Panel Discussion 25 - Managing Suicide Risk in Clinical Science: Turn down the Alarms, Raise the Compassion and Humility

Monitoring and responding to a participant’s suicide risk in the research setting is among the most important tasks that clinical researchers face. Researchers face pressure from institutions to use a “better safe than sorry” approach that may overlook the downsides of more aggressive measures (e.g., involuntary hospitalization, wellness checks from law enforcement). The purpose of this panel is to discuss common situations that researchers encounter in monitoring suicide risk during research, to review relevant literature regarding what approaches are commonly used and their efficacy, and to make recommendations for researchers to follow in monitoring and addressing suicide risk. The panelists and moderator on the panel have extensive experience with monitoring and addressing suicide risk in research, including with adults and adolescents, in cross-sectional and longitudinal research and in clinical trials, and in both online and in-person research settings. We will begin with a discussion of the common approaches to assessing and responding to suicide risk in clinical research, and the state of the literature regarding the strengths, weaknesses, and efficacy of these approaches. Next, we will address the risks and downsides to this approach, with a particular emphasis on addressing the considerable risks involved in more aggressive suicide risk management approaches, especially for those with marginalized identities. We will discuss the ethical concerns raised by an overly conservative approach to suicide risk, with attention to matters of justice, beneficence, and respect for persons. Furthermore, we will explore the possibility that, especially when the target of study is suicidality itself, aggressive intervention may undermine the scientific process. Finally, we will conclude with recommendations, based on the clinical and research experience of the panelists, for researchers interested in a compassionate approach to managing suicide risk in research participants.