Psychiatric inpatients' perceptions of written no-suicide agreements: an exploratory study

Suicide Life Threat Behav. Spring 2002;32(1):51-66. doi: 10.1521/suli.


One hundred thirty-five psychiatric inpatients admitted for suicidal danger were surveyed regarding their views on the benefits/limitations of written no-suicide agreements. A survey instrument developed for this study revealed that these inpatients, for the most part, rated written no-suicide agreements in a positive manner and in ways consistent with clinical opinion expressed in a number of qualitative/expert-opinion articles. Positive views of no-suicide agreements were not materially influenced by social desirability or age, nor were they moderated by gender, presence/absence of Axis II disorders, or admission suicidal danger. However, patient suicide attempt history (no attempts, one attempt, or more than one attempt) exerted a moderating effect on patients' ratings of the helpfulness of these contracts. Multiple attempters viewed written no-suicide agreements as less helpful than those patients with a single or no prior attempts. The methodological problems and generalizability concerns associated with these results are discussed and future research needs are suggested.

MeSH terms

  • Adult
  • Analysis of Variance
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Inpatients
  • Kansas
  • Male
  • Negotiating*
  • Psychotherapy / methods*
  • Suicide / prevention & control*
  • Suicide / psychology