Suicide Risk Assessment Flashcards
suicide as cause of death
4th - 10-65yo
3rd - 15-24 yo
2nd - 25-34
5% are inpatient
strongest predictor of suicide
psych illness
suicide prediction
foretelling if suicide will/not occur at SOME FUTURE TIME
based on risk factors
suicide (risk) assessment
clinical judgement of risk in VERY NEAR FUTURE
based on clinical details/hx
No one specific risk factor or set of risk factors is identified as specifically predictive of suicide
suicide risk assessment steps
- risk factors
- protective factors
- do specific suicide inquiry
- risk level determination & intervention
- documentation
Risk Factors
PRIOR SUICIDE ATTEMPT
Suicidal behavior
Current/past psychiatric disorders
SX (impulsivity, hallucinations, hopelessness, anhedonia)
Family hx - STATIC
Precipitant/Stressors (HUMILIATING events)
Change in TX
Access to firearms
Protective Factors
Internal (coping, RELIGIOUS beliefs)
External (marriage, children, pregnancy, pet, social support)
Suicide Inquiry
Ideation (frequency, intensity)
Plan
Behavior (past attempts)
Intent)
HIGH risk level
Psych dx w/ severe sx + stressors
LETHAL attempt or ideation/rehearsal
Hospitalization + Suicide Precautions
MODERATE risk level
Many risk factors
Few protective factors
Suicide ideation with plan. NO intent
?admission pending risk factors
develop crisis/emergency plan
LOW risk level
Modifiable risk factor
Strong protective factor
Thoughts of death. NO plan, NO intent
outpatient referral, sx reduction
emergency contacts
Documentation
risk level & basis for it
TX plan for reducing risk
+/- firearms
suicide rates
male complete more suicide (early 20s and >70s)
elderly - more lethal
female attempt more (early 20s)
Demographics
White, Native americans > other races
INC risk: LGBTQ
INC risk: docs/healthcare
Bipolar & suicide
bipolar Men and women at equal risk
Mood disorders & suicide
+ depression in suicidal pts
substances
INC # of substances used, INC risk
genetics
suicide is independent, inheritable risk factor
chronic illness
INC risk > fatal illness
domestic partner abuse
INC risk for victim, abuser, witness/children
past hospitalization
INC of suicide risk immediately following discharge and remain high for the following week - month.
need FUP with psych
exceptions for protective factors
children in home - women in postpartum with psychotic or mood dx
pregnancy exception - teenager, socioeconomic hardship
MODIFIABLE Factors
Patient safety TX x psych dx Tx sx - agitation/anxiety Psychological problems Social problems
NON modifiable factors
Demographics Past HX Family HX Financial difficulties Unemployment
