4.1 Article

Military mental health professionals' suicide risk assessment and management before and after experiencing a patient's suicide

Journal

SUICIDE AND LIFE-THREATENING BEHAVIOR
Volume 52, Issue 3, Pages 392-400

Publisher

WILEY
DOI: 10.1111/sltb.12829

Keywords

mental health military; suicide; suicide risk assessment; suicide risk management; therapists

Funding

  1. Israel Defense Forces Medical Corps
  2. Tali Bar Scholarship
  3. Medical Corps of the Israel Defense Forces

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This study examines the association between a patient's suicide and the therapist's suicide risk assessment (SRA) and suicide risk management (SRM) of patients. The findings suggest that therapists' fear of treating suicidal patients may lead to them overlooking non-prominent suicide-risk indicators. In terms of SRM, therapists are more likely to recommend additional therapy sessions rather than military release or referrals to other therapists.
Objective This study examines the association between a patient's suicide and the therapist's suicide risk assessment (SRA) and suicide risk management (SRM) of patients, following the occurrence. Method SRA values range from absence of suicidality to immediate suicidal intent to die. SRM consists of therapists' written recommendations. Rates of the various SRA and SRM values in therapists' evaluations were assessed 6-months prior to the suicide and at the two three- and six-month time-points thereafter. Results Of the 150 soldiers who died by suicides, 30 (20%) visited 50 military therapists in the 6 months preceding their deaths. Using Wilcoxon signed rank test, lower SRA rates of threatens suicide were found 2 months after a patient's suicide. Regarding SRM, the mean rates for recommendations for psychotherapy treatment were higher at the two (p = 0.022) and the 3 month time-points (p = 0.031) after a suicide. Conclusions The SRA findings may indicate therapists' fear of treating suicidal patients, causing them to overlook patients' non-prominent suicide-risk indicators. In SRM, the higher rate of recommendations for additional therapy sessions rather than military release or referrals to other therapists may relate to over-caution and attempts to control the patient's therapy ensuring it's done properly.

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