Risk Assessment and Decision Making Regarding Imminent Suicidality in Pediatric Settings

Abstract

Risk assessment for suicidality and related clinical decision making raises a number of ethical, clinical, and professional challenges for pediatric psychologists across the many clinical settings and professional roles in which these risk assessments may be conducted. Prior work has focused on ethical issues related to imminent risk concerns and the development of risk assessment protocols for use in clinical work or research. However, little work has attended to the real-world clinical scenarios in which risk assessment occurs, specifically within pediatric settings, and the unique clinical decision-making dilemmas faced by pediatric psychologists in these risk assessment scenarios. After a review of the ethical, clinical, and professional challenges often faced by pediatric psychologists in evaluating and addressing imminent risk among youth, a series of case vignettes is presented to illustrate these challenges and the clinical decision-making skills utilized to resolve such challenges.