Risk Management with Suicidal Patients

The loss of a patient to suicide is the most feared outcome in mental health care, signaling a calamitous, irrevocable failure in treatment. Clinicians working with patients at high risk of harming themselves are well acquainted with the pressures of professional and personal accountability/m-/and, in our increasingly litigious society, are continually aware of their legal accountability as well. How does the law define "reasonable care" in the treatment of suicidal patients? What are the most clinically and legally appropriate procedures for evaluating and managing suicide risks? And what forms of precautionary planning and documentation are recommended for minimizing the likelihood of malpractice actions?

Drawing upon years of clinical experience as well as extensive malpractice claims data and relevant case law, this book outlines effective assessment, management, and treatment procedures that balance the need for high-quality care with the requirements of court-determined and statutory standards. Three widely cited papers on standards of care, along with several new chapters, analyze common failure situations in outpatient and hospital settings and review salient findings on suicide risk factors. Contributors weigh the risks and benefits of hospitalization; review the clinician's legal and clinical responsibilities within the context of the hospital treatment team; and delineate the key components of sound clinical judgment. Taking a closer look at a central element of many suicide-related malpractice suits, the volume also explores specific issues surrounding pharmacotherapy. Surveying current pharmacological approaches to psychiatric disorders closely associated with suicidal behavior, chapters present clear, concise guidelines for treatment planning, documentation, and post-discharge planning. Finally, a dialogue between two forensic authorities illustrates the complexities involved in evaluating standards of professional practice in liability-related court cases.

Offering frank, balanced coverage of an extremely challenging clinical situation, [ital]Risk Management with Suicidal Patients[/ital] helps psychologists, psychiatrists, and other practitioners develop their own clinically and legally informed strategies for providing the best possible care. It is also an invaluable resource for legal professionals, and may serve as a text in courses in forensic psychology, forensic psychiatry, ethics, and mental health law.

Bruce Bongar, PhD, is Professor in the Clinical Psychology Program at the Pacific Graduate School of Psychology (PGSP), in Palo Alto, California, Consulting Professor of Psychiatry and Behavioral Sciences at Stanford University School of Medicine, and Director of the joint doctoral program in Psychology and the Law offered by PGSP and Golden Gate University School of Law.