What Went Wrong On This Psychiatry Oral Board Vignette
I received an email from a course candidate who failed her vignette section. This is one of the vignettes she believes she did not do well on. Let’s review and see what went wrong.
Suicide Assessment: Fantasies That Increase Risk
Today is the second in a series on the suicide assessment. A factor that really increases a patient’s risk of suicide that is often not even on our radar is the nature of the patient’s fantasies regarding their suicide. Read more on this fascinating topic.
Suicide Assessment: Beliefs That Can Increase Or Decrease Risk
Suicide assessments, to provide us any direction, need to be in-depth. Why? Because the suicide risk factors we’ve all learned about (e.g., living alone, abusing alcohol, even having suicidal thoughts) are poor predictive factors. So even after assessing a patient for suicide, we end up not knowing if and when that person will actually engage in a suicide attempt.
This state of affairs leads one to ask, “So what’s the point in conducting a suicide assessment at all?” The answer is that if we learn to conduct in-depth assessments, we can identify the factors that increase level of risk. We then can intervene to lower those risks, whether or not they would have led to suicide. In other words, even if we can’t predict future action, we can use the assessment to guide us to lower the risk. Today I start a series on different aspects of the suicide assessment. Today’s topic is on suicidal beliefs. The next topic is on suicidal fantasies.