No abstract

In an effort to identify modifiable risk factors for suicide in New York State prisons, the authors reviewed available statistical data and also examined a series of 40 psychological autopsies conducted on suicides of inmates who had received mental health services during their incarceration. Factors associated with suicide included substance abuse, history of prior suicide attempts, mental health treatment prior to incarceration, recent "bad news," recent disciplinary action, and manifestation of agitation and/or anxiety. This review led to changes in certain clinical policies and procedures, environmental modifications and hazard reduction in observation cells, and an improved process for quality assurance reviews of suicides.

No abstract

Guidelines addressing the variables that should be considered in making disposition decisions in psychiatric emergency services should be developed. The study found five variables that should be considered for inclusion.

Psychiatric emergency service assessments need improvement. This may be accomplished by exploring the underlying structure of psychiatric emergency service concepts, the creation and validation of structured assessment tools, and the creation of practice guidelines.