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The Standard of Care in Suicide Risk Assessment: An Elusive Concept

Published online by Cambridge University Press:  07 November 2014

Robert I. Simon  and
Daniel W. Shuman
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Abstract

Suicide risk assessment is now a core competency requirement in the residency training of psychiatrists.The purpose of suicide risk assessment is to identify modifiable or treatable acute, high-risk suicide factors, and available protective factors that inform patient treatment and safety management.The standard of care varies according to state statutory definitions. Heretofore, most states adopted an average physician or “ordinarily employed standard.” Currently, more states are adopting a “reasonable, prudent physician” standard. No single source or authority defines the standard of care for suicide risk assessment. Evidence-based psychiatry can inform clinicians' suicide risk assessments. Carefully documented risk assessments will assist the courts in evaluating clinicians' decision-making process.

Type
Review Articles
Information
CNS Spectrums , Volume 11 , Issue 6 , June 2006 , pp. 442 - 445
Copyright
Copyright © Cambridge University Press 2006

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References

REFERENCES

1.Scheiber, SC, Kramer, TAM, Adamowski, SE. Core Competence for Psychiatric Practice: What Clinicians Need to Know. Washington, DC: American Psychiatric Publishing; 2003.Google Scholar
2.Simon, RI. Psychiatry and Law for Clinicians. 3rd ed. Washington, DC: American Psychiatric Publishing; 2001.Google Scholar
3.Swann, AC, Dougherty, DM, Pazzaglia, PJ, Pham, M, Steinberg, JL, Moeller, FG. Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder. Am J Psychiatry. 2005;162:1680–1587.Google Scholar
4.American Psychiatric Association. Risk management issues in psychiatric practice. Workshop presented at: the annual meeting of the American Psychiatric Association. Philadelphia, Penn; May 20, 2002.Google Scholar
5.Pokorny, AD. Predictions of suicide in psychiatric patients. Report of a prospective study. Arch Gen Psychiatry. 1983;40:249–257.Google Scholar
6.Pokorny, AD. Suicide prediction revisited. Suicide Life Threat Behav. 1993;23:1–10.Google Scholar
7.Peters, PG. The quiet demise of deference to custom: malpractice law at the millennium. Wash Lee Law Rev. 2000;57:163–205.Google Scholar
8.Simon, RI. Suicide risk assessment: what is the standard of care? J Am Acad Psychiatry Law. 2002;30:340–344.Google Scholar
9.Stepakoff v Kantar, 473 N.E.2d 1131,1134 (Mass. 1985).Google Scholar
10.Shuman, DW. Legal perspectives on suicide assessment and management. In: Simon, RI, Hales, RE, eds. Standard of Care in American Psychiatric Publishing Textbook of Suicide Assessment and Management. Arlington, Va: American Psychiatric Publishing; 2006:511–526.Google Scholar
11.Gutheil, TG, Simon, RI. Avoiding bias in expert testimony. Psychiatr Ann. 2004;34:260–270.Google Scholar
12.Simon, RI. Standard-of-care testimony: best practices or reasonable care? J Am Acad Psychiatry Law. 2005;33:8–11.Google Scholar
13.Beck, AT, Steer, RA, Ranieri, WF. Scale for suicidal ideation: psychometric properties of a self-report version. J Clin Psychol. 1988;44:499–505.Google Scholar
14.Clark, DC, Fawcett, J. An empirically-based model of suicide risk assessment of patients with affective disorders. In: Jacobs, DJ, ed. Suicide and Clinical Practice. Washington, DC: American Psychiatric Association; 1992:55–73.Google Scholar
15.Jacobs, DG, Brewer, M. Klein-Benheim, M. Suicide assessment: an overview and recommended protocol. In: Jacobs, DJ, ed. Guide to Suicide Assessment and Intervention. San Francisco, Calif: Jossey-Bass; 1999:3–39.Google Scholar
16.Linehan, MM. Cognitive Behavioral Treatment of Borderline Personality Disorder. New York, NY: Guilford Press; 1993.Google Scholar
17.Mays, D. Structured assessment methods may improve suicide prevention. Psychiatr Ann. 2004;34:367–372.CrossRefGoogle Scholar
18.Rudd, MD, Joiner, T, Rajab, MH. Treating Suicidal Behavior: An Effective, Time-Limited Approach. New York, NY: Guilford Press; 2001.Google Scholar
19.Shea, SC. The delicate art of eliciting suicidal ideation. Psychiatr Ann. 2004;34:385–400.Google Scholar
20.Simon, RI. Suicide risk: assessing the unpredictable. In: Simon, RI, Hales, RE, eds. American Psychiatric Publishing Textbook of Suicide Assessment and Management. Arlington, Va: American Psychiatric Publishing; 2006,1–32.Google Scholar
21.Busch, KA, Clark, DC, Fawcett, J, Kravitz, HM. Clinical features of inpatient suicide. Psychiatr Ann. 1993;23:256–262.CrossRefGoogle Scholar
22.Shekelle, PG, Ortiz, E, Rhodes, S, et al.Validity of the Agency for Healthcare Research and Quality clinical practice guidelines: how quickly do guidelines become outdated? JAMA. 2001;286:1461–1467.CrossRefGoogle ScholarPubMed
23.Gray, GE. Evidence Based Psychiatry. Washington, DC: American Psychiatric Publishing; 2004.Google Scholar
24.Swartz, CM. Knowing that we don't know. Psychiatric Times. June 2004:53–54.Google Scholar
25.Simon, RI. Assessing and Managing Suicide Risk: Guidelines for Clinically Based Risk Management. Arlington, Va: American Psychiatric Publishing; 2004.Google Scholar