title: A model for therapeutic risk management of the suicidal patient.
abstract: While the practice of psychiatry involves many challenges, few scenarios are as clinically and emotionally demanding as managing the patient who is at high risk for suicide. Risk management is a reality of psychiatric practice, and this necessitates practicing and documenting thoughtful suicide risk assessment and management. Therapeutic risk management is based on clinical risk management that is patient-centered, supportive of the treatment process, and maintains the therapeutic alliance. In this article, the authors present a broad overview of a model for achieving therapeutic risk management of the suicidal patient that involves augmenting clinical risk assessment with structured instruments, stratifying risk in terms of both severity and temporality, and developing and documenting a safety plan. These elements are readily accessible to and deployable by mental health clinicians in most disciplines and treatment settings, and they collectively yield a suicide risk assessment and management process (and attendant documentation) that should withstand the scrutiny that often occurs in the wake of a patient suicide or suicide attempt.
authors.affiliation: Michael K. Cooper Professor of Neurocognitive Disease, and Faculty for Forensic Psychiatry Fellowship at University of Colorado, USA. hal.wortzel@ucdenver.edu
authors.forename: Hal S
authors.initials: HS
authors.lastname: Wortzel
authors.forename: Bridget
authors.initials: B
authors.lastname: Matarazzo
authors.forename: Beeta
authors.initials: B
authors.lastname: Homaifar
mesh_terms: D003134:Commitment of Persons with Psychiatric Disorders; D006801:Humans; D011369:Professional-Patient Relations; D011570:Psychiatry / Q000379:methods*; D012306:Risk; D018570:Risk Assessment / Q000379:methods; D000092864:Suicide Prevention