St Vincent’s Mental Health research offers promising insights for suicide prevention

15 Nov 2023

A St Vincent’s study has taken a deep dive to understand risk factors amongst people who present to hospital with suicidal thoughts and behaviours.

For many years, stratified risk assessments promised a breakthrough in predicting suicide risk, based on the theory of categorising individuals into 'high,' 'medium,' and 'low' risk to better inform interventions. However, as the years passed, a series of less-than-promising studies has dampened the initial enthusiasm.

In this definitive study, the largest meta-analysis conducted in the field, the findings are showing that what was once considered best practise in assessing suicide risk is actually not effective at all, and provides very little insight or ability to predict suicide.

"It has confirmed our suspicions”, said Dr Cameron Grover, lead author of the research paper, recently published in Acta Psychiatrica Scandinavica.

Of note, one significant finding emerges: the use of violent methods of self-harm stands out as the lone reliable predictor.

“It's a far cry from the comprehensive predictive capacity we initially hoped for, prompting a re-evaluation of our approach to suicide risk assessment and the need for a more nuanced understanding of the factors at play”, Dr Grover said.

Given this, St Vincent’s Emergency Mental Health team is looking for ‘beyond risk assessment’ treatment modalities for people who display behaviours that evoke concern for potential suicide.

In a series of Australian firsts, and in the largest of their kind, they are conducting qualitative studies across 13 PECC units and several emergency departments, to understand how the models are used, with the added intention of creating a Core Outcome Set - a systematised collection of outcome measures that could be used internationally across psychiatric short-stay units.

Over the next 5 years, these studies will establish an evidence-based foundation for the emergency and inpatient treatment for people in crisis, an area of psychiatry that is largely an evidence-free zone.

Jackie and Cameron

Co-authors Drs Cameron Grover and Jacqueline Huber