SLS Health Pocket Guide - Suicide Potential

7/23/2008

Suicide Potential

Risk Factors

Incidence in General Population - 11 to 12 per 100,000

Incidence among 15 to 19 year old males - 20 to 27 per 100,000

Incidence among 15 to 19 year old females - 3 to 5 per 100,000

Highest General Population Risk

Male
Over 45 years old
White
Lives alone
Poor health

Rates of completed Suicide by Diagnosis

Unipolar and Bipolar Disorders 15%
Borderline Personality Disorder 3% to 8%
Schizophrenia 10%
Substance Abuse increases risk 5 times

Quick Psychometric tests

Becks Suicide Scale by A. Beck
Becks Depression Inventory by A. Beck
Risk Estimator Scale for Suicide by Motto

Suicide Assessment

Be direct but supportive in tone with the patient.

Be aware of demographic risk factors.

Ask patient if they want to die or kill themselves.
Ask them if they have previously attempted suicide.
Ask them how they attempted suicide last time and whether medical care was needed.
Ask them if anyone in their family (or relatives) has tried or succeeded in committing suicide.
Ask them how they would kill themselves. What method would they use?
Ask them if they have the means on hand or how they would obtain them.
Ask them if they have written a suicide note or given away any of their possessions.
Ask them if they feel hopeless about the future.
Ask them when they intend to commit suicide.
Ask them how their loved ones would feel if they killed themselves.
Ask them if there is any reason why (or any one for whom) they would not harm themselves.
Ask them if they are willing to contract for safety.

Score Results of Interview

	Yes	No
Suicidal thinking present	2	0
Past attempts	1	0
Family history of suicide	1	0
Credible suicide plan	3	0
Means to kill self available	3	0
Has serious health problems	1	0
Lives alone	1	0
Will contract for safety	0	3

Instructions:
Add up the score. If it is 3 or highter the suicide risk is serious.

If after interviewing the patient you conclude they intend to harm themselves and they refuse to contract for safety seek immediate hospitalization.

Remember that studies suggest that up to 75% of those who commit suicide visit a health care professional in the 28 days prior to their act.

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