Suicide Assessment

These are not the only things that should be considered.  These are perhaps the most useful factors you should look for in the superacute setting (i.e. whether the patient is at risk today).  In most cases, suicide should be looked at in the context of depression, psychosis or other mental disorders, as well as in the context of their social history.

  1. Ideation- i.e. do they wish they were dead now?  Or are there any other thoughts of suicide/self-harm at the present?
    1. If yes to both, you should probably go straight onto questioning behaviour (see below)
    2. Ask about any ideas about
      1. methods
      2. intent
      3. planning (in this order, if possible)
  2. Severity/Intensity- i.e. how frequent are these thoughts?  how long do they last?
    1. Are they controllable?
    2. Are there any deterrents/causes?
    3. What is the reasoning behind them (desire to inflict pain on self, others / attention seeking)?
  3. Suicidal Behaviour– i.e. have they ever attempted suicide/ self-harm?
    1. If so, was it interrupted or aborted
    2. Have they made any preparations for a new attempt? e.g. letters, finances, etc etc

As well as this specific risk, you will also want to check for depressive and psychotic symptoms, as well as some social factors e.g.

  • Any symptoms of depression or psychosis
  • Feelings of hopelessness, worthlessness, anhedonia, anxiety/agitation, panic attacks, anger, impulsivity
  • Any recent or current substance abuse
  • Any family history, chronic medical illness, sexual/physical abuse

Also, a patient is more likely (statistically) to commit suicide if male, 15-35 years old or over 65.

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