Intended for healthcare professionals

Rapid response to:


Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study

BMJ 2006; 332 doi: (Published 25 May 2006) Cite this as: BMJ 2006;332:1241

Rapid Response:

Telephone consultations - a medico-legal minefield?

Telephone contact one month following a suicide attempt may well have
some benefit in reducing further attempts, but I wonder how many health
professionals would be willing to do this. Telephone assessments are
notoriously unreliable for many forms of doctor-patient consultation and
surely even more so in this situation – unknown patients, possibly in an
ongoing life-crisis, a significant proportion of whom will fulfil the
criteria for emotionally unstable personality disorder and whose actions
may be inherently unpredictable. It would have been useful to know whether
the researchers had predefined criteria for risk stratification and how
they decided upon the appropriate course of action for each patient.
Without clear guidelines of this sort, clinicians would be entering a
medico-legal minefield by undertaking such assessments, where they may be
held responsible for clinical judgements made in the absence of many
observation-based elements vital to a comprehensive mental state

Competing interests:
None declared

Competing interests: No competing interests

30 May 2006
Ruth V Reed
Senior House Officer, Psychiatry
Camden and Islington Mental Health and Social Care NHS Trust, NW3 2QZ