Suicide Risk Assessment
A suicide risk assessment is a confidential discussion with a trained professional to identify immediate risk and connect you with the right support.
Suicide risk assessment is a systematic process used by healthcare professionals to evaluate whether someone is at risk of harming themselves. It involves asking specific questions about thoughts, feelings, and behaviours to determine the level of risk and what immediate actions need to be taken to keep the person safe.
Table of Contents | Jump Ahead
- What It Is
- Why It's Important
- How It Works
- What to Expect
- Risk Levels
- Immediate Safety Measures
- Global Perspectives on Assessment
- Cultural Considerations
- What Happens After Assessment
- For Family and Friends
- Crisis Resources (International)
- Key Messages
- Key Takeaways
- References
What It Is
A suicide risk assessment is a careful evaluation that helps healthcare providers understand if someone is thinking about suicide and how likely they are to act on those thoughts. It's a standard part of mental health care and is also used in emergency rooms, primary care settings, and crisis intervention services worldwide.
Why It's Important
- Life-saving: Proper assessment can identify people who need immediate help and prevent suicide attempts.
- Global Health Priority: The World Health Organisation identifies suicide prevention as a global health priority, with nearly 800,000 people dying by suicide worldwide each year.
- Early Intervention: Assessment helps connect people with appropriate treatment and support before a crisis occurs.
- Safety Planning: It leads to specific plans to keep people safe during difficult times.
How It Works
Professional Assessment: Trained healthcare providers, counsellors, or crisis workers conduct the assessment through structured questions and clinical observation.
Key Areas Evaluated:
- Current suicidal thoughts or plans
- Previous suicide attempts
- Mental health conditions
- Recent life stressors
- Access to means of self-harm
- Protective factors and support systems
- Substance use
- Impulsivity and risk-taking behaviours
What to Expect
During the assessment:- Healthcare provider will ask direct questions about suicidal thoughts
- Questions may feel uncomfortable, but are necessary for your safety
- The conversation is confidential (except when immediate safety is at risk)
- Assessment usually takes 15-30 minutes
- You may be asked to complete questionnaires
Questions you might be asked:
- "Have you been having thoughts of hurting yourself?"
- "Have you thought about how you might do it?"
- "When did these thoughts start?"
- "What has stopped you from acting on these thoughts?"
- "Who can you call for support?"
Risk Levels
Low Risk:- Occasional thoughts without specific plans
- Strong protective factors (family, friends, future goals)
- No previous attempts
- Willing to seek help
Moderate Risk:
- More frequent thoughts with some planning
- Mixed protective factors
- Some previous self-harm or attempts
- Ambivalent about getting help
High Risk:
- Specific plan and means available
- Previous serious attempts
- Limited protective factors
- Immediate danger to self
Immediate Safety Measures
If you're assessed as high risk:- You may need to stay in a hospital for safety
- Means of self-harm will be removed from your environment
- You'll have constant supervision until the crisis passes
- Emergency contacts will be notified
- Immediate treatment will begin
If you're assessed as moderate risk:
- Safety planning will be developed
- Regular check-ins will be scheduled
- Support people will be involved
- Treatment recommendations will be made
- Crisis contact information will be provided
Global Perspectives on Assessment
- World Health Organisation (WHO): Emphasises that suicide risk assessment should be part of all healthcare interactions and provides international guidelines for healthcare workers.
- International Association for Suicide Prevention: Promotes evidence-based assessment practices worldwide and supports training for healthcare professionals globally.
- National Health Services (Various Countries): Countries like the UK, Canada, and Australia have developed comprehensive suicide risk assessment protocols that are used internationally.
Cultural Considerations
- Cultural Sensitivity: Assessment approaches may vary based on cultural background, religious beliefs, and social contexts.
- Language Barriers: Professional interpreters should be used when language differences exist.
- Family Involvement: Different cultures have varying approaches to family involvement in mental health care.
- Stigma Awareness: Assessment must account for cultural stigma around mental health and suicide.
What Happens After Assessment
- Safety Planning: Development of a specific plan for staying safe during difficult times.
- Treatment Referrals: Connection to appropriate mental health services, therapy, or medication.
- Follow-up: Regular check-ins to monitor risk and provide ongoing support.
- Support Network: Involvement of family, friends, or other support people as appropriate.
For Family and Friends
Warning Signs to Watch For:- Talking about wanting to die or hurt themselves
- Looking for ways to kill themselves
- Talking about feeling hopeless or having no purpose
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing use of alcohol or drugs
- Acting anxious, agitated, or reckless
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Displaying extreme mood swings
How to Help:
- Take all talk of suicide seriously
- Ask directly about suicidal thoughts
- Listen without judgment
- Help them connect with professional help
- Stay with them if they're in immediate danger
- Remove means of self-harm if possible
Crisis Resources (International)
By Region:
- United States: 988 Suicide & Crisis Lifeline
- United Kingdom: 116 123 (Samaritans)
- Canada: 1-833-456-4566
- Australia: 13 11 14 (Lifeline)
Global:
- International Association for Suicide Prevention: https://www.iasp.info/resources/Crisis_Centres/
- Find a helpline, suicide hotline, or crisis line in your country: https://www.therapyroute.com/article/helplines-suicide-hotlines-and-crisis-lines-from-around-the-world
- Find an emergency ambulance number in your country: https://www.therapyroute.com/article/ambulance-emergency-numbers-worldwide-list-by-therapyroute
Key Messages
For Those Being Assessed:- Suicide risk assessment is a standard, caring part of healthcare
- Being honest about your thoughts helps keep you safe
- Having suicidal thoughts doesn't mean you're "crazy" or weak
- Help is available and effective
- Many people who have felt suicidal go on to live fulfilling lives
For Healthcare Providers:
- Regular training in suicide risk assessment is essential
- Cultural competency improves assessment accuracy
- Documentation and follow-up are crucial
- Collaboration with other providers enhances safety
Key Takeaways
- Suicide risk assessment is a life-saving healthcare practice used worldwide
- It involves systematic evaluation of thoughts, behaviours, and risk factors
- Assessment leads to appropriate safety measures and treatment
- Being assessed shows that people care about your safety and well-being
- Suicidal thoughts are treatable, and help is available
- Early identification and intervention save lives
- Professional assessment is always needed when suicide risk is present
References
Be You. (n.d.). Suicide Prevention and Response: Risk Assessment. https://beyou.edu.au/resources/fact-sheets/suicide-prevention-and-response/risk-assessment
National Institute of Mental Health. (n.d.). Ask Suicide-Screening Questions (ASQ) Toolkit Materials. https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials
The Lancet Psychiatry. (2022). Suicide Risk Assessment and Management in Clinical Practice. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00314-5/fulltext
Rural Health Information Hub. (n.d.). Screening Tools – Suicide Prevention Toolkit. https://www.ruralhealthinfo.org/toolkits/suicide/2/screening-tools
American Academy of Pediatrics. (n.d.). Conducting a Brief Suicide Safety Assessment. http://aap.org/en/patient-care/blueprint-for-youth-suicide-prevention/strategies-for-clinical-settings-for-youth-suicide-prevention/conducting-a-brief-suicide-safety-assessment/
Important:
TherapyRoute does not provide medical advice. All content is for informational purposes and cannot replace consulting a healthcare professional. If you face an emergency, please contact a local emergency service. For immediate emotional support, consider contacting a local helpline.
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