Enablers and barriers of suicide risk assessments in inpatient and emergency department settings: a scoping review

Abstract

According to past mental health reports, the occurrence of suicide within inpatient healthcare facilities ranges between 1.0–4.5/1000 patients amongst North American, European, Australian and Chinese hospitals each year. As the risk of inpatient suicide continues to rise, tools such as suicide risk assessments may be useful in identifying at-risk patients. The current literature places a considerable amount of focus on validating suicide risk assessment tools. However, there is limited research on the implementation of these tools within inpatient facilities. This scoping review investigated the existing mental health literature surrounding suicide risk assessments to identify barriers and enablers to implementation of suicide risk assessments. MEDLINE and PsycINFO were systematically searched in April 2021, resulting in the inclusion of 52 articles. The Consolidated Framework for Implementation Research (CFIR) was employed to code and analyze implementation enablers and barriers. The main themes that emerged from this scoping review included: interprofessional collaboration amongst healthcare disciplines; perceptions of healthcare providers regarding risk screening; feasibility of risk screening; and training and education of healthcare providers. By unveiling both enablers and barriers to implementation, these results may guide decision-makers in determining the best course of action to effectively implement suicide risk assessments within inpatient facilities.