Patient suicide and homicide risk often missed say researchers

24 Jun 2013 The assessment of risk in patients who go on to die by suicide or commit homicide is often poor, a new study has found. A report by The University of Manchester's National Confidential Inquiry (NCI) into Suicide and Homicide by People with Mental Illness out today has raised concerns about the way that risk is assessed and led to criticism of the tick-box approach to clinical practice. Researchers looked at a sample of 81 cases where risk had been judged to be low, but seven days or less after the assessment the patient died by suicide or committed homicide, to retrospectively address the quality of the assessments. They found that in about a third of the cases (36% of the patient suicides and 41% or the patient homicides) the overall quality of risk assessment was unsatisfactory. In the majority of cases, however, risk assessment and management were satisfactory, even though they were followed within seven days by a fatal incident. Professor Louis Appleby, commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of the NHS England, NHSSPS Northern Ireland, the Scottish Government, the Welsh Government and the Channel Islands, said: "The results suggest there is a need for risk management to be individually tailored, or personalised, to each patient rather than following a "tick-box” approach. "In the majority of the 81 sample cases studied risk assessment and management were satisfactory, but in a significant minority of cases we studied we found clinical risk assessment and management may not have been adequate.