This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Drew, B. L. Search for Related Content Social Bookmarking                         What's this?

No-Suicide Contracts to Prevent Suicidal Behavior in Inpatient Psychiatric Settings

Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Ave., Cleveland, OH 44106-4904.

BACKGROUND: Many individuals who are hospitalized on psychiatric units are at high risk of suicide. Among the strategies commonly recommended for suicide prevention is the negotiation of a no-suicide or no-harm contract. In spite of the conventional acceptance of no-suicide contracts, there is little research about this intervention.

OBJECTIVE: To describe the use of no-suicide contracts in inpatient settings including the frequency of their use, the circumstances under which they are negotiated and the form of contracts.

STUDY DESIGN: Descriptive survey.

RESULTS: No-suicide contracts were used by 79% (n = 66) of the hospitals (N = 84). Contracts were generally negotiated after suicidal ideation was expressed (83% [n = 54] of those hospitals that use contracts), after self-harm (79%, n = 51), or after a patient who made a suicidal gesture or attempt was admitted (65%/, n = 42). In all but one hos- pital, nurses negotiated contracts with patients. Contracts were usually verbal (74%/, n = 48) or handwritten (72%, n = 47) rather than preprinted (15%, n = 10). Fifty-three percent of the respondents estimated more than 10 incidents of suicidal behavior by inpatients per year.

CONCLUSIONS: Suicidal behaviors occurred in hospital settings at a rate that is clinically significant. No-suicide contracting is a common nursing practice in psychiatric inpatient settings in Ohio. Contracts are not indiscriminately used but are negotiated when high suicide risk is assessed.

Journal of the American Psychiatric Nurses Association, Vol. 5, No. 1, 23-28 (1999)
DOI: 10.1177/107839039900500105


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				K. A. Garvey, J. V. Penn, A. L. Campbell, C. Esposito-Smythers, and A. Spirito Contracting for Safety With Patients: Clinical Practice and Forensic Implications J Am Acad Psychiatry Law, September 1, 2009; 37(3): 363 - 370. [Abstract] [Full Text] [PDF]