Suicide risk assessment: Clinicians’ confidence in their professional judgment

ABSTRACT

Suicide risk assessment is a critical component of mental health practice for which the stakes are high and the outcomes uncertain. This research examines the consistency with which clinicians make determinations of suicide risk and factors influencing clinical confidence. Seventy-one social workers interviewed two standardized patients performing in scenarios depicting suicidal ideation, judged whether the patient required hospitalization, and completed standardized suicide risk assessment measures. Self-ratings and qualitative interviews explored participants’ confidence in their judgment of risk. Participants had highly divergent views regarding whether or not the risk of suicide was sufficiently high to require hospitalization. However, regardless of the ultimate decision reached, participants were equally confident when recommending either clinical course of action. The variation in risk assessment appraisals in this study, despite at times high rates of confidence in risk appraisals, speaks to the need for ongoing training, consultation, and increased decision support strategies.

KEYWORDS:

• Assessment
• burnout
• decision making
• suicide risk

Additional information

Notes on contributors

Cheryl Regehr

Cheryl Regehr is the Vice-President and Provost of the University of Toronto. Former Dean of the Factor-Inwentash Faculty of Social Work, she is a Professor of Social Work with cross appointments to the Faculty of Law and the Institute for Medical Sciences.

Marion Bogo

Marion Bogo is a Professor in the Factor-Inwentash Faculty of Social Work at the University of Toronto and is an Officer of the Order of Canada.

Vicki R. LeBlanc

Vicki LeBlanc is the Chair of the Department of Innovation in Medical Education at the University of Ottawa. Previously she was the Associate Director and a Scientist at the Wilson Centre for Research in Education, and an Associate Professor in the Faculty of Dentistry and the Department of Medicine, at the University of Toronto.

Stephanie Baird

Stephanie Baird is a PhD student at Factor-Inwentash Faculty of Social Work. Her research interests in trauma, intimate partner violence, and social work education build on almost 15 years of direct service experience in community counseling agencies.

Jane Paterson

Jane Paterson is the Director of Interprofessional Practice for the Centre for Addiction and Mental Health in Toronto and is an Adjunct Professor of the Factor-Inwentash Faculty of Social Work.

Arija Birze

Arija Birze is a PhD Student in the Dalla Lana School of Public Health at the University of Toronto and a Currie Fellow at the Wilson Centre.