Electronic Letters to:
|
|
eLetters: Electronic letters published:
-
![[Read eLetter]](/icons/misc/sectionDOWN.gif)
confused clinician
- prakash raviraj (9 March 2005)
|
|
|||
|
prakash raviraj, senior house officer sheffield care trust
Send letter to journal:
drpraks{at}yahoo.com prakash raviraj
|
I wonder why reducing suicide is just the psychiatrist's responsibility? Joe Bouch and John James Marshall in this article have identified various factors including socioeconomic, family, interpersonal, and media influence, along with mental disoder, which all increase the risk of suicide. Obviously many of these factors are beyond psychiatrists' control. If we look carefully at high profile cases such as the deaths of Dr Kelly and Dr Harold Shipman, it is clear that no risk assessment tools are good enough to predict the imminent risk of suicide. I agree with authors about the use of stuctured professional judgement in managing suicide risk. If we look historically, the only time the suicide rate has fallen significantly is during periods of war. Health of the Nation targets have been criticised in the past because of difficulties in predicting such uncommon events (Hawton,BMJ,1998). Undoubtedly these targets have incresed the pressure on psychiatric services. The NICE guidelines on deliberate self harm, Safety First (DOH), and Confidential Inquiry findings have made us more cautious in discharging patients from A&E and inpatient settings. Is it not true that an excess of guidelines and assessment tools are confusing clinicians in this age old process of guesswork? References; Department of Health (2001). Safety First. Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. London: Department of Health. Department of Health (1998). Our Healthier Nation. London: Stationery Office. Hawton, K, British Medical Journal. 317,156-157. NICE CG16 Self-harm,2004. |
|||