Estimating the risk of suicide

Health professionals are in a key position for identifying people at risk of suicide and preventing suicide.

Not all health professionals treat suicidal clients on a regular basis and therefore it can be challenging when a client presents with suicide risk. This information should not replace specialised training, but may be a helpful guide.

The management of a person at risk of suicide requires the assessment of risk, followed by appropriate interventions to minimise any risk. In estimating the risk, health professionals need to consider those factors that elevate suicide risk and also consider those factors that mitigate suicide risk. These risk and protective factors are also an important consideration in any management decisions.

 

Identifying and monitoring suicide risk

Sometimes a person will clearly articulate suicidal ideation, other times the cues will be more subtle – a person may describe feelings of hopelessness, depression, insomnia or express a desire for medication change. Health professionals must be alert for the cues, and be ready to ask the patient directly about suicide intent.

 

Risk factors for suicide

  • Previous suicide attempt/s
  • Lack of support
  • Concurrent mental disorders
  • Increasing substance abuse
  • Low social support/living alone
  • Male gender (three times more likely than females)
  • Expressing feelings of hopelessness

 

Suicide risk assessment

When a thorough risk assessment is undertaken in a systematic way it is more than a guess or intuition – it is a reasoned and structured clinical judgement.

  • Be familiar with the concept of risk and the factors associated with increased risk
  • Establish rapport with the individual
  • Conduct and document a thorough risk assessment
  • Use clearly defined and commonly understood categories for defining levels of risk (For example: non-existent, mild, moderate, high and imminent.)
  • Recognise the need for ongoing monitoring of suicide risk, as risk fluctuates as circumstances change.

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