Suicide risk assessment and early recognition of risk factors

Abstract

Suicide is a common cause of death in people with mental health problems. No specific patient stereotype nor single risk factor can be used to easily identify which person or patient will attempt suicide. Mental health professionals often have to assess or manage suicide risk and this is challenging by reason of accurate methods of predicting remain elusive. Presence of multiple risk factors often suggest the need for additional evaluation for suicidal ideation, but an impending suicide attempt is not always recognized, even after evaluation by healthcare provider. More half of suicidals have seen a psychiatrist or psychologist or other healthcare provider within one month beforehand. The presentation of possible warning signs can be subtle and experience is required. Service provision for suicidal patients is often substandard, particularly at times of highest need such as after discharge from hospital or emergency department. As many as 75% or more of people who die by suicide have a diagnosable mental health disorder at the time of their death. The most common are bipolar disorder and schizophrenia over major depression. Between 25% and 50% of bipolar patients will attempt suicide at least once, and 5% to 20% will die by suicide. In schizophrenia diagnosis, 20% to 40% of patients will attempt suicide and more than 10% will die by suicide. Additional risk factors: alcohol misuse, family history, illegal substance use. The way in which suicide is broached and discussed with patient plays a significant role. Here, a focus on clinical management of suicide risk.

Disclosure of interest

The authors have not supplied their declaration of competing interest.