Suicide and self-harm risk assessment: A systematic review of prospective research

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dc.contributor.authorSaab, Mohamad M.
dc.contributor.authorMurphy, Margaret
dc.contributor.authorMeehan, Elaine
dc.contributor.authorDillon, Christina B.
dc.contributor.authorO'Connell, Selena
dc.contributor.authorHegarty, Josephine
dc.contributor.authorHeffernan, Sinead
dc.contributor.authorGreaney, Sonya
dc.contributor.authorKilty, Caroline
dc.contributor.authorGoodwin, John
dc.contributor.authorHartigan, Irene
dc.contributor.authorO'Brien, Maidy
dc.contributor.authorChambers, Derek
dc.contributor.authorTwomey, Una
dc.contributor.authorO'Donovan, Aine
dc.contributor.funderHealth Service Executiveen
dc.date.accessioned2023-01-18T10:21:26Z
dc.date.available2023-01-18T10:21:26Z
dc.date.issued2021-07-01
dc.date.updated2023-01-15T12:06:56Z
dc.description.abstractObjective: Suicide and self-harm are widespread yet underreported. Risk assessment is key to effective self-harm and suicide prevention and management. There is contradicting evidence regarding the effectiveness of risk assessment tools in predicting self-harm and suicide risk. This systematic review examines the effect of risk assessment strategies on predicting suicide and self-harm outcomes among adult healthcare service users. Method: Electronic and gray literature databases were searched for prospective research. Studies were screened and selected by independent reviewers. Quality and level of evidence assessments were conducted. Due to study heterogeneity, we present a narrative synthesis under three categories: (1) suicide- and self-harm-related outcomes; (2) clinician assessment of suicide and self-harm risk; and (3) healthcare utilization due to self-harm or suicide. Results: Twenty-one studies were included in this review. The SAD PERSONS Scale was the most used tool. It outperformed the Beck Scale for Suicide Ideation in predicting hospital admissions and stay following suicide and self-harm, yet it failed to predict repeat suicide and self-harm and was not recommended for routine use. There were mixed findings relating to clinician risk assessment, with some studies recommending clinician assessment over structured tools, whilst others found that clinician assessment failed to predict future attempts and deaths. Conclusions: There is insufficient evidence to support the use of any one tool, inclusive of clinician assessment of risk, for self-harm and suicidality. The discourse around risk assessment needs to move toward a broader discussion on the safety of patients who are at risk for self-harm and/or suicide.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationSaab, M. M., Murphy, M., Meehan, E., Dillon, C. B., O'Connell, S., Hegarty, J., Heffernan, S., Greaney, S., Kilty, C., Goodwin, J., Hartigan, I., O'Brien, M., Chambers, D., Twomey, U. and O'Donovan, A. (2021) 'Suicide and self-harm risk assessment: A systematic review of prospective research', Archives of Suicide Research, 26(4), pp. 1645-1665. doi: 10.1080/13811118.2021.1938321en
dc.identifier.doi10.1080/13811118.2021.1938321en
dc.identifier.eissn1543-6136
dc.identifier.endpage1665en
dc.identifier.issn1381-1118
dc.identifier.issued4en
dc.identifier.journaltitleArchives of Suicide Researchen
dc.identifier.startpage1645en
dc.identifier.urihttps://hdl.handle.net/10468/14089
dc.identifier.volume26en
dc.language.isoenen
dc.publisherTaylor & Francisen
dc.rights© 2021, the Authors. Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium,provided the original work is properly cited, and is not altered, transformed, or built upon in any way. Archives of Suicide Research 2022, 26(4), pp. 1645–1665. https://doi.org/10.1080/13811118.2021.1938321en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectRisk assessmenten
dc.subjectSelf-harmen
dc.subjectSuicidal ideationen
dc.subjectSuicideen
dc.subjectSystematic reviewen
dc.titleSuicide and self-harm risk assessment: A systematic review of prospective researchen
dc.typeArticle (peer-reviewed)en
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