scholarly journals A New Approach to Suicidal Behavior Diagnostics: A Review of Foreign Sources

2020 ◽  
Vol 28 (1) ◽  
pp. 8-24
Author(s):  
G.S. Bannikov ◽  
O.V. Vihristyuk ◽  
I. Galynker
Keyword(s):  
Suicidal Behavior ◽  
Suicide Risk ◽  
Assessment Tools ◽  
Suicide Risk Assessment ◽  
Short Term ◽  
New Approach ◽  
New Methods ◽  
Risk Assessment Tools ◽  
Suicidal Crisis

The paper presents a review of the studies on innovative suicide prevention strategies, methods, and approaches to diagnosing suicide risk. We examine the results of the studies that allow developing new approaches to creating effective suicide risk assessment tools, based on building a trusting relationship with the patient/client and focusing on the doctor’s/therapist’s own emotional experiences. We describe a complex narrative-crisis model of suicide that includes long-term and short-term risk factors for suicidal behavior and incorporates the suicidal crisis syndrome. We conclude with describing modern tendencies in suicide risk diagnostics — namely, overestimating the methods’ efficiency. New methods for assessing critical states possessing good predictive validity should be developed and implemented.

Suicide risk assessment in a large public mental health service: do suicide risk classifications identify those at risk?

2021 ◽  
pp. 103985622098403
Author(s):  
Marianne Wyder ◽  
Manaan Kar Ray ◽  
Samara Russell ◽  
Kieran Kinsella ◽  
David Crompton ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Assessment ◽  
High Risk ◽  
Suicide Risk ◽  
Public Mental Health ◽  
Assessment Tools ◽  
Suicide Risk Assessment ◽  
Public Mental Health Service ◽  
Risk Assessment Tools

Introduction: Risk assessment tools are routinely used to identify patients at high risk. There is increasing evidence that these tools may not be sufficiently accurate to determine the risk of suicide of people, particularly those being treated in community mental health settings. Methods: An outcome analysis for case serials of people who died by suicide between January 2014 and December 2016 and had contact with a public mental health service within 31 days prior to their death. Results: Of the 68 people who had contact, 70.5% had a formal risk assessment. Seventy-five per cent were classified as low risk of suicide. None were identified as being at high risk. While individual risk factors were identified, these did not allow to differentiate between patients classified as low or medium. Discussion: Risk categorisation contributes little to patient safety. Given the dynamic nature of suicide risk, a risk assessment should focus on modifiable risk factors and safety planning rather than risk prediction. Conclusion: The prediction value of suicide risk assessment tools is limited. The risk classifications of high, medium or low could become the basis of denying necessary treatment to many and delivering unnecessary treatment to some and should not be used for care allocation.

The Suicidal Crisis

2017 ◽  
Author(s):  
Igor Galynker
Keyword(s):  
Risk Assessment ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Stressful Life Events ◽  
Suicidal Patient ◽  
Short Term ◽  
Clinical Value ◽  
Reference Guide ◽  
Case Vignettes ◽  
Suicidal Crisis

One of the most difficult determinations a psychiatrist makes is whether the chronically suicidal patient is at risk for suicide in the immediate future. The Suicidal Narrative is the first book to help clinicians evaluate the risk of imminent suicidal behavior. The book describes a theoretical framework for a systematic and comprehensive assessment of short-term suicide risk and also describes practical ways of conducting risk assessment interviews in different settings. The book is based on the narrative crisis model of suicide, which posits that individuals with trait vulnerability for suicide attempt suicide after they develop the suicide crisis syndrome when they feel that their life narrative has no acceptable future. This book first reviews current models of suicidal behavior and introduces the narrative crisis model of suicide. Next, it provides a comprehensive description of trait vulnerabilities followed by a discussion of stressful life events that may increase short-term suicide risk. The book’s core introduces the key concepts of the narrative crisis model of suicide—the suicidal narrative and suicide crisis syndrome—and addresses the clinical value of clinicians’ emotional responses to suicidal patients. Finally, the book provides practical guidance for conducting short-term suicide risk assessment and introduces current approaches to suicide risk reduction. The Suicidal Narrative is designed as a textbook and reference guide. The book contains more than 50 clinical case vignettes, detailed examples of risk assessment interviews, as well as test cases for self-assessment.

