Suicide was found to be the second leading cause of death among adults aged between 15 and 24 in 2013. As the patterns of suicide may be different for young adults between 18 and 24 years of age than for teenagers between 15 and 17, CDC’s National Center for Health Statistics (NCHS) examined the rates and methods of suicide among young adults between 18 and 24 years of age by sex, race and Hispanic origin. This report published by the Centers for Disease Control and Prevention (CDC) revealed that young American Indians and Alaska Natives (AIAN) have much higher rates of suicide compared to other racial and ethnic groups. The relevance of a proper suicide risk assessment with improved clinical documentation through accurate behavioral medicine transcription is much higher in this scenario.
Out of five race and ethnicity groups studied including non-Hispanic, white, non-Hispanic black, Hispanic and Asian or Pacific Islander (API), the suicide rate was highest in the American Indian or Alaska Native (AIAN) population with 34.3 deaths of males and 9.9 deaths of females per 100,000 populations. The males in AIAN population were more than twice likely to commit suicide compared to other gender and racial and ethnic subgroups. However, the suicide rates for AIAN young adults are possibly underestimated as it was found in a previous CDC study that the overall deaths for all AIAN population were underreported by 30%.
As per the data combined from 2009 through 2013 for non-Hispanic black and non-Hispanic white young adults who committed suicide, the most common method used for suicide was firearms, followed by suffocation. At the same time, suffocation was the most common method used by Hispanic, API, and AIAN young adults who committed suicide, followed by firearms. The common methods used by API young adults who committed suicide were poisonings and falls (12.6% and 8.1% of suicide deaths, respectively).
Suicide Risk Assessment and Improved Clinical Documentation
Suicide prevention is an important part of a mental health practice. Suicide risk assessment is regarded as the core function for suicide prevention, which involves engaging with and assessing those patients who are at the risk of suicide. This assessment is a complex and stressful task for healthcare professionals as they have to weigh the relative risk of a person engaging in suicidal behaviors within the context of that person’s current clinical and psychosocial presentation. The degree to which the risk and protective factors affect the likelihood of suicidal behaviors is different for different people. Neither one risk factor or a set of risk factors increase the risk of suicide nor one protective factor or a set of protective factors guarantees against suicide. Therefore, physicians should sensitively enquire about the patient’s reasons for dying and synthesize all of this past and present knowledge to determine the current suicidal risk. They should be confident to ask genuine questions to their patients and ensure thorough assessment to strengthen patients’ hope for life or reduce their wish to die.
It is not enough for physicians to ask the right questions to ensure proper suicide risk assessment, but also record all relevant details in an accurate and standardized manner. An improvement should be made in the clinical documentation based on historical, clinical, situation and protective factors. All the gaps in the documentation should be updated and alternative interventions are provided, if needed. Of course, electronic health records or EHRs provide an easy way to enter and access relevant details in times of need. However, issues such as copy-paste errors and limited narrative description are a matter of concern. A combined approach of EHR and transcription is thus effective for accurate clinical documentation. Once the physicians’ recordings are transcribed and reviewed with the help of transcriptionists or a medical transcription service company, the data is quickly and accurately entered into the relevant fields in the electronic health record.