The role of psychiatric nurses in suicide risk assessment, crisisintervention, and continuity of care: A patient-centered review

Abstract

Suicide prevention in psychiatric services requires more than identification of a numerical risk category. It requires clinicians to recognize fluctuating distress, understand the person’s reasons for living and reasons for dying, respond to immediate danger, preserve therapeutic connection, and maintain continuity when the patient moves between emergency, inpatient, outpatient, and community settings. Psychiatric nurses occupy a central position in this continuum because they frequently have the most sustained contact with patients and families and are therefore well placed to detect changes in affect, behavior, engagement, cognition, substance use, environmental safety, and access to support. Current guidance emphasizes person-centered psychosocial assessment, clinical formulation, collaborative safety planning, restriction of access to lethal means when feasible, compassionate crisis management, and coordinated follow-up rather than reliance on a single scale or a global label such as “low” or “high” risk. Evidence also indicates that the period after psychiatric discharge is particularly vulnerable and that timely outpatient contact, structured follow-up, and caring contacts can strengthen continuity. This patient-centered review examines the psychiatric nurse’s role across assessment, crisis intervention, therapeutic engagement, inpatient management, discharge planning, family partnership, follow-up, professional training, documentation, ethical practice, quality improvement, and emerging digital care models. The review highlights how nursing practice can connect risk recognition with individualized action while avoiding false precision, coercive routines, and fragmented transition