Formal requirements for suicide risk assessment in mental healthcare services: Self-reported familiarity and perceptions among clinicians

Abstract

Background: Standardized routines and procedures are crucial in clinical practice, however, these may also restrict clinical autonomy. This study aims to assess clinicians’ familiarity with and perceptions of established formal requirements for suicide risk assessment in mental healthcare services. Methods: Clinical staff in the psychiatric section at a large hospital trust in Norway were invited to take part in an online survey designated for the study. Responses were measured on a Likert scale. 503 clinicians participated in the survey and data from 396 respondents whose tasks at work involved asking and recording patientś suicidal behavior were included in the analysis. Results: Participants reported high levels of familiarity with the formal requirements for suicide risk assessment, i.e., routines in their own work section, procedures in the hospital’s electronic quality management system, current legislation, and national guidelines. However, there are notable differences by clinical background with higher levels of familiarity being found among doctors and psychiatrists and among staff frequently seeing suicidal patients. The perceived benefits of these formal requirements are clear goal setting and confidence to do what is relevant, whilst the perceived drawbacks are that these routines and procedures are time consuming and have an overly legalistic focus. These perceptions exhibited a high level of internal consistency and were not associated with respondents’ familiarity with the requirements. Conclusion: Clinicians reported good familiarity with formal requirements and possessed ambivalent perceptions of required routines and procedures in practice. There is a need to enhance the understanding of the multi-purpose of implementing standardized procedures for suicide risk assessment in health services.