Improving Risk Assessment with Suicidal Patients

Crisis ◽  
2010 ◽  
Vol 31 (5) ◽  
pp. 231-237 ◽  
Author(s):  
Charles Nelson ◽  
Megan Johnston ◽  
Amresh Shrivastava
Keyword(s):  
Risk Assessment ◽  
Suicide Risk ◽  
Function Analysis ◽  
Psychiatric Patients ◽  
Assessment Tools ◽  
Suicide Risk Assessment ◽  
Risk Assessment Tools ◽  
Admission Status ◽  
Suicidal Patients ◽  
New Strategies

Background: Although a number of suicide-risk assessment tools are available to clinicians, the high levels of suicide still evident in society suggest a clear need for new strategies in order to facilitate the prevention of suicidal behaviors. Aims: The present study examined the utilization of a new structured clinical interview called the Scale for Impact of Suicidality Management, Assessment, and Planning of Care (SIS-MAP). Methods: SIS-MAP ratings were obtained from a group of incoming psychiatric patients over a 6-month period at Regional Mental Health Care, St. Thomas, Canada. Results: A canonical discriminant function analysis resulted in a total 74.0% of original grouped cases correctly classified based on admission status (admitted or not; Wilks λ = .749, p < .001). The specificity of the scale was 78.1%, while the sensitivity of the scale was 66.7%. Additionally, mean total scores on the scale were used to establish clinical cutoffs to facilitate future level of care decisions. Conclusions: Preliminary analysis suggests the SIS-MAP is a valid and reliable tool for determining the level of psychiatric care needed for adults with suicidal ideation.

scholarly journals Crisis Concept Re-loaded?—The Recently Described Suicide-Specific Syndromes May Help to Better Understand Suicidal Behavior and Assess Imminent Suicide Risk More Effectively

2021 ◽  
Vol 12 ◽  
Author(s):  
Viktor Voros ◽  
Tamas Tenyi ◽  
Agnes Nagy ◽  
Sandor Fekete ◽  
Peter Osvath
Keyword(s):  
Risk Factors ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Objective Assessment ◽  
Assessment Tools ◽  
Health Concern ◽  
Major Step ◽  
Suicide Prediction ◽  
Psychological Features ◽  
Suicidal Crisis

Background: Despite of the decreasing suicide rates in many countries, suicide is still a major public health concern worldwide. Traditional suicide risk factors have limited clinical predictive value, as they provide little reliable information on the acute psychological processes leading to suicide.Aims: The aim of this analysis is to describe and compare the recently introduced two suicide-specific syndromes [Acute Suicidal Affective Disturbance (ASAD) and Suicidal Crisis Syndrome (SCS)] with the classic psychological features of pre-suicidal crisis and also to assess the clinical utility of the new suicide prediction scales in contrast to classical risk factors.Method: Conceptual analysis.Results: Suicide-specific syndromes are not novel in terms of symptomatology or dynamics of symptom onset, but in their use of well-defined diagnostic criteria. In addition to symptomatic classification, they also provide an opportunity to objectively measure the current pre-suicidal emotional and mental state by validated tools.Limitations: Future studies need to be completed to prove the reliability and predictive validity of suicide-specific diagnostic categories and the related suicide risk assessment tools.Conclusion: Clinical use of suicide-specific syndromes is suggested. This transdiagnostic approach not only enables a more accurate and objective assessment of imminent suicide risk, but also facilitates research in neuroscience, which represent a major step forward in managing and complex understanding of suicidal behavior.

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