Suicide risk assessment in the emergency department: an investigation of current practice in Scotland

Kirstie McClatchey*, Jennifer Murray, Zoe Chouliara, Anne Rowat, Samantha R. Hauge

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Suicide is a global public health issue. Approximately one third of individuals who complete suicide have attended an emergency department in the year preceding their death. The aim of this study was to investigate current suicide risk assessment practices across emergency department clinicians in Scotland.

Methods: A mixed‐methods design was employed. A total of 112 surveys for emergency department clinicians were posted to 23 emergency departments in Scotland between March and September 2016. Follow‐up semi‐structured interviews were also conducted exploring clinician's experiences of suicide risk assessment. Interviews were analysed using thematic analysis.

Results: Fifty‐one emergency department clinicians across 17 emergency departments completed the survey. Thirty‐five (68.6%) participants were currently using a suicide risk assessment tool; with most using locally developed tools and proformas (n = 20, 62.5%) or the SAD PERSONS scale (n = 13, 40.6%). Remaining participants (n = 16, 31.4%) did not use suicide risk assessment tools during assessment. Variation in practice was found both across and within emergency departments. Six clinicians participated in follow‐up interviews, which identified four major themes: Clinician Experiences of Suicide Risk Assessment; Components of Suicide Risk Assessment; Clinical Decision‐Making; and Supporting Clinicians.

Conclusions: There is substantial variation in current practice, with around two‐thirds of clinicians using a variety of empirically and locally developed tools, and a third using their judgement alone. Clinicians find suicide risk assessment a challenging part of their role and discuss the need for increased training, and appropriate and helpful guidelines to improve practice.
Original languageEnglish
Article numbere13342
Number of pages7
JournalInternational Journal of Clinical Practice
Volume73
Issue number4
Early online date28 Mar 2019
DOIs
Publication statusPublished - 29 Apr 2019

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Scotland
Suicide
Hospital Emergency Service
Interviews
Public Health
Guidelines

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McClatchey, Kirstie ; Murray, Jennifer ; Chouliara, Zoe ; Rowat, Anne ; Hauge, Samantha R. . / Suicide risk assessment in the emergency department : an investigation of current practice in Scotland. In: International Journal of Clinical Practice. 2019 ; Vol. 73, No. 4.
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abstract = "Background: Suicide is a global public health issue. Approximately one third of individuals who complete suicide have attended an emergency department in the year preceding their death. The aim of this study was to investigate current suicide risk assessment practices across emergency department clinicians in Scotland.Methods: A mixed‐methods design was employed. A total of 112 surveys for emergency department clinicians were posted to 23 emergency departments in Scotland between March and September 2016. Follow‐up semi‐structured interviews were also conducted exploring clinician's experiences of suicide risk assessment. Interviews were analysed using thematic analysis.Results: Fifty‐one emergency department clinicians across 17 emergency departments completed the survey. Thirty‐five (68.6{\%}) participants were currently using a suicide risk assessment tool; with most using locally developed tools and proformas (n = 20, 62.5{\%}) or the SAD PERSONS scale (n = 13, 40.6{\%}). Remaining participants (n = 16, 31.4{\%}) did not use suicide risk assessment tools during assessment. Variation in practice was found both across and within emergency departments. Six clinicians participated in follow‐up interviews, which identified four major themes: Clinician Experiences of Suicide Risk Assessment; Components of Suicide Risk Assessment; Clinical Decision‐Making; and Supporting Clinicians.Conclusions: There is substantial variation in current practice, with around two‐thirds of clinicians using a variety of empirically and locally developed tools, and a third using their judgement alone. Clinicians find suicide risk assessment a challenging part of their role and discuss the need for increased training, and appropriate and helpful guidelines to improve practice.",
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Suicide risk assessment in the emergency department : an investigation of current practice in Scotland. / McClatchey, Kirstie; Murray, Jennifer; Chouliara, Zoe; Rowat, Anne; Hauge, Samantha R. .

In: International Journal of Clinical Practice, Vol. 73, No. 4, e13342, 29.04.2019.

Research output: Contribution to journalArticle

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