Risk assessment of patients in general practice is a challenging area of clinical practice. Competing interests of managing patient wishes, consideration of duty to warn others and invoking the Mental Health Act while practising in a medicolegally accountable manner can be difficult.
This article summarises the risk assessment of patients with possible mental disorders and provides suggestions regarding measures that may be undertaken to manage risk in psychiatric emergencies.
The evidence of effectiveness for risk assessment interventions in acute settings is limited. While it is not possible for general practitioners to predict the future, and particularly to predict fatal outcomes, they can be expected to meet a standard of care that identifies those at risk and provide an acceptable clinical response.
Suicide accounts for 1.6% of deaths in Australia.1 However, it comprises more than 20% of deaths in men between the ages of 20 and 39 and men are four times more likely to die by suicide than women.1 The 2007 National Survey of Mental Health and Wellbeing showed that 1880 deaths in Australia were classified as suicide in that year, an overall nonage adjusted rate of 8.9 per 100 000. The prevalence of suicidal ideation was 2.3%, with 0.4% of respondents in the general population reporting previous suicide attempts.2 The aftermath of suicide in terms of grief and loss for the bereaved, as well as lost productivity for society, is considerable.
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