017 - Volume 23 - Issue 2 - p 82–91
doi: 10.1097/PRA.0000000000000216
Articles

Objective: Although risk assessment for suicide has been extensively studied, it is still an inexact process. The current study determined how busy emergency clinicians actually assessed and documented suicide risk, while also examining the differences between psychiatric and emergency medicine opinions on the importance of various suicide predictors.

Method: Phase 1 of the study involved the administration of a survey on the relative importance of various suicide predictors for the specialties of psychiatry and emergency medicine. In phase 2 of the study, a chart review of psychiatric emergency room patients was conducted to determine the actual documentation rates of the suicide predictors.

Results: Several predictors that were deemed to be important, including suicidal plan, intent for suicide, having means available for suicide, and practicing suicide (taking different steps leading up to suicide but not actually attempting suicide), had low documentation rates.

Conclusions: Medical specialties have different opinions on the importance of various suicide predictors. Also, some predictors deemed important had low documentation rates. Educational interventions and simple assessment tools may help to increase documentation rates of several suicide predictors in busy clinical settings.

ALAVI, RESHETUKHA, PROST, ANTONIAK, and GROLL: Department of Psychiatry, Queen’s University, Kingston, ON, Canada

The study was partially funded through a Queen’s University Department of Psychiatry internal grant.

The authors declare no conflicts of interest.

Please send correspondence to: Nazanin Alavi, MD, Hotel Dieu Hospital, 166 Brock Street, Kingston, ON, Canada K7L 5G2 (e-mail: nazanin.alavi@queensu.ca).

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