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Outpatient Standards of Care and the Suicidal Patient
Author(s) -
Bongar Bruce,
Maris Ronald W.,
Berman Alan L.,
Litman Robert E.
Publication year - 1992
Publication title -
suicide and life‐threatening behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.544
H-Index - 90
eISSN - 1943-278X
pISSN - 0363-0234
DOI - 10.1111/j.1943-278x.1992.tb01039.x
Subject(s) - malpractice , alliance , medicine , intervention (counseling) , ambulatory care , statutory law , medical emergency , psychology , nursing , health care , political science , law , economics , economic growth
This article is a review of the legal and clinical literature on standards of care for nonhospitalized adult suicidal patients. The authors discuss effective assessment, management, and treatment procedures that balance the need for high‐quality care by a reasonable and prudent practitioner with the requirements of court‐determined and statutory standards. Through a review of malpractice claims data and through an examination of the clinical literature we detail the essential guidelines for sound assessment, intervention, and management procedures. The authors specifically discuss common failure situations in outpatient care (e.g., problems in pharmacotherapy, the decision to hospitalize, inappropriate and dual relationships, the assessment of imminence and lethality, and so on). Details regarding practical considerations in developing an outpatient standard of care are provided, as are suggestions that such a standard of care must include an ongoing assessment of the therapeutic alliance.