Efficient, Holistic, Heuristic and Semi-structured Suicide Assessment Tool (EHSSA) - Very Accurate Prediction of Risk.

Study Overview
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Brief Summary
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Many studies have found that insights regarding suicide risk-factors for cohorts does not translate to practical value in the identification of such risk in specific individuals. E.H.S.S.A. - a suicide assessment tool that was empirically designed by an emergency psychiatry department (P.E.S.P. of Bergen County) in its effort to accurately predict, in specific patients, the risk of suicide attempts in the reasonably foreseeable future. It is of a unique paradigm that combines critical elements of holism, heuristics and semi-structured design.

Detailed Description
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Objective: Many studies have found that insight regarding suicide risk-factors for cohorts does not translate to practical value in the identification of such risk in specific individuals. This performance improvement study formally examined the effectiveness of EHSSA (efficient, holistic/heuristic semi-structured suicide-risk assessment) - an empirically derived tool designed by this emergency psychiatry department. It is a suicide assessment tool for predicting in a specific patient (as opposed to a cohort), the risk of serious suicide attempts in the reasonably foreseeable future. Methods: At P.E.S.P. (Psychiatric Emergency Screening Program) of Bergen County of New Jersey, a prospective performance improvement study was done on all patients (N = 1,505) that had presented with psychiatric crisis to the department over the course of a 6 month period, (of which approximately 50% had significant suicidal ideations). The only exclusionary criteria was active delirium. Each patient was evaluated using EHSSA by departmentally trained mental health professionals. Patients were deemed to either require hospitalization or be safe to be discharged to the community (with appropriate outpatient referrals). Those that were discharged (N = 137) were followed up with phone calls approximately 15 days post discharge.

Official Title
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Predicting Suicide: E.H.S.S.A. - An Efficient, Holistic, Heuristic and Semi-structured Suicide Assessment Tool for Accurately Predicting, in a Specific Patient, the Risk of Suicide in the Reasonably Foreseeable Future. (EHSSA)

Conditions
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Suicide Risk

Intervention / Treatment
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* Other: EHSSA- An Efficient and Holistic/Heuristic Semi-structured Suicide Assessment Tool


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients of any age/gender/economic class with or without dementia and/or substance use disorders All patients presenting to P.E.S.P.(Psychiatric Emergency Screening Program of Bergen County) in psychiatric distress/crisis. Exclusion Criteria: - Active Delirium.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| All Patients evaluated by PESP during the trial period.<br>EHSSA tool applied to every patient in cohort. | Other: EHSSA- An Efficient and Holistic/Heuristic Semi-structured Suicide Assessment Tool<br>* EHSSA will be used to evaluate every patient for suicide risk.<br>* Other names: EHSSA;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate or number of completed or attempted suicide. | Reported/ascertained cases among the cohort of completed or serious suicide attempts within 15 days of EHSSA evaluation and discharge to community or until the start of treatment with an outpatient mental health professional, whichever came sooner. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Suicide Risk Assessment Tool, Holistic, Heuristic, Semi-structured, Predictive Capacity