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How do mental health professionals deal with uncertainty in suicide risk assessment?

Published online by Cambridge University Press:  16 April 2020

K. Manley
Affiliation:
Academic Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK General Adult Psychiatry, Norfolk and Waveney Mental Health NHS Foundation Trust, Norwich, UK
J. Beezhold
Affiliation:
General Adult Psychiatry, Norfolk and Waveney Mental Health NHS Foundation Trust, Norwich, UK

Abstract

Introduction

Suicide risk-assessment forms a significant part of the workload of mental health professionals (MHPs). There is much research regarding efficacy of different methods/scales of suicide risk-assessment, and effects of formal training on risk-assessment. To date, there is little investigation into how approach to risk-assessment varies amongst professionals on an individual level, or how MHPs react when confronted by lack of information.

Objective

This study evaluated how MHPs respond to uncertainty when assessing suicide risk.

Methods

720 MHPs were given 10 clinical scenarios and asked to assess suicide risk in each case. The scenarios were a mixture of high, medium and low risk cases. In addition, there were scenarios where information provided was incomplete or ambiguous. Subjects graded suicide risk-severity from 1–10 (1 = low, 10 = high).

Results

The simple scenarios produced a predictable consensus of opinion amongst MHPs. The ambiguous scenario produced three distinct response peaks (Fig. 1) at low, medium, and high risk.

Fig. 1

[Fig 1]

Conclusions

Ambiguous suicide risk separates MHPs into three responder groups:

  1. 1. ‘don’t know’

  2. 2. more cautious, assumes higher risk

  3. 3. less cautious, assumes lower risk.

This has implications for suicide risk training. Further research is required to fully understand why individuals respond in different ways to suicide risk scenarios.

Type
P03-458
Copyright
Copyright © European Psychiatric Association 2011
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