Although we can’t reliably predict individual suicides, we can identify periods of heightened suicide risk (Rudd, 2006). The “standard of practice” in suicidality includes: Foreseeability, treatment planning, and follow-up. A thorough and accurate, suicide risk assessment makes foreseeability and treatment planning possible.
Foreseeability and its role in tort law were reviewed by Owen (2009), who concluded “foreseeability is an explicit, central consideration in evaluating whether a person's conduct should be declared negligent . Liability, in patient suicide (or attempts), often focuses on whether the suicide (or attempt) was reasonably foreseeable.” David Lang J.D. (2013) emphasized, clinicians should use a suicide screening tool with patients, who have co-existing concerns (e.g., depression, anxiety, substance (alcohol/drug) abuse, etc.).
As our society has become more litigious, the number, of malpractice lawsuits filed against clinicians (physicians, psychologists, psychiatrists, counselors, probation officers, and other mental health professionals) has greatly increased. And, the number, of lawsuits involving outpatient treatment providers, has escalated (Packman, O’Connor, Bonger, Orthwein, 2004).
Civil lawsuits, referenced to as “tort actions,” are increasing after suicide attempts and suicides. Tort is a civil action, wrong (an act or failure to act) alleged to have caused injury or death (Maris, Berman & Silverman, 2000). It is a clinician’s professional responsibility (duty), to protect their patients from foreseeable harm and, this includes suicide (Owen, 2009).
Suicide risk assessment (e.g., Suicide Risk Assessment) helps identify suicide risk, clarifies foreseeability, and establishes appropriate levels of care. A properly administered and documented suicide risk assessment positively meets professional standards, for identifying suicide risk, and clarifying foreseeability standards (Simon, 2002). In other words, completing a suicide risk assessment helps the clinician protect their patients from foreseeable harm, while, concurrently, strengthening a clinician’s legal defense.
Sometimes, it is argued that by not administering a suicide risk assessment, a clinician is neglectful. A properly documented, suicide risk assessment provides suicide risk foreseeability (Simon, 2002). The suicide risk assessment would have established suicide risk severity, clarified suicide foreseeability, and documented the patient’s optimum level of care.
Foreseeability is an important concept in tort law, as it applies to clinician negligence. Judges and juries are often interested, in how lack of foreseeability applies in negligence law. There is little doubt that foreseeability is an important consideration, when deciding if a clinician’s omission (e.g., not administering a suicide risk assessment) should be considered negligent. It has been found that omission of a suicide risk assessment, in many cases, may have resulted in suicide (or a suicide attempt).
In conclusion, the Suicide Risk Assessment (SRA) identifies acute and chronic suicide states, assesses suicide ideation (thoughts), evaluates suicide risk, and sets forth risk and protective factors. The severity of co-occurring DSM-5 disorders (symptom clusters), like depression, anxiety, alcohol, drug use, and substance use, are established along with self-control. Suicide Risk Assessment (SRA) reports provide comprehensive suicide assessment documentation, while enabling clinicians to adjust levels of care to, optimally match patient needs. Visit www.Suicide-Risk-Assessment.com to review an SRA example report.
The Suicide Risk Assessment (SRA) is a computer scored, 142-item self-report that takes, on average, 25 minutes to complete. After data (answers) input, 4-page SRA reports are scored and, reports printed on-site, within 3½. All reports are HIPAA compliant.
Accurate, risk assessment is only possible, if accurate patient information is attained.
Lang, D., (2013). Was Suicide Attempt Foreseeable? Retrieved online at: www.clinicianreviews.com.
Maris, R. W., Berman, A. L., & Silverman, M. M. (2000). Comprehensive textbook of suicidology . NY: Guildford Press.
Owen, D.G., (2009). Figuring Foreseeability, 44 Wake Forest L. REV. 1277, 1277.
Packman, W.L., Pennuto, Bongar, Orthwein J. Legal issues of professional negligence in suicide cases. Behavioral Sciences and the Law. 2004;22:697–713.
Rudd, M. D. (2006). The assessment and management of suicidality. Sarasota, FL: Professional Resource Press.
Rudd, M.D. (2006). Fluid vulnerability theory: A cognitive approach to understanding the process of acute and chronic suicide risk. Cognition and Suicide: Theory, Research, and Therapy. Washington, DC: American Psychological Association: 355–368.
Simon, R.I. Suicide risk assessment: What is the standard of care? Journal of the American Academy of Psychiatry and the Law. 2002;30:340–344.
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