Estimating the risk of suicide

Health professionals play an important part in suicide prevention through their role in assessing people at risk.

A suicidal client can be challenging for health professionals, particularly if they do not regularly deal with such cases.

This information should not replace specialised training, but may be a helpful resource for professionals dealing with suicidal clients.

When a person is suicidal, their management first requires an assessment of risk, followed by appropriate intervention to minimise any risk. The risk assessment needs to consider both the factors that increase the risk of suicide as well as those that mitigate the risk. These risk and protective factors should also be considered in any management decisions.

 

Recognising suicide risk

Sometimes a client may openly express suicidal ideation, but often the cues may be more subtle. They may speak about feeling hopeless, depressed, having trouble sleeping, or perhaps ask for a medication change. It is important that health professionals look out for risk factors or cues, and are ready to question the patient about suicidal intent.

 

Suicide risk factors

  • Previous suicide attempt/s
  • Lack of social or professional support
  • Co-existing mental illness
  • Increasing substance abuse
  • Male gender (three times more likely than females)
  • Expressing feelings of hopelessness

 

The risk assessment

A comprehensive, systematic risk assessment is a logical, structured clinical judgement.

  • Understand the concept of risk and the factors associated with increased risk
  • Establish rapport with the individual
  • Conduct and document a thorough risk assessment
  • Establish and record level of risk using clear, commonly understood categories/definitions (e.g. non-existent, mild, moderate, high and imminent)
  • Acknowledge the need for ongoing monitoring of suicide risk, which may fluctuate under changed circumstances

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