Use of Psychiatric Observation and No-suicide Contracts (NSC)
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In patients who utilize psychiatric services, does the implementation of observation or no suicide contracts increase patient safety? The use of various observation methods, including no-suicide contracts (NSC), in the treatment of patients who utilize psychiatric services is currently the standard of care. The use of no-suicide contracts became commonplace in the USA in 1973 when Drye, Goulding, & Goulding published a report which reflected data from their own practice.
McMyler and Pryjmachuk (2008) explain Drye’s study:
Firstly, within a 5-year period in the authors’ own practice, NSCs had been made with 600 service users and none had resulted in suicide. Secondly, as part of the study, Drye et al. surveyed 31 therapists who were using NSCs and ascertained that, in the 609 cases wherein the NSC had been used in accordance with their instructions, there had been no suicides. (p. 513)
A no-suicide contract is an agreement between a provider and a patient who utilizes psychiatric services. This agreement is “sometimes verbal but usually written, whereby the service user pledges not to harm themselves… they commonly comprise a statement of assent, details of the duration of the agreement and a contingency plan in the event that the service user feels unable to uphold the agreement” (McMyler & Pryjmachuk, 2008, p. 513).
Included in the treatment of psychiatric patients, differing levels of observation have also been used. These levels of observation include: “routine or general observation, 30- to 15-min checks, and constant or continuous observation” (Manna, 2009, p. 268). While a mental health professional such as a Licensed Professional Counselor, Licensed Clinical Social Worker, Psychiatrist, or Advance...
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