Tools used by medical professionals to assess the extent to which a patient will kill himself or herself are unreliable, a new analysis suggested.
The research, published this week in the US journal PLOS ONE, called for a review of the allocation of resources to mental health patients based on their suicide risk assessments.
"It is widely assumed that the care of psychiatric patients can be guided by a mental health professional's estimate of suicide risk and by using patient characteristics to define high-risk patients," said clinical psychiatrist
Matthew Large from Australia's University of New South Wales, who led the research.
"However, the reliability of categorizing suicide risk remains unknown," Large said.
In order to investigate the odds of suicide in high-risk compared to lower-risk categories, the researchers reviewed every long-term prospective study of suicide risk assessment published worldwide over the past 50 years.
They found that there was no reliable method for assessing suicide risk, with the results of the assessments varying enormously across the 37 studies reviewed.
Actually, half of all suicides occurred in lower-risk groups while 95 percent of high-risk patients did not suicide, they said.
Overall, the research demonstrated that suicide risk assessments provide results that are slightly better than chance.
Currently, suicide risk assessments are used in many hospitals to categorize mentally distressed patients, with those considered at high risk being hospitalized and those at low risk being denied treatment.
"In many hospitals, resources are still being allocated on the basis of suicide risk. It is time we moved away from paternalist medical decision making and classifying people into suicide risk categories," Large said.
"If a patient presents with a suicide crisis they should be thoroughly assessed, without categorization. Mental health professionals must also involve patients in the decision making process about their ongoing care to improve their outcomes," he said.
