Suicide Among Psychiatric Patients Essay

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Suicide rates are remarkably high worldwide and nationally, making suicide one of the leading causes of death (Schwartz-Lifshitz, Zalsman, Giner et al, 2012; Tillman, 2014). Although most suicides do not occur in the hospital setting, psychiatric disorders—especially mood disorders and psychotic disorders—are risk factors that increase the likelihood of a suicidal event (Appleby, 1992; Sarzetto, Delmonte, Seghi, et al, 2017). Suicide not only affects the patient, but reverberates throughout the patient’s family and social circle, also causing distress and potential performance issues among clinical staff (Tillman, 2014).



Therefore, it is important that psychiatric nurses understand how to recognize risk factors, and establish a clinical practice environment that prevents suicide. Minimizing suicidal tendencies requires different types of treatment interventions individually tailored for at-risk patients, as well as implementing best practices for creating a clinical environment that reduces risk. Best practices may also include preparing, teaching, and training nursing staff, especially when working with at risk populations.

Both psychiatric patients and psychiatric nursing staff can be considered target populations for an intervention designed to prevent suicide in the clinical setting. Preliminary research questions using the PICO (patient/population, intervention/issue, comparison, and outcome) model include the following:


1. Among psychiatric patients (P), do mandatory intake assessments specifically for suicide risk (I) reduce rates of suicide (O) versus institutions without such policies (C)? This is a reasonable PICO question, but one that would require a large-scale assessment of different psychiatric institutions.

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Therefore, it might be too difficult to find sufficient evidence to make an informed decision for evidence-based practice.



2. Among psychiatric patients with mood disorders and other high-risk populations (P), do pharmacological interventions (I) reduce rates of suicide (O) versus patients who only receive talk or group therapies (C)? This is a commonly posed question related to suicide in the population group. The problem with this PICO question is there are too many different pharmacological interventions and individual differences among patients to come up with a clear, definitive guide for evidence-based practice.



3. Among psychiatric patients with suicidal ideations or a history of suicidal behavior (P), does family and group therapy (I) reduce risk (O) versus patients who do not receive any family or group therapy (C)? This is one of the most feasible PICO questions to use because family and group therapy options might offer some sound solutions for preventing….....

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References

Appleby, L. (1992). Suicide in psychiatric patients. British Journal of Psychiatry 1992(161): 749-758.
Jacobs, D.G., Baldessarini, R.J., Conwell, Y., et al (2010). Practice guideline for the assessment and treatment of patients with suicidal behaviors. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/suicide.pdf

Sakinofsky, I. (2014). Preventing suicide among inpatients. Canadian Journal of Psychiatry 59(3): 131-140.
Sarzetto, A., Delmonte, D., Seghi, F. et al (2017). Suicide in depressed patients. European Psychiatry 41(April 2017 Supplement): S891-S892.

Schwartz-Lifshitz, M., Zalsman, G., Giner, L., et al (2012). Can we really prevent suicide? Current Psychiatry Reports 14(6): 624-633.

Tillman, J.G. (2014). Patient suicide: impact on clinicians. Psychiatric Times. Dec 31, 2014. http://www.psychiatrictimes.com/special-reports/patient-suicide-impact-clinicians

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