Virtual Suicide Risk Assessment: A Review of Current Literature

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Ramnauth, Alana
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Background: Approximately 11 people every day die by suicide in Canada. Canadians have self-reported an increase in mental health challenges including suicidal thoughts following the start of the COVID-19 pandemic. With physical distancing measures in place, suicide risk assessments often need to be addressed virtually. Clinical video telehealth (CVT) can be used to conduct a suicide risk assessment and provide ongoing care to high-risk individuals and ultimately prevent the loss of life. Objectives: To review the literature on the use of CVT for suicide risk assessments, summarize the specific challenges faced by providers conducting these assessments and highlight suggested safety protocols for providers. Method: An online search pertaining to CVT and suicide risk assessment was performed using PsycINFO and PubMed databases. Titles and abstracts were reviewed and studies demonstrating the feasibility and effectiveness of CVT for suicide risk assessment were summarized. Additional articles discussing challenges from a provider’s perspective and safety protocol suggestions were separately reviewed. Results: A total of 10 articles were included in the review, 6 for feasibility and/or effectiveness of CVT for suicide risk assessment, 3 additional articles summarizing provider challenges, and 1 article specific to safety protocols. Findings were in support of CVT use for high suicide risk individuals. Strong evidence for the equivalency of CVT to in-person care delivery, increasing comfort amongst both providers and patients, and increased access to timely safety plan development are all features supporting virtual suicide risk assessment. Provider challenges include determining appropriateness, effective emergency management, and managing technological failures. In terms of safety, pre-planned guidelines are essential to protect both the patient and provider, particularly in clinically unsupervised settings which were less frequent and less studied before the pandemic. Conclusion: Virtual suicide risk assessment via CVT is feasible and effective for those with an elevated suicide risk. Although provider challenges exist, proactively addressing these can reduce provider apprehension, especially for those who are new to CVT use. More rigorous study of CVT that is inclusive of high-risk participants is needed. The available literature suggests that CVT can be effectively used to conduct an initial assessment for suicidal individuals. This is useful for providers as mental health challenges continue to persist and suicide risk assessments are being done virtually.
Virtual suicide, risk assessment