Effect of Patient and Therapist Factors on Suicide Risk Assessment

Abstract

The present study examined how patient risk factors and clinician demographics predict the assessment of suicide risk. Clinicians (N = 333) read two vignettes, one of which manipulated patient risk factors, then rated the patient's likelihood of suicide and need for hospitalization. Clinicians' assessments were heterogeneous. Results indicated that certain patient risk factors (access to excess medication) and clinician demographics (relationship status, religiosity) predicted perceived suicide risk; and, moreover, clinicians' suicide risk assessment did not always align with the decision to hospitalize the patient. The authors discuss methods for standardizing clinicians' judgment of risk and minimizing error through debiasing strategies (cognitive forcing strategy).

Suicide Crisis Syndrome: A review of supporting evidence for a new suicide‐specific diagnosis

“…A patient's suicide attempt has been found to be extremely stressful for the clinician (Berman, Stark, Cooperman, Wilhelm, & Cohen, 2015). The emotional burden that comes with this event is critical to understand.…”

How accurate are suicide risk prediction models? Asking the right questions for clinical practice

“…It has also been argued that the process of stratifying risk detracts from undertaking a holistic, therapeutic assessment of needs. 15 These two do not have to be mutually exclusive, and it is possible to consider the situation where a tool acts as an adjunct or aid for clinical decision-making that can improve efficiency and consistency, 16 and anchor assessments in an evidence base, thus giving clinicians greater confidence and time to focus on developing an individualised treatment plan, importantly shifting the focus away from lengthy risk assessments and on to risk management. This will form part of the process of translating advances in data science to clinical benefit.…”

Associations between clinicians' emotional responses, therapeutic alliance, and patient suicidal ideation

“…In clinical encounters with individuals at risk for suicide, clinicians are challenged to make accurate risk assessments and critical treatment decisions while developing or maintaining a solid therapeutic alliance (American Psychiatric Association, ). Encounters with suicidal individuals (i.e., individuals who present with suicide attempts and/or ideation) are consistently reported by mental health professionals to be highly stressful (Berman, Stark, Cooperman, Wilhelm, & Cohen, ; Deutsch, ; Jahn, Quinnett, & Ries, ; Roush et al, ). Documented emotional responses to suicidal patients include feelings of anxiety, incompetence, frustration, anger, as well as helplessness, discouragement, sadness, and guilt (For recent reviews see Ellis, Schwartz, & Rufino, ; Soulié, Bell, Jenkin, Sim, & Collings, ).…”