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Cited by 22Suicide and Self-Harm StudiesPsychiatric care and mental health servicesOpioid Use Disorder Treatment

How Veterans Health Administration Suicide Prevention Coordinators Assess Suicide Risk

Pease, James L., Forster, Jeri E., Davidson, Collin L., Holliman, Brooke Dorsey, Genco, Emma, Brenner, Lisa A.·2017·Clinical Psychology & Psychotherapy
DOI 10.1002/cpp.2011
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Abstract

This cross‐sectional study was designed to examine the suicide risk assessment practices of Suicide Prevention Coordinators (SPCs) within the Veterans Health Administration. Specifically, this study sought to (1) identify factors SPCs consider most important in assessing risk and patient priority; (2) measure the level of consistency and agreement between SPCs in assessing suicide risk and prioritizing cases; and (3) measure individual SPC consistency between cases. SPCs (n = 63) responded to online survey questions about imminent and prolonged risk for suicide in response to 30 fictional vignettes. Combinations of 12 acute and chronic suicide risk factors were systematically distributed throughout the 30 vignettes using the Fedorov () procedure. The SPCs were also asked to identify the level of priority for further assessment both disregarding and assuming current caseloads. Data were analysed using clinical judgement analysis. Suicidal plan, β = 1.64; 95% CI (1.45, 1.82), and preparatory behaviour, β = 1.40; 95% CI (1.23, 1.57), were considered the most important acute or imminent risk factors by the SPCs. There was less variability across clinicians in the assessment of risk when alcohol use (p = 0.02) and hopelessness (p = 0.03) were present. When considering acute or imminent risk factors, there was considerable variability between clinicians on a vignette‐by‐vignette basis, median SD = 0.86 (range = 0.47, 1.13), and within individual clinicians across vignettes, median R2 = 0.80 (0.49, 0.95). These findings provide insight into how this group of providers think about acute and chronic risk factors contributing to imminent suicide risk in Veterans. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message: Identifies factors that practitioners consider most important in suicide risk assessment Discusses how to distinguish between chronic and acute risk for suicide Identifies factors that lead to more consistent clinical judgments

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  • Unstructured clinical approaches may be more inaccurate and subject to cognitive biases, including overemphasis on predisposing factors and risk aversion.

    “Some studies have shown that these unstructured approaches may be more inaccurate and subject to a range of cognitive biases on the part of the assessor, including an overemphasis on predisposing factors51 and risk aversion.52”

    From Suicide (2020) · cites this paper as [51]

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Authors
Pease, J. L., Forster, J. E., Davidson, C. L., Holliman, B. D., Genco, E., & Brenner, L. A.
Affiliations
  • University of Colorado Anschutz (US)
  • Colorado School of Public Health (US)
  • Rocky Mountain Mental Illness Research, Education and Clinical Center Denver Colorado USA
Corresponding author
Pease, James L.
ORCID
Venue
Clinical Psychology & Psychotherapy
Publisher
Wiley
Published
2016-04-13
Volume
24
Issue
2
Pages
401-410
ISSN
  • 1063-3995 (ISSN-L)
  • 1099-0879
DOI
10.1002/cpp.2011
OpenAlex
W2339156440
Cited by
22
References
20
Citations by year
2026: 3 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 2
FWCI
1.78
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Psychology & Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
Funders
Health Services Research and Development
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
suicide risk assessment, Veterans Health Administration, veterans, suicide planning, alcohol consumption, hopelessness, case prioritization
MeSH terms
Suicide Prevention, Adult, Aged, Attitude of Health Personnel, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Risk Factors, United States, United States Department of Veterans Affairs, Risk Assessment, Veterans Health

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