Reliability and rationality in the prediction of suicide

The reliability and validity of psychiatrists' predictions of a patient's potential for suicide are increasingly being questioned, both by mental health professionals and by the courts. The authors describe a study conducted in 1978 to measure the reliability with which a team of mental health professionals assessed suicidal risk in a group of 16 patients seen in videotaped interviews. They found that the highest reliability was on an item that assessed the seriousness of the patient's past suicide attempts; the lowest reliability came in assessing the patient's risk of death from accidents, homicide, or neglect of self. Over-all, the authors say, the clinicians made their judgments based on rational and consistent evaluation of the data.