Objective risk
Details of actions taken
Actions taken to make the attempt more or less likely to be successful
Consequences of attempt
Current intent
Introduction
These notes provide a checklist for some of the information which needs to be considered when making a judgement about a patient's risk of committing suicide.
The notes are laid out as a single HTML file which is designed to be viewed in a mobile device. This means that you can load it and it will display the headings at the top. You can then click on any heading to view the relevant explanation. From there, you can either scroll up and down through the text or you can use the back button on your browser to return to the headings. A standard web version is also available (see link below).
You can access the document live over the internet but better is to obtain a copy and store it on your mobile device so that you can view it without a data connection. Top
Suicide, attempted suicide and deliberate self-harm
When thinking about suicide risk, it can be helpful to use objective language when describing what has happened. If you say that a patient "tried to kill themself" or "attempted suicide" then you are implying that you know that this was the patient's real intent. It may be better to avoid such language and instead to say what the patient actually did rather than presume to know what they were trying to achieve.Top
Mental health problems
Be aware of the patient's actual psychiatric diagnosis (or diagnoses). You cannot manage a patient effectively without thinking about their diagnosis.Top
Physical health problems
Be aware of physical illnesses, especially if chronic, painful, deteriorating, terminal.Top
Demographics
Age, gender, marital status, occupation, etc. There are some epidemiological associations with suicide risk but usually factors specific to the individual will be more relevant.Top
Substances
Prescribed medication (consider side effects and compliance), alcohol, recreational drugs.Top
Social situation
Domestic situation, financial situation.Top
Stressors
For example bereavement, job loss, relationship problems, accommodation problems.Top
Protective factors
Anything making it less likely that the patient will commit suicide - e.g. children, religious beliefs.Top
Previous attempts
Obtain the following information about recent and past episodes of deliberate self-harm and suicide attempts.
Top
Events leading up to attempt
Time course of deterioration, precipitants, planned, impulsive? Intoxicated?
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Subjective risk as judged by patient
Did the patient really believe that their actions would lead to death?
Top
Objective risk
How dangerous in fact were the patient's actions?
Top
Details of actions taken
What did the patient actually do?
Top
Actions taken to make the attempt more or less likely to be successful
Extent of planning. Steps taken to avoid discovery. How did the patient end up in contact with services? Did they phone anybody? Or were they discovered accidentally?
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Consequences of attempt
Did they require medical treatment? Admission to hospital?
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Current intent
What is the patient's current expressed attitude towards killing themselves? If they have a method in mind, what is the subjective and objective risk? Is their intent conditional on other factors such as whether they are admitted, whether they are rehoused, etc.?
What is the extent of their hopelessness? Do they have psychotic symptoms which affect their risk of suicide?
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Link to latest mobile version: http://www.davecurtis.net/dcurtis/lectures/SuicideRiskAsssessmentMobile.html
Link to web version: http://www.davecurtis.net/dcurtis/lectures/SuicideRiskAsssessment.html
Link to other notes: http://www.davecurtis.net/dcurtis/lectures.html
Dave Curtis (http://www.davecurtis.net/dcurtis.html)
Copyright Dave Curtis 2011. You can distribute this material freely provided my copyright remains acknowledged.