Suicide, the act of intentionally killing oneself (as determined by coronial ruling), is rare but remains a significant cause of mortality in 34 of the Organisation for Economic Co-operation and…
The full contents of this page is only available to subscribers.
To view this content please login or subscribe
This study evaluated how Mental Health & Addiction Services staff members, working in a busy emergency department service, adhere to the New Zealand Ministry of Health’s Clinical Practice Guidelines for DSH. This study identifies the importance of the individualised, tailored assessment. It also outlines weaknesses of the assessment and treatment of patients following a suicide attempt and makes recommendations for improving assessment of patients following attempted suicide.
The primary aim of this audit was to determine the quality of psychiatric risk assessments conducted by Mental Health & Addiction Services clinicians for patients presenting to the emergency department, Waikato Hospital, Hamilton, New Zealand following an attempted suicide.
A retrospective, randomised audit of 376 files of patients who had presented to the ED over a 12-month period from 1 July 2015 to 30 June 2016 was conducted, following the standards outlined in the present New Zealand Ministry of Health Clinical Practice Guideline for Deliberate Self Harm (DSH).
It was found that clinicians routinely focused on the historical features of the suicide attempt presentation while failing to record judgements about future suicidal behaviours. Interactions with family members were recorded in less than half of the cases. The guideline most poorly adhered to was checking whether Māori patients wanted culturally appropriate services during the assessment and treatment planning, with this recorded in less than 10% of the clinical records.
To improve the quality of the suicide risk assessments, and to better align with Clinical Practice Guidelines, the authors propose redevelopment of clinician training, including focus on cultural competence, and training in confidentiality and privacy relating to an attempted suicide episode.