Psychiatrists’ experiences of suicide assessment

BMC Psychiatry

Research Article

Ellinor Salander Renberg¹  Niclas Kaiser²  Margda Waern³ 

[1] Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden;Department of Psychology, Umeå University, Umeå, Sweden;Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden;Section of Psychiatry and Neurochemistry, Gothenburg University, Blå Stråket 15, 41543, Gothenburg, Sweden;

关键词: Suicide assessment;    Psychiatrists’ experiences;    Involuntary care;    Medical training;    Professional development;   

DOI  :  10.1186/s12888-016-1147-4

 received in 2016-10-06, accepted in 2016-11-29,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundClinical guidelines for suicide prevention often stress the identification of risk and protective factors as well as the evaluation of suicidal intent. However, we know very little about what psychiatrists actually do when they make these assessments. The aim was to investigate psychiatrists’ own accounts of suicide assessment consultations, with a focus on their behaviors, attitudes and emotions.MethodSemi-structured in depth interviews were carried out with a purposive selection of 15 psychiatrists.ResultsThematic analysis revealed three main themes: understanding the patient in a precarious situation, understanding one’s own reactions, and understanding how the doctor-patient relationship impacted on risk assessment and management decisions. Emotional contact and credibility issues were common subthemes that arose when the respondents talked about trying to understand the patient. The psychiatrists stressed the semi-intuitive nature of their assessments. Problems related to the use of risk factor assessments and rating scales were apparent. Assessment consultations could evoke physical and emotional symptoms of anxiety, and concerns about responsibility could lead to repressive management decisions. In situations of mutual trust, however, the assessment consultation could kick-start a therapeutic process.ConclusionThis study highlights psychiatrists’ experiences in clinical suicide assessment situations. Findings have implications for professional development as well as for service delivery.

【 授权许可】

CC BY   
© The Author(s). 2016