Support for Alternative Suicide Risk Models in Hospital Emergencies

20 May 2013

Today, one of Australia’s leading medical journals reported that the current model of suicide risk assessment used in hospitals is “unhelpful” and “unreliable”.

Suicide Prevention Australia’s (SPA) CEO Sue Murray said “Australia needs to develop alternative models of care to hospital emergency departments to provide better care for people in crisis.

We believe that taking a holistic approach that extends beyond the medical model to include community-based care to help support individuals in suicidal crisis connect again to a life worth living.”

Patients who present to hospitals in psychological crisis or after a suicide attempt are more than 50 times more likely than the general population to die by suicide in the following year. Fewer than one in 200 of these people will go on to die by suicide in the next 6 months.

The Medical Journal of Australia’s (MJA) editorial by Dr Matthew Large from the University of NSW’s School of Psychiatry wrote that “it is simply not possible to predict suicide in an individual patient and any assessment that does try to sub-divide patients into high risk and low risk categorise is at best unhelpful and at worst will prevent provision of useful and needed psychiatric care.”

Dr Large commented in a Sydney Morning Herald on-line article that “suicide risk assessment leads us to neglect treatment for the people we perceive to be at low risk and it leads down the party of overly restrictive care for this to be perceived to be at high risk.”

The MJA editorial reports that only 3 per cent of those who are identified in the ultra high risk category would suicide in the year after leaving hospital. Meanwhile, about 60 per cent of people who did eventually suicide over the same period would have been categorised at lower risk.

Suicide Prevention Australia is organising a gathering of health professionals and community-minded people to address these critical issues facing suicide prevention at its National Conference for Suicide Prevention in Melbourne 24 July 2013.

“Our role as the peak body in suicide prevention is to bring together all the core groups so we can work together to reach a 50 percent reduction in suicide by 2023,” said Sue Murray.