Assessing and Managing Suicide Risk: Guidelines for Clinically Based Risk Management

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, presents a thorough examination of the clinical practices that best serve patients and that also protect clinicians from malpractice claims. He uses numerous case examples and extensive references to peer-reviewed literature on suicide and actual malpractice cases triggered by patient suicides to present the key concepts involved in coping with the risks associated with suicidal patients.

Dr. Simon examines how medical malpractice law applies to patient suicides -- the standards of care physicians must meet, the conditions associated with malpractice liability, and the best ways to minimize risks of litigation. He discusses suicide risk assessments and suicide prevention contracts and considers in detail the management of suicide risk in various settings: outpatient, inpatient, emergency, and collaborative. He concludes by describing what clinicians should do in the aftermath of a patient's suicide.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.

American Psychiatric Publishing

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.

Doody Review Services

Reviewer:Steven T. Herron, MD(University of Arizona Health Sciences Center)
Description:This book presents various issues surrounding the assessment, treatment, and litigation of suicide. Clinical vignettes illustrate practices useful in clinical settings and assist in driving home points in the section labeled "Clinically Based Risk Management" ending each chapter.
Purpose:Written "by a clinician for clinicians" evaluating and treating patients at risk for suicide, this book presents basics for clinical practice in the evaluation and management of a vast and varied population.
Audience:Geared for clinicians, this book will be beneficial for individuals charged with the delicate task of assessing another's risk for suicide. It may be especially useful for those in training to develop more comprehensive assessments of patients at risk for suicide.
Features:Divided into eight chapters, the book addresses topics such as suicide contracts and malpractice litigation as well a focusing on subsets of patients, both inpatient and outpatient. Each chapter contains a case example designed to highlight information presented in the text. In addition, each chapter ends with the bulleted list of "Clinically Based Risk Management" points to ensure the reader has absorbed relevant information.
Assessment:Condensing the immense amount of literature on this subject into one book, while ensuring it maintains its clinical focus, proves quite challenging. Yet, Dr. Simon imparts his vast clinical experience and keen forensic knowledge in a book that is both readable and educational. Clinically sound advice is offered with the caveat not to infer his methods are considered "standard of care" in the field. For maximum clinical benefit, it might be helpful if future editions include a chapter on how to manage the wealth of information and time needed in an assessment of a suicidal patient with the increasing time constraints placed on clinicians in all settings. Nonetheless, Dr. Simon's book will prove valuable to mental health practitioners, whether seasoned veterans or new trainees to the field.

Robert I. Simon, M.D., is Clinical Professor of Psychiatry and Director of the Program in Psychiatry and Law at Georgetown University School of Medicine in Washington, DC, and Chairman of the Department of Psychiatry at Suburban Hospital in Bethesda, Maryland.