Date of Award

Summer 2014

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Clinical Psychology

First Advisor

Saunders, Stephen

Second Advisor

De St. Aubin, Ed

Third Advisor

Hoelzle, James

Abstract

Emergency departments (EDs) are critical sites for identifying patients with heightened suicide risk but there are no practice guidelines for the assessment of such patients. This study aimed to inform ED suicide risk assessment practices by examining ED providers' perspectives on this practice via a mixed methods approach. ED providers (n = 92) from two hospital systems completed an online survey that assessed demographic information, occupational information related to screening for suicide risk and related conditions, attitudes toward suicide prevention, and knowledge of suicide risk factors. A subset of ED providers (n = 19) completed a qualitative interview to gain further information about their views on the barriers and facilitators of suicide risk assessment and their perspectives on the strengths and weaknesses of different assessment methods. The results suggested that negative attitudes toward suicide prevention were related to less knowledge about suicide risk factors. Furthermore, knowledge of suicide risk factors, attitudes toward suicide prevention, and marital status predicted providers' comfort in asking patients about suicidal ideation. Hospital system and provider type were not significantly related to attitudes toward suicide prevention, knowledge of suicide risk factors, or occupational experiences related to assessing suicide-related concerns. Qualitative results suggested that suicide risk assessment practices in EDs should be brief, place little demand on the patient, involve a standardized protocol, and include consultation with others. Findings are further discussed in the context of improving suicide prevention efforts in this critical setting.

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