I enjoyed the review of assessing harm to self and others by Drs. Charles Scott and Phillip J. Resnick (“Assessing potential for harm: Would your patient injure himself or others?” Current Psychiatry, July 2009). All too often mental health professionals rely on “gut instinct” and neglect evidence-based strategies when assessing for dangerousness. Generally, I believe this to be an issue of complacency rather than willful neglect or lack of training.
I would like to add a few points that I believe are key to conducting a proper assessment of suicide risk. First, schedule and document a firm follow-up appointment with the patient after evaluation. Second, I believe religious and spiritual beliefs function as a protective factor for many individuals, although this varies from person to person. And last, inquiring about the patient’s immediate future orientation (eg, “What are your plans for tomorrow?”) is crucial when conducting a comprehensive risk assessment.
Bret A. Moore, PsyD, ABPP
Poplar, MT