Who gains from suicide risk assessment: Health inspectorate and health insurances, or also psychiatrist and patient?

Abstract

IntroductionThe number of suicides rises in the Netherlands. In 2008, 1435 suicides were recorded; in 2012: 1753 (CBS). Adequate risk assessment with suicidal behaviour (SRA) is essential for prevention. The Health Inspectorate and Insurances seek to have a stronger grip on the way suicide risk is assessed and insist on using questionnaires. This runs counter to the multidisciplinary guidelines in the Netherlands for diagnosis and treatment of suicidal behaviour, which state that “questionnaires or observation instruments cannot replace clinical diagnostic examination.”ObjectiveDo questionnaires rather than ‘care as usual’ (CAU) in SRA lead to different treatment policies?AimTo determine whether the use of questionnaires rather than CAU in SRA leads to different treatment policies.MethodsPatients who were seen by staff at the department of Psychiatry at the ETS Hospital, either for in-house consultation or at the MPU, in connection with attempted suicide, auto-intoxication, or psychological distress with suicidal statements. Patients were examined by conducting a questionnaire, resulting in treatment policy (admission, discharge with an appointment with patient's own practitioner, discharge with referral to a practitioner, discharge without aftercare). Then, the same patient was again examined by another colleague in a free interview (CAU). The colleague was not informed about the outcome of the first assessment. Again, treatment policy was determined as a result. The two outcomes were then compared.ResultsData collection still continues.ConclusionsThere are signs that there are no differences in the determined treatment policies following SRA based on the use of questionnaires or CAU.Disclosure of interestThe authors have not supplied their declaration of competing interest.