An overview of the assessment tools available to mental health professionals to help determine patients at risk of suicide.
Tools are frequently used in psychiatry in an attempt to assess the patient's mental state and this in turn should partly determine his management. A given example is suicide evaluation, where tools are regularly used but seldom questioned as to their effectiveness or appropriateness. At the outset, this paper highlights the relative paucity of research into suicide assessment scales and rationales are offered explaining this. Furthermore, attention is drawn to the concept that relatively low base rates of suicide can provide false and misleading data. Additionally, analyses are made of a number of suicide assessment scales and this is achieved through a comprehensive literature review on the subject area. The five pieces of research examined come from different parts of the world, however they all share a commonality in that they are Western in culture. Nevertheless, no obvious leader arises from the combined results, with all the scales offering different conclusions as to the most effective scale for evaluating those at risk of suicide. These contradictions may be due to the fact that the research design and methodology used in the studies has been ill thought out and omissions such as the use of qualitative data is discernible in studies that deal with human behaviour. The suggested recommendations provided include further research in this area and that it should include the use of qualitative methods. A further recommendation is that suicide assessment should encompass both the physical environment as well as the patient's mental health and this would help ensure a more encompassing and in-depth assessment of the patient. Nevertheless, assessment scales, no matter how thorough they appear, should not be seen as a panacea for determining the overall management of a patient.
McPherson
Andrew
A
Dykebar Hospital, Paisley, United Kingdom.
D006801:Humans; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D018570:Risk Assessment; D000092864:Suicide Prevention