PT - JOURNAL ARTICLE AU - Simon, RI TI - The suicide prevention contract: clinical, legal, and risk management issues DP - 1999 Sep 01 TA - Journal of the American Academy of Psychiatry and the Law Online PG - 445--450 VI - 27 IP - 3 4099 - http://jaapl.org/content/27/3/445.short 4100 - http://jaapl.org/content/27/3/445.full SO - J Am Acad Psychiatry Law1999 Sep 01; 27 AB - In the managed care era, mental health professionals increasingly rely upon suicide prevention contracts in the management of patients at suicide risk. Although asking a patient if he or she is suicidal and obtaining a written or oral contract against suicide can be useful, these measures by themselves are insufficient. "No harm" contracts cannot take the place of formal suicide risk assessments. Obtaining a suicide prevention contract from the patient tends to be an event whereas suicide risk assessment is a process. The suicide prevention contract is not a legal document that will exculpate the clinician from malpractice liability if the patient commits suicide. The contract against self-harm is only as good as the underlying soundness of the therapeutic alliance. The risks and benefits of suicide prevention contracts must be clearly understood.