Avoiding the Malpractice Snare: Documenting Suicide Risk Assessment

Simpson, Skip; Stacy, Michael

doi:10.1097/00131746-200405000-00008

Cited by 33 publications

(36 citation statements)

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“…It is imperative for a psychiatric office or facility to have good documentation (4,7,22,40). Careful documentation of evaluations and treatment interventions with a description of changes related to the patient's clinical condition indicates clinically and legally appropriate psychiatric care.…”

Section: The Importance Of Documentationmentioning

confidence: 99%

“…Discussion with another psychiatrist about whether or not to discharge a possibly suicidal patient or whether or not to allow him/her leave an outpatient clinic without being hospitalized is an excellent idea (7). It demonstrates both good treatment and the original psychiatrist's desire to do the right thing.…”

Section: The Importance Of Documentationmentioning

confidence: 99%

“…It is important to note that error of judgment will not necessarily make the physician liable. Compared with other physicians, psychiatrists are less frequently to be charged with professional neglect (1,3,7). However, the United States is a litigious society (3,4).…”

Section: Introductionmentioning

confidence: 99%

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Suicide medical malpractice: an educational overview

Sher

2015

International Journal of Adolescent Medicine and Health

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A malpractice lawsuit is in the legal category of an action in tort, which is a demand for compensation for the damages that have occurred. For a physician to be found liable to a patient for malpractice, four essential elements must be proved to sustain an assertion of malpractice: duty, negligence, harm, and causation. The incidence of malpractice litigation in the field of psychiatry is increasing. The most common malpractice claim related to psychiatric practice is the failure to provide reasonable protection to patients from killing themselves. A psychiatrist should be able to evaluate suicide risk on the basis of all available information, including patient responses to direct and indirect questions, known risk factors, information on how the patient behaved under similar circumstances in the past, and collateral information. Reasonable care necessitates that a patient who is either thought of being or established to be suicidal must be the subject of some precautions. A failure either to soundly assess a patient's suicide risk or to employ an appropriate safety plan after the suicide potential becomes foreseeable is likely to make a physician liable if the patient is harmed because of a suicide event. It is imperative for a psychiatric office or facility to have a good documentation. Careful documentation of evaluations and treatment interventions with a description of changes related to the patient's clinical condition indicates clinically and legally appropriate psychiatric care.

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Section: The Importance Of Documentationmentioning

confidence: 99%

Section: The Importance Of Documentationmentioning

confidence: 99%

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Suicide medical malpractice: an educational overview

Sher

2015

International Journal of Adolescent Medicine and Health

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“…In light of this, clinicians need to conduct regular, systematic suicide risk assessments, document these assessments, take actions commensurate with the degree of risk, and document these actions. It is also important to seek information for the risk assessment from sources other than the patient (e.g., past mental health providers, family members) -with proper consent that is -because the patient may be motivated to conceal suicidal intent (Simpson & Stacy, 2004). Specifically, clinicians should make several attempts to secure permission from the client to speak to these other sources and appropriately document this effort.…”

Section: The Role Of Impulsivity In the Foreseeability Of Suicidementioning

confidence: 99%

Revisiting impulsivity in suicide: Implications for civil liability of third parties

Smith

Witte

Teale

et al. 2008

Behavioral Sci & The Law

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Previous research and popular conceptualizations of suicide have posited that many suicides are the result of impulsive, "on a whim" decisions. However, recent research demonstrates that most suicides are not attempted impulsively, and in fact involve a plan. Legally, suicide has historically been considered to be a superseding intervening cause of death that exonerates other parties from liability, but currently there are two general exceptions to this view. Specifically, another party may be found responsible for a suicide if that party either caused the suicide or failed in its duty to prevent the suicide from occurring. Both of these exceptions assume that the resulting suicide was foreseeable. Given that recent research has indicated that most suicides are planned, and thereby foreseeable to a certain extent under many circumstances, this article discusses issues of foreseeability as they pertain to litigation involving third party liability for the suicide of university students, prison inmates, and mental health patients. The authors contend that the surest way for universities, prison staff, and mental health practitioners to avoid being held liable for a suicide is to appropriately assess for suicidal intent.Suicide is the third leading cause of death for people aged 15 to 24 and the 11 th leading cause of death overall (Centers for Disease Control [CDC], 2004). Approximately 30,000 people die by suicide every year in the U.S. Moreover, four times that many people are hospitalized due to injuries sustained while attempting suicide (CDC, 2004). For the purposes of this paper we will use Silverman and colleagues ' (Silverman, Berman, Sanddal, O'Carroll, & Joiner, 2007) definition of a "suicide attempt," which is "a self-inflicted, potentially injurious behavior with a nonfatal outcome for which there is evidence (either explicit or implicit) of intent to die." Suicide is thus a serious mental health issue and public health problem. In the wake of a suicide, loved ones are often left looking for answers. When family members or friends feel something more should have been done for the decedent, they may ultimately try to settle things in a court of law. In fact, the most common type of lawsuit brought against psychiatrists is in regard to patient suicide (Simon, 2002). Furthermore, records from the American Psychological Association's Insurance Trust indicate that of claims closed by 1990, patient suicide was the second most costly claim for psychiatrists and psychologists insured by the company (Bongar, Maris, Berman, & Litman, 1998). As our society has become more litigious, the number of malpractice suits filed against therapists has risen dramatically and will likely continue to rise (Berman, 1986).Although the causes of suicide are complex, they are not mysterious, and in fact are becoming better understood thanks to decades of scientific research. One comprehensive (Van Orden, et al., 2008). According to this theory three proximal, jointly necessary, and sufficient causes must be present befo...

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“…''No suicide'' contracts are of questionable utility even within the context of a therapeutic relationship (e.g., Farrow, 2002;Kelly and Knudson, 2000) and are not recommended for use in EDs (APA, 2003). Finally, careful documentation of the triage assessment and safety measures in place is of crucial importance (Simpson and Stacy, 2004).…”

Section: Issues Regarding Patient Safetymentioning

confidence: 99%