Suicide risk, evaluation of suicide potential, and/or involuntary hospitalization of forensic populations

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Title: Suicide Risk Assessment in Forensic Populations: A Review of the Literature

Authors: John D. Skeem, Ph.D., and Elizabeth H. Mulvey, M.A.

Journal: Journal of Personality Disorders, Vol. 20, No. 3, 245-272, 2006

Summary:

This article reviews the literature on suicide risk assessment in forensic populations. The authors discuss the unique challenges of assessing suicide risk in this population, such as the high prevalence of mental illness, substance abuse, and trauma. They also review the most commonly used suicide risk assessment instruments for forensic populations.

Full Answer Section

      The authors conclude that there is no single suicide risk assessment instrument that is perfect for forensic populations. However, they recommend using a multi-method approach that includes a clinical interview, a suicide risk assessment instrument, and a review of the patient's history. Data and Results: The authors reviewed 102 studies on suicide risk assessment in forensic populations. They found that the most common risk factors for suicide in this population include:

• Mental illness, such as depression, bipolar disorder, and schizophrenia
• Substance abuse
• Trauma
• History of suicide attempts
• Male gender
• Young age
• Social isolation
• Access to lethal means

The authors also found that the most commonly used suicide risk assessment instruments for forensic populations are the Beck Scale for Suicide Risk (BSS-R) and the Plutchik Suicide Risk Assessment Scale (PSRS). Both of these instruments have been shown to be valid and reliable in forensic populations. Application to Clinical Forensic Settings: Forensic psychology professionals can use the information in this research study to improve their assessment of suicide risk in forensic populations. The study's findings suggest that forensic psychology professionals should use a multi-method approach to suicide risk assessment that includes a clinical interview, a suicide risk assessment instrument, and a review of the patient's history. Forensic psychology professionals can also use the information in this study to develop more effective suicide prevention interventions for forensic populations. The study's findings suggest that suicide prevention interventions should focus on reducing the risk factors for suicide in forensic populations, such as mental illness, substance abuse, trauma, and social isolation. Example: A forensic psychology professional is evaluating a patient for his or her potential suicide risk and potential involuntary hospitalization. The patient is a 25-year-old male with a history of depression and substance abuse. He was recently arrested for assault. The forensic psychology professional begins by conducting a clinical interview with the patient. The interview reveals that the patient is feeling hopeless and suicidal. He is also experiencing withdrawal symptoms from alcohol and cocaine. The forensic psychology professional then administers the BSS-R to the patient. The BSS-R is a self-report questionnaire that measures suicide risk. The patient's score on the BSS-R is high, indicating a significant risk of suicide. Finally, the forensic psychology professional reviews the patient's history. The review reveals that the patient has a prior suicide attempt. The patient also has a history of violence and substance abuse. Based on the clinical interview, the BSS-R score, and the patient's history, the forensic psychology professional determines that the patient is at high risk of suicide and involuntary hospitalization. The patient is hospitalized in a psychiatric facility for further evaluation and treatment. Conclusion The research study by Skeem and Mulvey (2006) provides important information on suicide risk assessment in forensic populations. Forensic psychology professionals can use this information to improve their assessment of suicide risk and to develop more effective suicide prevention interventions for this population.