Paper Example on Geriatric Psychiatric Current Suicidal Risk Assessment Tools

Introduction

There have been experiences of uncovered suicidal thoughts among patients ranging from the young to the aged. The suicidal cases have therefore been reviewed, and literary documents presented to bring control on the same having set the policies that are believed to be fit to control it. The researchers have had limited information concerning the protocol to be used in protecting the patients. The guide of the researchers, therefore, has been limited hence impacting the human subject significantly to suicidal risk management. This paper analyses the developments and the progress in the implementation of the protocol to be used the researchers. Suicide causes the high number of deaths more or so in the United States of America. Many people are hospitalised due to the non-fatal suicidal acts and attempts. This paper, therefore, seeks to make a change on the geriatric psychiatric current suicidal risk assessment tools which are outdated to a more evident based tool that the Columbia Suicide Risk Assessment. This change will have an impact mostly n those that are patients of geriatrics, hospitalized and the organizations. The new regulatory standards render the current suicide assessment tool as being out of compliance and entailing a safety risk to the patients. It is therefore essential to shift to a more evidence-based suicide risk assessment that is based on the practice to prevent the further increase in the number of individual suicide patients. The cause of suicide while impatient has been proved to have a relationship with the invalid assessment tools.

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Sources of Information/Evidence

According to the cause analysis completed, 1089 suicides occurred between 2010 and 2014 and the patients were hospitalized due to lack of adequate assessment offered to them. For instance, in the US 1500 suicides occur while the patients were hospitalized. Studies conducted to several countries have shown that the suicidal risks the more among the elderly ageing from 65 years and above. The suicides in Pennsylvania is of the high rate among the senior men with the total suicides of males and females in Pennsylvania ageing between 75 and 79 are 13.9 per 10000, age between 80 and 84 years are16.5 per 100000 and in the age of 85 and above is 12.7 per 100000. This now in the US the rate of the suicide rates are higher in the aged individuals between the age of 45 and 54 at 19.7 per 100000 and age 85 and above at 12.7 per 100000. Generally, suicides have decreased of the past decade through the rate has remained constant on the elderly in the US.

The patients involved in suicidal instances have often viewed the act to have been subjected to the action by the circumstances that that themselves are defined not be in a position to handle and to fix. They opt to commit suicide to evade the problems that face them. The subjective view puts it as a delaying tactic that they use to circumvent the responsibilities. Otherwise, the risk of suicide is increased by both the factors that are rural-specific and traditional. These factors can also reduce the risk of suicide in some areas while increasing the risk in other communities. This is so because the population in the various communities differs and the norms also differ from one city to another. The advancement in knowledge even to some extent contributes to the push to suicide acts. The transformation of the human kind to apply and keep glued at the computers have led to the dehumanization effects that in time have eroded the cultures and the morals of the societies. This, in the long run, has caused a significant deviation from the original societal values that guarded a man against suicide.

The potential crisis of suicide is intuited by the expression of the patient to the patient, the health provider and the service provider. The tragic death of the patient may come with profound adverse outcomes for the health providing system for the patient, the family and those are charged with the responsibility of making provisions to the patient. The result has effects on the professional, financial and emotional domains. The assessments done in promptness by the individual clinicians need the knowledge and skills of; report establishment with extremely distressed patients, the risk factor for suicide and the clinically approved ability to assess the degree of the suicide risk.

The suicidal patient initial contact according to the healthcare organizations is the person who picks the phone at the practice. The chain the involves the intervention of the clinician who takes care of the victim is quite a complex chain especially if there is urgency needed. On deciding on the course of action, the clinician must activate the response following the current context. This in itself involves bringing on board other service providers, relevant departments that may include; on-call physicians, inpatient unit, the admission officer and the emergency room officer. The mental health treatment team, as well as the primary care provider, may also be included in the panel. These are all expected to incorporate the various disciplines that apply to the situation in question. The process of the clinical, administrative support and the clinical assessment give then the appropriate response as the institutions involved. There are gaps and deficits in the suicide prevention which renders the patients to be identified after the occurrence of the suicidal attempt. Otherwise, these points are challenges the challenges that need addressing within the clinical organization in a bid to prevent the future incidents of the suicide events. Just as pointed out in this paper, the process of avoiding the suicide acts should involve the effort and corporation of clinicians of a multidisciplinary team. The teams being conscious about the policy features that are important are yet to summarize the lessons about the need for the development suicide act.

