Chapter 5 - Suicide risk assessment

Summary

The components of a suicide risk assessment should be easy to remember, be based on empirically demonstrable essential features, be readily transferable from emergency room or intensive care unit to consulting room, foster a therapeutic alliance, facilitate the gathering of valid information, and guide treatment decisions. Often after a serious suicide attempt, the patient suffers from medical complications while at the same time needing intensive psychiatric evaluation and treatment. Medical-psychiatry units (MPUs) can fill this gap in care for those with combined, complex medical and psychiatric illness. It is very important to restrain other physicians from automatically prescribing antidepressants for every medically ill patient who expresses a wish to die, which tends to pathologize normal grieving and leads to the overuse of psychotropic drugs. No empirical evidence has been found to support no-suicide or no-harm contracts; these contracts do not prevent suicides, nor do they protect one against malpractice lawsuits.