Use of no-suicide contracts by psychiatrists in Minnesota

Am J Psychiatry. 2000 Oct;157(10):1684-6. doi: 10.1176/appi.ajp.157.10.1684.


Objective: The no-suicide contract is widely recommended as an important intervention in the care of suicidal patients; however, there are no data demonstrating its effectiveness or its acceptance in the professional community. This study examines the use of no-suicide contracts by psychiatrists in Minnesota.

Method: A postcard questionnaire was mailed to 514 psychiatrists in Minnesota inquiring about their practices and experiences with no-suicide contracts.

Results: There were 267 responses, yielding a response rate of 52%. No-suicide contracts were used by 152 (57%) of the respondents. Within this group, 62 (41%) of the psychiatrists had patients who committed suicide or made serious attempts after entering into a no-suicide contract.

Conclusions: Among the respondents to the questionnaire, slightly more than half used no-suicide contracts, indicating that such contracts are not universally accepted as standard practice among these psychiatrists. More data are needed to determine the effectiveness of no-suicide contracts in preventing suicide.

MeSH terms

  • Female
  • Humans
  • Male
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Minnesota
  • Patient Care
  • Physician-Patient Relations
  • Postal Service
  • Practice Patterns, Physicians'*
  • Psychiatry / organization & administration*
  • Risk Assessment
  • Risk Management / methods
  • Risk Management / statistics & numerical data
  • Suicide / prevention & control*
  • Suicide, Attempted / prevention & control
  • Suicide, Attempted / psychology
  • Surveys and Questionnaires