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Assessing risk of suicide and self-harm
Published in Chambers Mary, Psychiatric and mental health nursing, 2017
Following an act of self-harm, it is important to establish whether suicidal intent was a motivating factor for this act. If the answer is ‘yes’, interventions must be geared towards keeping the patient safe, and a full suicide risk assessment, plan of action and support appropriate to the risk are necessary.13 Ambivalence is common in self-harm and suicide,51 so trying to understand the degree to which the person wanted to live or die at the time of the act is helpful. Tools like the Beck28 and Pierce52 intent scales are helpful in determining suicide intent at the time of their act. It may be useful to differentiate between the suicide intent and medical lethality of self-harm.6 Caution is needed in interpreting the scoring in isolation, as a low score could result from a patient being unaware that their self-harm was of such a medical lethality. Some patients may find their self-harm highly cathartic and an initial high intent may convert to a low-risk situation. Other tools that may help the nurse as part of a comprehensive holistic assessment following self-harm include the Manchester Self-harm Rule & ReACT,53,54 the Barratt Impulsivity Scale55 and the SAD PERSONS Scale.56
Suicide Presentations to an Emergency Department Pre and During the COVID Lockdown, March–May 2020, in Spain
Published in Archives of Suicide Research, 2022
Juan L. Prados-Ojeda, Rafael M. Gordillo-Urbano, Teresa Carrillo-Pérez, Alba Vázquez-Calvo, Mario A. Herrera-Cortés, M. Ángeles Carreño-Ruiz, Pilar Font-Ugalde
In the present study, we aimed to investigate the attempted suicide and suicide cases that presented to the emergency department (ED) of the University Hospital Reina Sofia, Cordoba, Spain, during the state of emergency decreed by the Spanish government and compare those with the cases recorded during the same time period, the year before in 2019. The University Hospital Reina Sofia is a tertiary referral hospital and covers a population of 790,000 persons. We further aimed to determine if there were differences between the 2019 and 2020 period in terms of sociodemographic characteristics, previous mental health and suicide attempt history, consult reason, hospital admissions, number of days of admission, and severity on the SAD PERSONS scale. We hypothesized that during the state of emergency nation-wide population quarantine due to the COVID-19 pandemic in 2020, the number of suicide attempts presenting to the ED would have increased.
Protective Factors of Suicide and Suicidal Behavior Relevant to Emergency Healthcare Settings: A Systematic Review and Narrative Synthesis of Post-2007 Reviews
Published in Archives of Suicide Research, 2019
Kirstie McClatchey, Jennifer Murray, Zoë Chouliara, Anne Rowat
Research has also investigated whether protective factors can predict suicide attempts. For example, Choi et al. (2013) found that a person’s previous year’s highest global functioning score, as measured by the Global Assessment of Functioning, and being over 45 years old, served as protective factors against multiple suicide attempts, however this was not a longitudinal study, and only assessed participants from one hospital. Simon (2011) notes that protective factors are frequently overlooked in clinical assessments and suicide risk assessment forms. Recent research established that the SAD PERSONS scale is the most commonly used risk assessment scale used in hospitals in England to assess suicide risk following self-harm (Quinlivan et al., 2014), however SAD PERSONS fails to adequately address protective factors. In violence risk assessment practices, the consideration for protective factors within the assessment is increasingly being brought to the forefront (Jones & Brown, 2008), with some assessment tools now focused solely on protective factors (e.g., the Structured Assessment of Protective Factors [SAPROF]; de Vogel, de Ruiter, Bouman, & de Vries Robbe, 2007).
Preventing suicidal behavior in patients with multiple sclerosis: a scoping review
Published in Expert Review of Neurotherapeutics, 2018
Angelina Mellentin, Elsebeth Nylev Stenager, Egon Stenager
Independently of the concerned healthcare professional having the contact and responsibility, an important issue is availability of tools for healthcare professionals to identify the patients with an increased suicide risk. Several standardized risk assessment instruments are available, such as Becks scale for suicide ideation and intent, Becks hopelessness scale, Beck depression inventory [67–72], SAD PERSONS scale [73], the Columbia-suicide severity rating scale (C-SSRS) [74], the suicide trigger scale (STS [75,76]), the suicide probability scale (SPS [77]), the self-injurious thoughts and behaviors interview (SITBI [78]), etc. However, studies are lacking in regards to the predictive validity of many instruments in non-MS populations and the identification of suicide ideation and behavior is based on self-reporting [64,65]. Further, due to the interdisciplinary contact with MS patients and the rare occurrence of suicidal behavior it may not be relevant to initiate screening and diagnostic assessment programs for all patients but restrict it to vulnerable patients. The best way to routinely assess suicidal ideation and behavior is simply be courageous and to talk with the patient about the topic and show interest, with a focus on relevant risk factors in patients with MS. This presupposes education of healthcare professionals in identifying suicidal ideation and behavior and knowledge how to act competent when meeting such behavior, which may also be applicable to patients with other neurological disorders.