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Welfare Checks for Suicide Risk Management

Risks and Benefits

WORTZEL, HAL S. MD; BARNES, SEAN M. PhD; CANNIZZARO, KAILY A. PsyD; VILLARREAL, EDGAR J. PhD; ALLEN, MICHAEL H. MD; MATARAZZO, BRIDGET B. PsyD

Journal of Psychiatric Practice®: September 2019 - Volume 25 - Issue 5 - p 379–382
doi: 10.1097/PRA.0000000000000419
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In clinical practice, welfare checks have become a fairly common aspect of suicide prevention. At the same time, there is almost no guidance in the medical literature to inform clinicians under what circumstances welfare checks should be requested, how best to go about placing those requests, or how to document decision-making around this important subject. Literature searches spanning both PubMed and Google Scholar fail to yield any applicable results. Performed correctly, welfare checks have the potential to be life-saving interventions for persons in suicidal crises. Performed incorrectly, the welfare check may become an overly defensive practice that damages therapeutic relationships, violates patients’ rights, and consumes important and limited community resources. The need for thoughtful guidance to assist clinicians in navigating these difficult clinical scenarios is long overdue. This article, the first in a 2-part series, will describe welfare checks and explore their potential risks and benefits.

WORTZEL: Michael K. Cooper Professor of Neurocognitive Disease, Director of Neuropsychiatry, an Associate Professor in Psychiatry, Neurology, and Physical Medicine and Rehabilitation, and Faculty for the Forensic Psychiatry Fellowship at the University of Colorado School of Medicine, Aurora, CO, and Director of Neuropsychiatric Services for the Rocky Mountain MIRECC at the Rocky Mountain Regional VA Medical Center, Aurora, CO

BARNES, CANNIZZARO: Clinical and Research Psychologists with the Rocky Mountain MIRECC. Dr Barnes is an Assistant Professor in the Department of Psychiatry at the University of Colorado School of Medicine, Aurora, CO

VILLARREAL: Suicide Prevention Manager for the VA Eastern Colorado Health Care System, Aurora, CO

ALLEN: Medical Director for Psychiatric Emergencies and Telehealth at UCHealth, Medical Director of Rocky Mountain Crisis Partners and Professor of Psychiatry and Emergency Medicine at the University of Colorado School of Medicine, Aurora, CO

MATARAZZO: Director of Clinical Services for the Rocky Mountain MIRECC and Associate Professor in the Department of Psychiatry at the University of Colorado School of Medicine, Aurora, CO

The authors declare no conflicts of interest.

Please send correspondence to: Hal S. Wortzel, MD, Rocky Mountain MIRECC, Rocky Mountain Regional Medical Center, 1700 N. Wheeling Street, Bldg G3 Room 185, Aurora, CO 80045 (e-mail: hal.wortzel@ucdenver.edu).

Online date: September 6, 2019

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