Risk Assessment of Suicide in Clinical Practice

Abstract

Suicide is a global public health problem. Its management in clinical practice is complex and challenging .Studies show about 26% suicide in mental health system. Out of these, 14% commit suicide during hospital stay; about 50-90% have at least one psychiatric diagnosis. 60-70% of patients are hospitalized due to an attempt or potential crisis, about 15-20% attempt suicide prior to admission. Suicide is also common in post-discharge period. Every psychiatrist on an average loses atleast on client due to suicide in an average span of 20 years of practice. In about 70% of cases, suicide behavior is there as on for hospitalization in acute settings. Continuous training and skill development are two of the most important measures in clinical practice for dealing with suicide behavior. High suicide rates are reported in prodromal stage, acute illness, post-hospitalization and soon after discharge in the community. A clinician faces challenging situations while determining the level of care and referral for a patient with a high suicide potential. There is continued struggle amongst clinicians for decision-making in regards to the need for hospitalization, level of monitoring, voluntary status, and time of discharge. It is generally agreed that suicide is difficult to predict and prevent; however, in order to develop clinical excellence and offer a standard of care, continued education and knowledge translation for bringing research into practice is the least that can be done. Inspite of this need, continued education for mental health professionals and psychiatrists in-training remains limited.