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