Clinician Perspectives of the Evidence Underpinning Suicide Risk Assessment: A Mixed Methods Study

Abstract

ABSTRACT In recent years, suicide risk assessment has become the subject of a vigorous academic debate, due in part to several meta-analyses that have cast doubt on the accuracy of risk categorisation. Little is known about how clinicians make sense of this academic debate. However, it is anticipated that it may pose a tension due to organisational expectations that multidisciplinary health professionals, including social workers, assess and manage suicide risk. As part of a larger mixed methods study to be reported elsewhere, we conducted a qualitative study aiming to explore clinician perspectives on the evidence underpinning suicide risk assessment before and after being presented with the results of two meta-analyses. Findings highlight three modes of reasoning: academic, emotive, and experiential. Perceptions of accuracy of assessing suicide risk at baseline interviews and after hearing the evidence were influenced by heuristics and cognitive biases. IMPLICATIONS Mental health practitioners, including social workers, employed in mental health settings may be more likely to use experiential reasoning to inform their practice in suicide risk assessment. Social work practitioners in general health settings may be more likely to use academic reasoning when making decisions about suicide risk assessment. Further research is required on how social workers and other mental health professionals can best respond to the crisis of suicide.