Leo Sher, M.D.

My invited commentary, “Advanced suicide risk assessments and suicide medical malpractice” has been published in the Evidence-Based Nursing (1). The Editors of the Evidence-Based Nursing invited me to comment on the article, “Storytelling in care: leveraging narrative identity and suicide narratives for advanced suicide risk assessments” that was published in the Journal of the American Psychiatric Nurses Association in March 2025 (2).

The article, “Storytelling in care: leveraging narrative identity and suicide narratives for advanced suicide risk assessments” is a narrative review of findings from qualitative studies of the use of the Narrative Identity theory and the Suicidal Narrative framework in clinical practice (2). The review discusses how the Narrative Identity and Suicidal Narrative frameworks expand our ability to understand the psychological basis of suicidality using qualitative study of individual stories. The paper also discusses how to use Narrative Identity and Suicidal Narrative constructs in clinical practice.

In my commentary, I noted that suicide medical malpractice is an important medico-legal issue and that in the U.S. 50% of hospital inpatient and 25% of outpatient suicides result in medical malpractice allegations (1,3). The use of Narrative Identity and Suicidal Narrative frameworks may help to reduce suicidal acts and, consequently, suicide malpractice litigations. Suicide risk evaluations and suicide prevention interventions should be carefully documented (4). High-quality medical documentation may play an important role in legal proceedings. I also noted that medical professionals take good care of their patients not because of fear of malpractice litigations but because taking top-quality care of our patients is our fundamental duty.

Reference

1. Sher L. Advanced suicide risk assessments and suicide medical malpractice. Evid Based Nurs. 2025 Sep 8:ebnurs-2025-104348. doi: 10.1136/ebnurs-2025-104348. Epub ahead of print.
2. Gay M. Storytelling in care: leveraging narrative identity and suicide narratives for advanced suicide risk assessments. J Am Psychiatr Nurses Assoc. 2025:10783903251321502. doi: 10.1177/10783903251321502. Epub ahead of print.
3. Resnick PJ. Suicide risk assessment and malpractice prevention. Presented at: U.S. Psychiatric and Mental Health Congress; Sept. 16-19, 2017; New Orleans. URL: https://www.healio.com/news/psychiatry/20170916/suicide-assessment-must-be-comprehensive-to-prevent-malpractice
4. Sher L. Suicide medical malpractice: an educational overview. Int J Adolesc Med Health. 2015;27(2):203-6. doi: 10.1515/ijamh-2015-5012.