Proposal for a Suicide Risk Assessment Protocol (Procedura Oceny Ryzyka Samobójczego, PORS) – protection of health and life of patients in psychiatric hospitals

Abstract

As estimated by the World Health Organization, suicide, which defined as an act of intentionally taking one’s own life, accounts for approximately 1.4% of all deaths worldwide. There are many concepts of suicide, including those based on the cognitive theory – suicidal cognitive mode theory, interpersonal theory of suicide, or on the integrated motivational-volitional model of suicide. Suicide attempts can be made by both mentally ill people and people in crisis (suffering from, for example, adjustment disorder). A reliable and standardised procedure of suicidal risk assessment for patients in Polish psychiatric hospitals is currently missing, hence it was decided to develop a suicidal behaviour risk assessment model that would improve the quality of therapeutic work and maximise the protection of health and life of psychiatric patients. The procedure is to be understood as a set of activities primarily involving psychological and psychiatric examination. The lack of psychological procedures for assessing risk factors and protective factors at the State Hospital for Mental Diseases in Rybnik mobilised a team of specialists to develop the PORS (Procedura Oceny Ryzyka Samobójczego – Suicide Risk Assessment Protocol) model as a proposal for data collection, assessment and intervention in patients with a suicidal riswk. It was proposed to start the suicidal risk assessment with determining the severity of risk factors, which include, inter alia, mental disorders, sudden situational factors (in combination with personality traits) as well as substance abuse. The initial and final risk assessment allows to estimate not only the presence of predictors that increase suicidal tendencies, but also the actual risk of an intentional suicide attempt. PORS is a kind of systematisation of knowledge and experience in working with a patient with suicidal thoughts, intentions, or after a suicide attempt. The individual stages of psychological and psychiatric procedures contain guidelines and schemes in relation to the individual needs of a patient at risk of suicide.