RESUMEN
The objective of this study was to explore suicide risk identification and flow of patients with differing suicide risk through the Psychiatric Emergency Service (PES) to their clinical dispositions. 3 focus groups (N = 15 psychiatric providers working in the PES of a large urban teaching hospital) discussing suicide risk assessment in the PES were conducted, followed by thematic analysis. A total of 7 themes were identified in 624 coded passages. In focus groups conducted to explore suicide risk assessment, discussions shifted to broader matters, e.g., frustrations with the system in which the providers worked. 4 main messages emerged: screening tools cannot replace clinical judgment; the existing electronic health record is not efficient and sufficiently informative; competing demands challenge PES psychiatrists; and post-discharge patient outcome data are needed. These concerns suggest directions for improving patient care.
Asunto(s)
Servicios de Urgencia Psiquiátrica , Psiquiatría/métodos , Medición de Riesgo , Prevención del Suicidio , Suicidio , Actitud del Personal de Salud , Servicios de Urgencia Psiquiátrica/métodos , Servicios de Urgencia Psiquiátrica/normas , Grupos Focales , Humanos , Investigación Cualitativa , Mejoramiento de la Calidad , Medición de Riesgo/métodos , Medición de Riesgo/normas , Factores de Riesgo , Suicidio/psicologíaRESUMEN
To examine gaps in effective self-directed violence risk assessments by emergency medicine physicians. Four focus groups (N = 16 physicians) were conducted, followed by thematic analysis. Eight themes were identified in 1,293 coded passages. Participants discussed the practical ways they deal with the challenges of assessing and managing self-directed violence in low-resource settings. Emergency medicine physicians find mechanistic suicide screenings problematic, especially when intervention options are scarce; they find patient rapport, clinical experience, and corroboration from colleagues to be valuable in addressing the complex challenges of suicide risk assessment and management.