Centre for Health and Development, Staffordshire University, Stoke-on-Trent, Staffordshire, United Kingdom.
Faculty of Health and Education, Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom.
PLoS One. 2023 Feb 2;18(2):e0280789. doi: 10.1371/journal.pone.0280789. eCollection 2023.
A high proportion of people contact healthcare services in the 12 months prior to death by suicide. Identifying people at high-risk for suicide is therefore a key concern for healthcare services. Whilst there is extensive research on the validity and reliability of suicide risk assessment tools, there remains a lack of understanding of how suicide risk assessments are conducted by healthcare staff in practice. This scoping review examined the literature on how suicide risk assessments are conducted and experienced by healthcare practitioners, patients, carers, relatives, and friends of people who have died by suicide in the UK. Literature searches were conducted on key databases using a pre-defined search strategy pre-registered with the Open Science Framework and following the PRISMA extension for scoping reviews guidelines. Eligible for inclusion were original research, written in English, exploring how suicide risk is assessed in the UK, related to administering or undergoing risk assessment for suicide, key concepts relating to those experiences, or directly exploring the experiences of administering or undergoing assessment. Eighteen studies were included in the final sample. Information was charted including study setting and design, sampling strategy, sample characteristics, and findings. A narrative account of the literature is provided. There was considerable variation regarding how suicide risk assessments are conducted in practice. There was evidence of a lack of risk assessment training, low awareness of suicide prevention guidance, and a lack of evidence relating to patient perspectives of suicide risk assessments. Increased inclusion of patient perspectives of suicide risk assessment is needed to gain understanding of how the process can be improved. Limited time and difficulty in starting an open discussion about suicide with patients were noted as barriers to successful assessment. Implications for practice are discussed.
在自杀死亡前的 12 个月内，相当高比例的人会接触医疗保健服务。因此，识别高自杀风险人群是医疗保健服务的关键关注点。虽然有大量关于自杀风险评估工具的有效性和可靠性的研究，但对于医疗保健人员在实践中如何进行自杀风险评估，仍缺乏了解。本范围审查研究了英国自杀死亡者的医疗保健从业者、患者、护理人员、亲属和朋友如何进行和体验自杀风险评估的文献。在 Open Science Framework 上预先注册的预定义搜索策略的基础上，使用主要数据库进行文献检索，并遵循 PRISMA 扩展用于范围审查指南。符合纳入标准的是原始研究，以英文撰写，探讨了在英国如何评估自杀风险，与进行自杀风险评估有关，与这些经验相关的关键概念，或直接探讨进行或接受评估的经验。最终样本中包括了 18 项研究。包括研究背景和设计、抽样策略、样本特征和发现等信息。提供了文献的叙述性说明。在实践中，自杀风险评估的进行方式存在相当大的差异。有证据表明缺乏风险评估培训、对自杀预防指南的认识不足，以及缺乏与患者对自杀风险评估的看法相关的证据。需要更多地纳入患者对自杀风险评估的看法，以了解如何改进该过程。有限的时间和难以与患者开始公开讨论自杀被认为是成功评估的障碍。讨论了对实践的影响。
