Suicide Risk Assessment

There are no perfect risk assessment tools

some risk assessment tools

Trying to determine intent:

  • What did you think would happen when you did [x]?
  • How do you feel now that you're not dead, and you're here talking to me?

Columbia suicide severity rating scale

  1. Have you wished you were dead or wished you could go to sleep and not wake up?

  2. Have you actually had any thoughts about killing yourself?

    If Yes to 2, ask Q3-6
    If No to 2, skip to Q6

  3. Have you been thinking about how you might do this?

  4. Have you had these thoughts and had some intention of acting on them? (high risk)

  5. Have you started to work out or worked out the details of how to kill yourself? Did you intend to carry out this plan? (high risk)

  6. Have you done any thing, started to do anything, or prepared to do anything to end your life?

    1. If yes, was this within the past 3 months? (high risk)

SAD PERSONS - limited evidence for its use...

  1. Sex (+1 if male)
  2. Age +1 if <19 or >45
  3. Depression +2 if present
  4. Previous suicide attempt or psych care +1 if present
  5. Excess alcohol or drug use +1
  6. Rational thinking disrupted +2
  7. Separated, widowed, divorced +1
  8. Organised or serious attempt +2
  9. No social support +1
  10. Stated future attempt/ambivalence +2

<6: may be safe to discharge
6-8: specialist rv

8: high risk