Therapeutic relationships key to reducing suicides – University of Otago experts

Professor Paul Glue, Department of Psychological Medicine.

Ongoing contact between health professionals and patients is likely to have more of an impact in helping to reduce suicide death rates than a perfectly completed risk assessment tool, University of Otago psychological experts say.

In an editorial published in the latest issue of the New Zealand Medical Journal today, Dr Christopher Gale and Professor Paul Glue from the University of Otago's Department of Psychological Medicine consider current practice in suicide risk assessment at Waikato Hospital.

Specifically, they are commenting on an audit also published in the latest issue of the New Zealand Medical Journal of risk assessment in patients presenting to Waikato Hospital's emergency department following an attempted suicide.

The findings suggest many aspects of the recommended clinical assessments were incomplete.

The study highlights the potential for clinical documentation not complying with guidelines, no matter how well written and practical the risk assessment tool is, the experts write in their editorial.

Reliance on current suicide risk assessment tools to predict future suicide lacks evidential support, they say.

“Given the current state of knowledge, ongoing contact is likely to make more difference to suicide death rates than a perfectly-completed risk assessment tool.”

This requires adequate time to build a relationship and develop a plan for the patient, which should be the basis for treatment, they say.

However, the academics note that building therapeutic relationships and developing a treatment plan to recognise future suicidality is more time-consuming for doctors and is more complex than any assessment tool.

“In the future, developing robust interventions for patients presenting with suicidal ideation and deliberate self harm might be a more appropriate focus for research than screening for suicide risk without such an intervention being readily available.”

For further information, please contact:

Professor Paul Glue,
Head of Department of Psychological Medicine,
Associate Dean Division of Health Sciences,
Phone: +64 3 470 9430
Email: paul.glue@otago.ac.nz

Liane Topham-Kindley
Senior Communications Adviser,
Phone: +64 3 479 9065
Email: liane.topham-kindley@otago.ac.nz

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