A Clinician S Guide To Suicide Risk Assessment And Management

This book offers mental health clinicians a comprehensive guide to assessing and managing suicide risk. Suicide has now come to be understood as a multidimensionally determined outcome, which stems from the complex interaction of biological, genetic, psychological, sociological and environmental factors. Based on recent evidence and an extensive literature review, the book provides straightforward, essential information that can easily be applied in a wide variety of disciplines.

Meeting a vital need, this book helps clinicians rapidly identify risks for suicidal behavior and manage an at-risk teen's ongoing care. It provides clear guidelines for conducting suicide risk screenings and comprehensive risk assessments and implementing immediate safety-focused interventions, as well as longer-term treatment plans. Designed for day-to-day use in private practice, schools, or other settings, the volume is grounded in a strong evidence base. It features quick-reference clinical pointers, sample dialogues with teens and parents, and reproducible assessment and documentation tools. Most of the reproducible materials can be downloaded and printed in a convenient 8 1/2" x 11" size. Winner (First Place)--American Journal of Nursing Book of the Year Award, Child Health Category

This highly practical book explains how to identify and manage suicidal individuals and supports the health professional in assisting the patient to choose life rather than death.

Today's psychiatrists practice in an environment that poses difficult challenges. Both treatment time and duration are limited by insurance requirements; many facilities are understaffed; split treatment arrangements are typical; and high-risk, acutely suicidal patients are admitted to inpatient units for short lengths of stay. In addition, law now plays a pervasive role in the practice of psychiatry. The doctor-patient relationship is no longer defined solely by the involved parties. Clinicians must juggle these requirements and limitations while providing the very best care to their patients, especially those at high risk. Preventing Patient Suicide: Clinical Assessment and Management provides the wisdom of Dr. Robert I. Simon's vast clinical experience, combined with the latest insights from the evidence-based psychiatric literature, to offer a cutting-edge survey of suicide prevention and management techniques. The author: Addresses sudden improvement in high-risk suicidal patients, a phenomenon both common and perilous, with techniques for determining whether the improvement is real or feigned. Explores in depth the misuse of suicide risk assessment forms, with emphasis on their inherent limitations. Examines the many entrenched myths and traditions about suicide, exposing them to the critical light of evidence-based medicine, including the concept of "imminent suicide risk" and the myth of "passive suicide ideation". Discusses the continuum of chronic and acute high-risk suicidal patients, the fluidity with which one can become the other, and the difficulty in assessing these patients. Explores how the law and psychiatry interact in frequently occurring clinical situations, and the importance of therapeutic risk management. In addition, the book contains a variety of features that illuminate the subject and enhance the reader's understanding, including: Inclusion of illustrative case studies, combined with commentary on commonly occurring but complex clinical situations. Key points at the end of each chapter that identify critical information. A Suicide Risk Assessment Self-Test, a teaching instrument that consists of fifty questions designed to enhance clinician suicide risk assessment by incorporating evidence-based risk and protective factors. Dr. Simon provides a nuanced, empathic, yet pragmatic perspective on identifying, assessing, and managing the suicidal patient while successfully navigating a complex legal and clinical environment that poses its own risks to the practitioner.

Patient suicide is an unavoidable occupational hazard of psychiatric practice. Indeed, it is the rare clinician who does not struggle, even agonize, over the complex task of assessing and managing the risk of suicide in patients. Patient suicides account for the greatest number of malpractice suits filed against psychiatrists and for the greatest number of settlements and verdicts covered by professional liability insurers. In this book, written by a clinician for clinicians, Dr. Simon, an established expert in psychiatry and law, offers A solid, easy-to-understand review of how medical malpractice law applies to patient suicides. He discusses the standards of care physicians must meet, the conditions associated with malpractice liability, and how best to minimize risks of litigation. Extensive references to peer-reviewed literature on suicide and recent malpractice cases, including those triggered by patient suicides, which give insight into the latest developments in both the scientific community and the courts. Much-needed practical advice, including advice on working with suicide risk assessments and suicide prevention contracts, on treating suicidal patients in various settings (outpatient, inpatient, collaborative, and emergency), and on coping with issues arising in the aftermath of a patient's suicide (documentation, confidentiality, and survivor care). Clearly defined risk management guidelines that will help clinicians avoid litigation or establish a sound legal defense if sued for malpractice. Numerous case examples that make the theoretical discussions and clinically based risk management guidelines that follow come alive. Rich in advice that draws on the author's more than 40 years of clinical experience, this book serves as an essential aid to clinicians.

Since the first edition of Clinical Manual for Assessment and Treatment of Suicidal Patients was published in 2005, advances have been made that increase our understanding of suicidal and self-destructive behavior. Although clinicians cannot unerringly predict which patients will die by suicide, they can focus more successfully on early identification of suicidal behavior and effective intervention, and this new edition of the clinical manual thoroughly explores not only assessment of suicidality but what comes after an at-risk patient has been identified. The authors argue that treating specific psychiatric disorders is not enough to prevent suicide, and they offer clinicians the necessary information and strategies to bridge that gap. The authors' main premise is that suicide is a dangerous and short-term problem-solving behavior designed to regulate or eliminate intense emotional pain -- a quick fix where a long-term effective solution is needed -- and this understanding is the underpinning of the assessment and treatment strategies the authors recommend. The content of this new edition has been thoroughly reviewed and revised, and substantive changes have been made to specific chapters to ensure that the book represents the most current thinking and research, while retaining the strengths of the previous edition. The chapter on assessment has been revised to put the fundamental components of effective treatment in a clinical, case-oriented context and includes an easy-to-use assessment protocol that allows clinicians to determine where individual patients stand on seven dimensions (cognitive rigidity, problem-solving deficits, heightened mental pain, emotionally avoidant coping style, interpersonal deficits, self-control deficits, and environmental stress and social support deficits). The many issues involved in the use of psychotropic medications in suicidal patients are addressed in a new chapter, which includes information on the relevant classes of drugs (such as antidepressants and antianxiety agents) and the issues that may arise with their use, including side effects, degree of lethality, and tendency to aggravate suicidality on introduction and withdrawal of the medication. The chapter on special populations has been expanded to include adolescents, elders, and patients with co-occurring substance abuse or psychosis. Because of additional vulnerabilities, treating these groups may call for the use of added or special techniques to ensure the best therapeutic outcomes. Primary care physicians are the first point of contact for many patients, and they may require additional preparation in order to assess and respond to those experiencing suicidal thoughts. The chapter "Suicidal Patients in Primary Care" explores strategies for screening, recognizing, and assessing risk; treating the initial crisis; and developing a crisis management plan. "Tips for Success" appear at intervals, and "The Essentials" are included at the end of each chapter, highlighting the most important concepts. In addition, there are scores of helpful charts and exercises. Practical, accessible, and reader-friendly, the Clinical Manual for Assessment and Treatment of Suicidal Patients is not an academic book but rather is one designed to become an indispensable part of clinicians' working libraries.

Grounded in decades of research and the clinical care of thousands of depressed and suicidal teens, this highly accessible book will enhance the skills of any therapist who works with this challenging population. The authors describe the nuts and bolts of assessing clients and crafting individualized treatment plans that combine cognitive and behavioral techniques, emotion regulation interventions, family involvement, and antidepressant medication. Illustrated with many clinical examples, each chapter includes a concise overview and key points. Reproducible treatment planning forms and client handouts can also be downloaded and printed by purchasers in a convenient full-page size.

A practical and easy-to-use guide for healthcare professionals on the prevention, assessment and treatment of people at risk of suicide.