Weren't Asked, Didn't Tell: Prevalence of Communication of Suicidal Ideation in Suicide Decedents During the Last Year of Life

Abstract

With providers screening less than half of SDs at any point in the year before death, and less than 60% of SDs ever endorsing SI, including none at final appointments, the findings of this naturalistic study bring into question both current screening practices and screening effectiveness. Nonetheless, when SDs were screened, they were significantly more likely to endorse SI than were controls, not 1 of whom ever expressed SI. Taken together, these data suggest that patients expressing SI at any point are at elevated risk for eventual suicide.

Grappling With Suicide Risk

“…Current approaches include studying the etiology of suicidal behaviors, 1,2 designing more effective treatments, 3 developing predictive algorithms, 4 and improving clinical systems for identifying and engaging suicidal individuals. Taking the latter tack, in this issue of Mayo Clinic Proceedings, Bommersbach et al 5 focus on the effectiveness of existing processes for identifying at-risk individuals who present for health care. A strength of the study is the availability of comprehensive data from the Rochester Epidemiology Project, with which Bommersbach et al performed a retrospective cohort study of health encounters during the year preceding death of suicide decedents from Olmsted County over a 9-year period.…”