The suicide act and policy aims at eliminating the chances of the individuals getting involved in the suicidal act without being noticed. The procedure is set to ensure that the patients are safe and free from the action by ensuring they are offered a solution to provide them with the alternatives solutions to their problems rather than suicide or to curb them from committing suicide by denying the fertile grounds for such activity. The policy is majorly based on the improvement of the quality of methodology applied in controlling and preventing the suicide. The procedure is demonstrated rather than being stated rigorously to help in identifying and solving of the challenges that face the various medical institutions that work on unison to ensure that the harmful impacts are reduced and prevented if possible.

Alternative Solutions

The alternative solutions that can be put in place include:

Sad Person Scale-which was initially developed for use with children but later advanced to meet the needs of the adults and has a completion time of 5-10 minutes. It has a specific scale with a low sensitivity that does not reveal any clinical value that has the potential to cause harm. Manchester Self-Harm Rule (MSHR)-this was developed for the adults specifically. It has completion of 5 minutes, and as per the studies, the scale performs with very high sensitivity but with very low specificity. This has been proven to be more accurate in predicting suicide as compared to the self-harm.

The Black Hopeless Scale- which measures the degree of negativity towards failure. This was recommended for the ages between 17 and 80and has a completion time of 5-10 minutes. It has high sensitivity and average specificity.

ReACT- this was initially developed for the assessment of self-harm in the departments of emergency. It is a modified version of MSHR and has a completion tie of 5 minutes. It has a performance with high sensitivity and low specificity. It has low accuracy in the prediction of suicide the repeat self-harm

Some practices are related to suicidal risks and practices. These practices are either direct, and some are indirect as well. The cause of the incidence and occurrence of the training that leads the individuals to commit suicide are of several magnitudes as well through the impact of suicide is similar once it occurs regardless of the cause. Some efforts have come up with the practices based on the management and prevention of the occurrence of suicidal incidences. The exercises are meant to be a resolution to the challenge to be able to reduce the risks. One of the best practices related to suicide is evidence-based practices. These practices are aimed at preventing the occurrences of the cases of suicide in the American state by using the research and the data available to plan and implement the suicidal prevention efforts.

The Criteria That Will Be Used to Decide on Alternatives

These evidence-based practices include; getting engaged in the evidence-based practice and selecting and developing the evidence-based programs to eliminate the suicidal threats.

When getting engaged in the evidence-based practice, it should be well understood that this practice requires the accurate, explicit and consciousness. These are incorporated to come up with the best current evidence to decide community care and the protection of the protected health domain, Maintenance and improvement of health and disease prevention. This will practically include; systematic use of data and information systems, dissemination of what is learnt, conduction of sound elevation, getting engaged in community decision making, considering the best scientific evidence available in making decisions and applying the program-planning framework.

These practices form the strategic planning approach to suicide prevention. This practice as implemented by my stakeholders and the policymakers has been of a great move to bringing the solution to the suicidal process. This process that as well as included the communities and incorporated them in the enforcement of the policy has solved a better percentage of the problem. Though many resources are needed, the impact is notably positive, and this has attracted the financial aid institutions that have stood with the project in the fight of suicide. There has been the devolvement of an idea that allows the provision to the vulnerable to avoid the situations that may push them to the wall financially hence reducing their stress based on financial limitations. Closely related to that is the enlightenment of the community.

The stakeholder and the decision makers have come to a consensus with the adoption of the adoption of the scale with the most supportive evidence-based practice which can meet or exceed the regulatory standards. The affordability plays a significant role in adopting the new scale that includes the SAD person scale which is free for the organizations and needs limited training. The Manchester Self-Harm which requires limited training, Becks Scale kit of the manual that has an annual subscription ReACT Scale also free and requires limited training. The scale chosen must effectively be able to determine the risk to prevent the organization from facing much costs incurred in the whole process of risk determination.

The organization structure that will include the hospital structure, geriatric psychiatric unit, staff training and trained personnel who can teach others, the training plan, the suicide assessment tool and the compliance audits which have the feedback.

The collaboration with the UPMC making in the process of affiliation with Allegheny Health Systems that ensure both systems utilizes a similar scale for continued care. The policy that regulates the change in the internal is related to the old scale and would need a revision to fix the new scale.

Decision Making

Deciding on the alternatives, various criteria ca...