Brief Treatment and Crisis Intervention Advance Access originally published online on February 20, 2008
Brief Treatment and Crisis Intervention 2008 8(1):5-14; doi:10.1093/brief-treatment/mhm029
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Avoiding Malpractice Lawsuits by Following Risk Assessment and Suicide Prevention Guidelines
From the Rutgers University (Roberts, Monferrari) and the Ohio State University School of Medicine (Yeager)
Contact author: Albert R. Roberts, Professor of Criminal Justice and Social Work, Rutgers University, Livingston Campus, Lucy Stone Hall, B-261, 54 Joyce Kilmer Avenue, Piscataway, NJ 08854. E-mail: prof.albertroberts{at}comcast.net
Every 17 min, someone in the United States commits suicide. This equates to 83 suicides every day throughout the year (A. R. Roberts & K. Yeager, 2005). Suicide results in approximately 30,000 reported deaths annually. The loss of a patient to suicide is often a feared outcome among psychiatrists, psychologists, social workers, and crisis counselors, especially because the law assumes that in most situations suicide is preventable. Suicide accounts for many of the largest monetary settlements and judgments as well as a large proportion of malpractice lawsuits filed against mental health clinicians. Yet, clinician's often lack sufficient education on the legal aspects of malpractice associated with patient suicide. This article reviews several legal cases in which psychiatrists and/or social workers failed to protect patients. This includes failure to conduct a comprehensive biopsychosocial and lethality assessment, failure to warn of imminent risk of suicide, and/or breach of duty to care standards. Each case presentation concludes with recommendations for actions. Next, the article identifies common allegations made in suicide malpractice lawsuits. Conditions necessary to meet the criteria for a malpractice suit are laid out. The article concludes with the authors' guideline (FIKKE) for managing malpractice risk along with a decision-making flowchart designed to reduce a patient's risk of suicide during the treatment process.
KEY WORDS: suicide, malpractice lawsuits, duty to care, lethality assessment, risk factors