The effectiveness of suicide risk assessment tools in predicting the need for hospitalization

Abstract

Objective: In this study, adults presenting to the emergency room after a suicide attempt were evaluated by means of some suicide risk assessment tools, and the effectiveness of these tools in identifying those who needed to be hospitalized was investigated. Method: A total of 60 participants were included in the study. The clinical risk assessment of a psychiatrist was considered to be the gold standard for evaluation, and the consistency of the scores obtained by the tools used in the study (Modified “SAD PERSONS” Scale, California Suicide Risk Estimator, Suicide Risk Assessment Tool) were compared with this gold standard by receiver operating curves (ROC). For each tool, the optimal cut-off score, and its sensitivity and specificity at this value, which identified those who needed to be hospitalized were calculated. Independent samples’ t test was used to demonstrate whether the clinical assessment and the cut-off scores of the tools were able to differentiate the groups who needed to be hospitalized or not. The relationship between the clinical assessment and the tools was investigated by Pearson correlation analyses. Results: The sensitivity of the assessment tools for the need for hospitalization ranged from 44.4% to 72.2%, and their specificity ranged from 81.0% to 95.2%. No differences were found between the ROCs of the assessment tools when they were compared with each other. The cut-off scores of the assessment tools managed to differentiate those who needed to be hospitalized. Discussion: Although the assessment tools may not replace the clinical risk assessment of a psychiatrist, some of them may be helpful for the emergency room healthcare staff in identifying the adults who need to be hospitalized after an attempted suicide.

Keywords

• Hospitalization
• risk assessment
• suicide