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Abstract
Although negotiation of no-suicide contracts is common practice, research regarding
the outcomes of contracting is inadequate. The purpose of this retrospective review
of medical records was to examine how no-suicide contracting affected the likelihood
of self-harm behavior in psychiatric inpatient settings. Thirty-one patients (4.8%)
engaged in self-harm behaviors representing 2.64% of all patients admitted to both
study settings during the 6 ![Math Eq]()
-month period from which data were collected. Approximately half of those patients
expressed suicidal intent. Logistic regression analysis suggested that patients with
no-suicide contracts and with higher levels of restriction had a significantly higher
likelihood of self-harm behavior (OR = 7.43 and 2.47, respectively, p = .005). Consistency of nursing assignment is likely associated with a lower probability
of self-harm (OR = .07) but p .068 when this variable was included in the model. Prevention of self-harm behaviors
by the use of no-suicide contracting is not shown. Negotiation of a contract is likely
a reflection of staff assessment that the patient was at high risk for suicide. These
findings confirm the need for thorough, ongoing assessment of suicidal risk, whether
or not a patient has agreed to a no-suicide contract.
-month period from which data were collected. Approximately half of those patients
expressed suicidal intent. Logistic regression analysis suggested that patients with
no-suicide contracts and with higher levels of restriction had a significantly higher
likelihood of self-harm behavior (OR = 7.43 and 2.47, respectively, p = .005). Consistency of nursing assignment is likely associated with a lower probability
of self-harm (OR = .07) but p .068 when this variable was included in the model. Prevention of self-harm behaviors
by the use of no-suicide contracting is not shown. Negotiation of a contract is likely
a reflection of staff assessment that the patient was at high risk for suicide. These
findings confirm the need for thorough, ongoing assessment of suicidal risk, whether
or not a patient has agreed to a no-suicide contract.To read this article in full you will need to make a payment
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Article Info
Footnotes
☆Supported in part by a grant from the Frances Payne Bolton School of Nursing Alumni Association.
Identification
Copyright
© 2001 Published by Elsevier Inc. All rights reserved.
