Suicide Prevention Blog Series: Clinical Tip #2

by Staff and Faculty of the QPR Institute Saturday, October 26, 2013

 

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Releasewe bring you this five part series of clinical tips with the most up to date research and thinking on suicide prevention.  

Paul Quinnett, PhD, President and CEO, The QPR Institute, Inc, says 22 veterans will take their own lives today.  So will someone's daughter, a brother, a co-worker, and far too many working men and grandfathers.  According to the Centers for Disease Control and Prevention, in just one day, more then 105 of our fellow Americans will die by suicide.  Perhaps this clinical tip will save just one.

Clinical Tip #2 -- Documenting Reasons to NOT Hospitalize

When deciding not to hospitalize a patient at risk for suicide, it is important that the clinician conduct a risk-benefit analysis.  The reasons for hospitalization may include the relative assurance of a safer, more controlled environment, a beneficial milieu, multidisciplinary staff evaluation, initiation of stabilizing medications, etc.  The reasons not to hospitalize a suicidal person might include potential loss of self-esteem, stigmatization, risk of losing a job, fostering unwanted dependency, failure to benefit from prior hospitalizations, etc.  When confronted with a possible hospitalization, the patient may also express a willingness to participate in outpatient treatment and adhere to a medication regimen. 

Whatever your reasons to not hospitalize a consumer who has expressed suicidal ideations, prior plans or suicide attempts, it is strongly recommended that the primary care provider seek consultation and/or supervision regarding the decision and to carefully document the reasons for this decision.  In a world of increasing litigation for suicide malpractice, and if a bad outcome is experienced, an uniformed jury will need to be convinced that 1) you thought the problem through, 2) you weighed the risks and benefits carefully with the patient and his or her family, and 3) you took a reasonable and prudent course of action.

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals including: Mental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers.

For more information please visit our full library of advanced courses!

 

Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRinstitute.com

 


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Self-Care | Social Work | Suicide Bereavement | Suicide Prevention | Treatment Modalities

Suicide Prevention Blog Series: Clinical Tip #1

by Staff and Faculty of the QPR Institute Friday, October 4, 2013

 

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Release) we bring you this five week series of clinical tips with the most up to date research and thinking on suicide prevention.

Clinical tip #1 -- So-called “No-Suicide Contracts”

Despite clinical lore there is no scientific evidence that so-called “no suicide” contracts actually save lives or prevent suicide attempts.  Despite their widespread use, specific training in their purpose, utility, and employment is largely unavailable.  

The use of a no-suicide contract as a defense against a complaint of suicide malpractice is at best dubious and at worst negligent.  However, experts generally agree that the refusal of a suicidal person to enter into a good-faith agreement to remain safe (which implies a willingness to participate in recommended treatment), suggests the risk for a suicide attempt may be higher than first assessed. 
 
Documentation of clinical status, including the results of a mental status examination, together with a detailed suicide risk assessment are the best evidence that due clinical diligence was undertaken. Care planning, level of monitoring, frequency of visits, and similar interventions hinge on the quality of the initial and subsequent reassessment of suicide risk. For the most recent literature review, please see Lisa McConnell Lewis, LCSW’s “No-Harm Contracts: A Review of What We Know, Suicide and Life-Threatening Behavior, vol. 7, #`, February, 2007.

The QPR Institute (www.QPRinstitute.com) provides Online Advanced Suicide Prevention Courses for a wide range of professionals including: Mental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers.

For more information please visit our full library of advanced courses!

 

  Paul Quinnett, PhD., Founder & CEO QPR Institute, www.QPRinstitute.com

 


Tags:

Self-Care | Social Work | Suicide Bereavement | Suicide Prevention

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