Suicide Risk Assessment in the Emergency Department: An Investigation of Current Practice in Scotland

McClatchey, Kirstie; Murray, Jennifer; Chouliara, Zo�; Rowat, Anne; Hauge, Samantha R.

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

Citation

McClatchey, K., Murray, J., Chouliara, Z., Rowat, A., & Hauge, S. R. (2019). Suicide Risk Assessment in the Emergency Department: An Investigation of Current Practice in Scotland. International Journal of Clinical Practice, 73(4), Article e13342. https://doi.org/10.1111/ijcp.13342

• Journal Article Type: Article
• Acceptance Date: Mar 11, 2019
• Online Publication Date: Mar 12, 2019
• Publication Date: Apr 29, 2019
• Deposit Date: Mar 19, 2019
• Publicly Available Date: Mar 13, 2020
• Journal: International Journal of Clinical Practice
• Print ISSN: 1368-5031
• Electronic ISSN: 1742-1241
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 73
• Issue: 4
• Article Number: e13342
• DOI: https://doi.org/10.1111/ijcp.13342
• Keywords: Emergency Department, suicide, clinical assessment, risk assessment,
• Public URL: http://researchrepository.napier.ac.uk/Output/1671230
• Contract Date: Mar 20, 2019