Suicide and malpractice liability: Assessing and revising policies, procedures, and practice in outpatient settings.

Abstract

This article broadly addresses policies and procedures as well as issues of liability and malpractice related to working with suicidal outpatients in agency and private practice settings. Issues related to ethical practice with suicidal patients are raised, general recommendations for risk management are discussed, and a step-by-step model for establishing, assessing, and/or revising suicide policies and procedures is presented. Also provided are concrete and practical suggestions to improve clinical practice with suicidal patients that may significantly decrease the risk of malpractice liability and ultimately provide better clinical care to these patients.

Suicide Prevention: Critical Elements for Managing Suicidal Clients and Counselor Liability Without the Use of a No-Suicide Contract

“…The counselor makes decisions for treatment based on known risk factors as well as mental status and diagnosis. One may not be able to accurately predict a client's actions but failure to assess risk and make sound judgments sets the counselor up as a target of litigation ( Jobes & Berman, 1993;Maltsberger, 1991).…”

“…However, counselors in contemporary practice are seeing a dramatic increase in the number of malpractice claims brought against those who have treated clients on an outpatient basis who committed suicide. Therefore, mental health professionals must provide competent care of suicidal clients and at the same time protect themselves from litigation ( Jobes & Berman, 1993). A no-suicide contract was never intended to be used as a contract for life but rather as part of the assessment for lethality (Drye et al,l973).…”

“…Counselors should keep abreast of current legal and ethical standards, have a current policy for handling crisis clients, maintain clinical competency, ensure accurate and thorough documentation, and develop relevant resources such as contact with professional colleagues and state licensing boards ( Jobes & Berman, 1993).…”

CAMS-tilnærmingen til selvmordsrisiko

“…CAMS er i høy grad en levende klinisk tilnaerming i stadig utvikling basert på klinisk forskning i klinikk (Drozd, Jobes & Luoma, 2000;Eddins & Jobes, 1994;Jobes & Berman, 1993;Jobes, 1995;2000;2003;2006;Jobes & Drozd, 2004;Jobes & Mann, 1999;2000;Jobes et al, 1997;2007;i trykk). En ny studie har replisert og utvidet funnene i Jobes et al (1997) med hensyn til gyldighet og reliabilitet av "Core Assessment" i SSF (Conrad et al, i trykk).…”

Risk management and life-threatening patient behaviors

“…Brief outpatient treatment has become more common and crisis intervention services have been developed. Advances in psychopharmacology now permit the outpatient treatment of many patients who were previously treated within hospitals (Jones & Berman, 1993). Also, as civil commitment laws became more stringent, many patients could no longer be forced into hospital treatment only because they threatened suicide or needed treatment.…”