Resource Tag: RISK MANAGEMENT

This column is the fourth in a series describing a model for therapeutic risk management of the suicidal patient. Previous columns presented an overview of the therapeutic risk management model, provided recommendations for how to augment risk assessment using structured assessments, and discussed the importance of risk stratification in terms of both severity and temporality. […]

Highlights •The increase in suicides is suggested to link with the no exclusion period life insurance policy. •The suicide risk after the usual 12 month exclusion period in Hong Kong is higher than usual. •The payment of claims arising from insured suicide deaths is higher than that of other death claims. •Some changes to the […]

Suicide is a public health problem and a leading cause of death. The number of people thinking seriously about suicide, making plans, and attempting suicide is surprisingly high. In total, primary care clinicians write more prescriptions for antidepressants than mental health clinicians and see patients more often in the month before their death by suicide. […]

While the practice of psychiatry involves many challenges, few scenarios are as clinically and emotionally demanding as managing the patient who is at high risk for suicide. Risk management is a reality of psychiatric practice, and this necessitates practicing and documenting thoughtful suicide risk assessment and management. Therapeutic risk management is based on clinical risk […]

Suicide attempt survivorsÕ interpretations of reactions to attempts are understudied, yet could inform prevention efforts concerning subsequent attempts. Interviews with 40 attempt survivors about family and friend reactions were analyzed using interpretive phenomenological techniques. Three distinct patterns emerged as follows: (a) Stigmatizing statements and emphasis on reactor’s feelings were interpreted as signs that attempt survivors […]

Psychiatrists-in-training typically learn that assessments of suicide risk should culminate in a probability judgment expressed as Òlow,Ó Òmoderate,Ó or Òhigh.Ó This way of formulating risk has predominated in psychiatric education and practice, despite little evidence for its validity, reliability, or utility. We present a model for teaching and communicating suicide risk assessments without categorical predictions. […]

In this study, we set out to extend empirical research on the Life-Death Implicit Association Test (IAT) by administering the measure to an adult psychiatric inpatient population with suicidal ideation. We sought to examine its association with other suicide-relevant measures and to determine whether it adds predictive utility beyond that offered by other measures of […]

Prospective predictors of persistent nonsuicidal self-injury (NSSI) were examined in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Seventy-one (77%) participants reported NSSI at baseline, and 40 (56%) persisted at the 6 month follow-up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI […]

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To describe the intent and process of reviews undertaken following the death by suicide of an inpatient and suggest possible improvements. While Root Cause Analysis remains a useful methodology, review of inpatient suicides should go beyond examination of systems issues only, and include consideration of the care and treatment provided: whether it met accepted clinical […]

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The patient who is at-risk for suicide is complex and is difficult to evaluate and treat effectively. Should suicidal behavior occur, the clinician faces the potential wrath of bereaved survivors and their externalized blame exercised through a malpractice suit.

Six years ago the Journal of Transcultural Psychiatry published the results of an epidemiological study (Chandler & Lalonde, 1998) in which the highly variable rates of youth suicide shown to characterize British ColumbiaÕs (BCÕs) First Nations were set in relation to a half dozen markers of Òcultural continuityÓÐÐcommunity level variables meant to document the extent […]