Efficient, Holistic, Heuristic and Semi-structured Suicide Assessment Tool (EHSSA) - Very Accurate Prediction of Risk.

Objective:

Many studies have found that insight regarding suicide risk-factors for cohorts does not translate to practical value in the identification of such risk in specific individuals.

This performance improvement study formally examined the effectiveness of "EHSSA" (efficient, holistic/heuristic semi-structured suicide-risk assessment) - an empirically derived tool designed by this emergency psychiatry department. It is a suicide assessment tool for predicting in a specific patient (as opposed to a cohort), the risk of serious suicide attempts in the reasonably foreseeable future.

Methods:

At P.E.S.P. (Psychiatric Emergency Screening Program) of Bergen County of New Jersey, a prospective performance improvement study was done on all patients (N = 1,505) that had presented with psychiatric crisis to the department over the course of a 6 month period, (of which approximately 50% had significant suicidal ideations). The only exclusionary criteria was active delirium.

Each patient was evaluated using "EHSSA" by departmentally trained mental health professionals. Patients were deemed to either require hospitalization or be safe to be discharged to the community (with appropriate outpatient referrals). Those that were discharged (N = 137) were followed up with phone calls approximately 15 days post discharge.

Inclusion criteria

• Patients of any age/gender/economic class with or without dementia and/or substance use disorders
• All patients presenting to P.E.S.P.(Psychiatric Emergency Screening Program of Bergen County) in psychiatric distress/crisis.

Exclusion criteria

• Active Delirium.