September 28, 2007
A colleague pointed me to a nice article on suicide risk assessment written by David J. Muzina, MD in the September issue of Current Psychiatry Online. The article is well-written and well-organized. The stepwise approach described can be quite helpful. I wish the article included more on documentation (there is only one sample note, and I’m not sure how helpful it is). The article also pays scant attention to families. But otherwise this is a really solid general reference on the subject.
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Thanks for the feedback on the article – I agree with your point about the need for family involvement as part of the suicide risk assessment and management. From the perspective of building up the protective factors for an individual patient with suicidal thinking, developing insight into the permanent pain endured by family members surviving after suicide is often a powerful deterrent to turning suicidal thoughts into actions. Engaging family involvement as much as the patient allows or as safety dictates is absolutely necessary.
For a better review of documentation of suicide risk assessment, I would refer the reader to several of the referenced articles in my paper – especially to the work of Jacobs and colleagues.
http://www.currentpsychiatry.com/article_pages.asp?AID=5306
David
Thank you for commenting on this post. I admire your work.
Couldn’t agree more with your thoughts about the suicidal individual’s insight into family pain. My additional concern is that we don’t really have good models for how to develop that. Nor do we yet have models for conducting suicide assessment when those presenting for treatment are couples or families–most training and articles assume a 1:1 therapeutic relationship.
Regarding documentation, thanks for pointing to those Jacobs et al references. Jacobs is the master! Yet even in those foundational pieces, I see few documentation exemplars. It’s not a criticism of their work (or yours!) just a comment on the fact that this remains a needed contribution.
Thank you again for commenting! I look forward to continuing to follow you work.