title: The effects of suicide ideation assessments on urges to self-harm and suicide.
abstract: BACKGROUND
  Participants' safety is the primary concern when conducting research with suicidal or potentially suicidal participants. The presence of suicide risk is often an exclusion criterion for research participants. Subsequently, few studies have examined the effects of research assessments on study participants' suicidality.
  
  
  OBJECTIVE
  The purpose of this research was to examine the patterns of postassessment changes in self-harm and suicide urges of study participants who were recently discharged from an inpatient psychiatric service.
  
  
  METHODS
  Study participants (N = 120) were recruited from patients with a lifetime history of suicidal behavior admitted with current suicidal ideation or suicide attempt to an inpatient psychiatric service and/or a crisis stabilization unit. Participants were assessed for suicidal ideation with the Suicide Ideation Scale at 1, 3, and 6 months following their discharge from hospital. The risk assessment protocol was administered at the start and at the end of each of the study follow-up assessments.
  
  
  RESULTS
  Changes in self-harm and suicide urges following study assessments were small, infrequent, and were most likely to reflect a decrease in suicidality. Similarly, participants rarely reported worsening self-control over suicidal urges, and when they did, the effect was minimal. By the end of the 6-month follow-up period, increases in self-harm and suicidal urges postassessment were not seen.
  
  
  CONCLUSIONS
  The inclusion of suicidal participants in research interviews rarely increased suicide risk. Research involving suicidal individuals is possible when study protocols are well planned and executed by trained assessors and clinicians who are able to identify participants at risk and provide intervention if necessary. The few participants that required intervention had high levels of suicide ideation and behavior at baseline and almost all reported symptoms of posttraumatic stress disorder. Further study is needed to better characterize this subgroup of participants.
authors.affiliation: <location>Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada</location>
authors.forename: Rahel
authors.initials: R
authors.lastname: Eynan
authors.affiliation: <location>St. Michael's Hospital, Toronto, Ontario, Canada</location>
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Bergmans
authors.affiliation: <location>St. Michael's Hospital, Toronto, Ontario, Canada</location>
authors.forename: Jesmin
authors.initials: J
authors.lastname: Antony
authors.affiliation: <location>University of Ottawa, Ottawa, Ontario, Canada</location>
authors.forename: John R
authors.initials: JR
authors.lastname: Cutcliffe
authors.affiliation: <location>University of Northern British Columbia, Canada</location>
authors.forename: Henry G
authors.initials: HG
authors.lastname: Harder
authors.affiliation: <location>The Hospital for Sick Children, Toronto, Ontario, Canada</location>
authors.forename: Munazzah
authors.initials: M
authors.lastname: Ambreen
authors.affiliation: <location>St. Michael's Hospital, Toronto, Ontario, Canada</location>
authors.forename: Ken
authors.initials: K
authors.lastname: Balderson
authors.affiliation: <location>Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada</location>
authors.forename: Paul S
authors.initials: PS
authors.lastname: Links
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D016728:Self-Injurious Behavior / Q000523:psychology*; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology*
keywords: self-harm urges; suicidal ideation; suicide; suicide risk assessment; suicide urges