ORCID

0000-0002-2196-1148

Date of Award

Summer 2024

Language

English

Embargo Period

8-14-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

Department of Educational and Counseling Psychology

Program

Counseling Psychology

First Advisor

Susan Phillips

Second Advisor

Lisa McAndrew

Third Advisor

Katharine Bloeser

Committee Members

Brett Harris

Keywords

suicide risk assessment, provider perceptions, bias, chronic pain, anxiety

Subject Categories

Other Psychiatry and Psychology | Patient Safety

Abstract

Objective: Suicide is the 10th leading cause of death in the U.S. with nearly 50,000 people per year dying by suicide. Public health approaches to suicide prevention focus on screening people in primary and mental health care settings and offering treatment to those who screen positive. Research shows that mental health providers may not recognize risk factors for suicide and miss opportunities to screen patients who may be at risk. Providers’ mental representations of suicide risk may be influencing their perception of patient risk and contributing to low screening rates. This study used an experimental vignette case design to examine providers interpretation of patient risk level based on the presenting concern of the patient. Methods: A large sample (N=436) of mental health providers and graduate students in mental health fields participated in this study. Participants were mostly women, mostly psychologists, and were distributed across the United States. Participants were randomly presented one of two conditions, a patient presenting with pain and anxiety, or a patient presenting with anxiety and were asked to rate four factors of the vignette patient’s suicide risk: perceived distress, risk of suicide ideation and behavior, and resilience. While the sample was randomized, there was an administrative error in distribution that lead to unequal randomization and thus results should be interpreted cautiously. A series of ANOVAs were used to examine between group differences for the four factors of suicide risk. Results: There were significant differences between groups for three of the four factors of suicide risk, perceived distress, risk of suicide ideation and behavior but not resilience which provides support for 3 of 4 study hypotheses. Conclusions: The study found that providers did perceive patient’s risk to be higher when the patient presented with both pain and anxiety, compared to anxiety alone. These results are encouraging because they demonstrate that providers do consider a patient to be at higher risk for death by suicide when the patient has high levels of pain. These findings should be replicated in future studies.

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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