A review of suicide risk assessment instruments and approaches

Abstract Introduction: Conducting an accurate suicide risk assessment (SRA) is no simple task as there are a number of factors that influence an individual's level of suicidality and his/her willingness to share this information. Therefore, it is imperative that practitioners adopt a systematic approach to conducting and documenting the foreseeability that a patient will commit suicide. Methods PubMed was used to search for articles published in MEDLINE journals using the following keywords: suicide, risk assessment, measure, scale. Randomized trials and pilot, proof-of-concept publications investigating the use of specific SRA measurements were included in the review. The scales are described based on the prevailing opinions in psychiatry from the American Psychiatric Association's Textbook of Suicide Assessment and Management (2nd ed., 2012). Results Although various SRA scales exist, experts in the field have repeatedly concluded that there is not any one scale that can predict who will commit suicide to any useful degree. However, when used along with the clinical interview, standardized suicide risk factor components of clinical and research scales remain crucial to gaining information often omitted by patients regarding thoughts and preparation for suicide. A summary of the most widely cited scales and approaches used in SRA is provided. Discussion SRA remains a challenge largely due to the fact that suicidal behavior is multifactorial. As a result, risk formulation is a process that should involve both standardized measures and detailed clinical interviews repeated over time.

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Evaluation of the Reliability and Validity of Two Clinician-Judgment Suicide-Risk Assessment Instruments

PsycEXTRA Dataset ◽

10.1037/e504562008-001 ◽

2008 ◽

Author(s):

Prachi Kene ◽

Joseph D. Hovey

Keyword(s):

Risk Assessment ◽

Suicide Risk ◽

Reliability And Validity ◽

Assessment Instruments ◽

Suicide Risk Assessment ◽

Clinician Judgment

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Concurrent validity and reliability of suicide risk assessment instruments: A meta analysis of 20 instruments across 27 international cohorts

10.1101/2021.09.15.21263562 ◽

2021 ◽

Author(s):

Adrian I. Campos ◽

Laura S. Van Velzen ◽

Dick J. Veltman ◽

Elena Pozzi ◽

Sonia Ambrogi ◽

...

Keyword(s):

Risk Assessment ◽

Suicidal Ideation ◽

Concurrent Validity ◽

Suicide Risk ◽

Rating Scale ◽

Assessment Instruments ◽

Depression Severity ◽

Suicide Risk Assessment ◽

Suicidal Thoughts ◽

Severity Rating

AbstractObjectiveA major limitation of current suicide research is the lack of power to identify robust correlates of suicidal thoughts or behaviour. Variation in suicide risk assessment instruments used across cohorts may represent a limitation to pooling data in international consortia.MethodHere, we examine this issue through two approaches: (i) an extensive literature search on the reliability and concurrent validity of the most commonly used instruments; and (ii) by pooling data (N∼6,000 participants) from cohorts from the ENIGMA-Major Depressive Disorder (ENIGMA-MDD) and ENIGMA-Suicidal Thoughts and Behaviour (ENIGMA-STB) working groups, to assess the concurrent validity of instruments currently used for assessing suicidal thoughts or behaviour.ResultsOur results suggested a pattern of moderate-to-high correlations between instruments, consistent with the wide range of correlations, r=0.22-0.97, reported in the literature. Two common complex instruments, the Columbia Suicide Severity Rating Scale (C-SSRS) and the Beck Scale for Suicidal Ideation (SSI), were highly correlated with each other (r=0.83), as were suicidal ideation items from common depression severity questionnaires.ConclusionsOur findings suggest that multi-item instruments provide valuable information on different aspects of suicidal thoughts or behaviour, but share a core factor with single suicidal ideation items found in depression severity questionnaires. Multi-site collaborations including cohorts that used distinct instruments for suicide risk assessment should be feasible provided that they harmonise across instruments or focus on specific constructs of suicidal thoughts or behaviours.Key pointsQuestion: To inform future suicide research in multi-site international consortia, it is important to examine how different suicide measures relate to each other and whether they can be used interchangeably.Findings: Findings suggest detailed instruments (such as the Columbia Suicide Severity Rating Scale and Beck Scale for Suicidal Ideation) provide valuable information on suicidal thoughts and behaviour, and share a core factor with items on suicidal ideation from depression severity rating scale (such as the Hamilton Depression Rating Scale or the Beck Depression Inventory).Importance: Results from international collaborations can mitigate biases by harmonising distinct suicide risk assessment instruments.Next steps: Pooling data within international suicide research consortia may reveal novel clinical, biological and cognitive correlates of suicidal thoughts and/or behaviour.

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Evaluation of the Reliability and Validity of Two Clinician- Judgment Suicide Risk Assessment Instruments

Crisis ◽

10.1027/0227-5910/a000003 ◽

2010 ◽

Vol 31 (2) ◽

pp. 76-85 ◽

Cited By ~ 2

Author(s):

Prachi Kene-Allampalli ◽

Joseph D. Hovey ◽

Gregory J. Meyer ◽

Joni L. Mihura

Keyword(s):

Risk Assessment ◽

Factor Analysis ◽

Internal Consistency ◽

Suicide Risk ◽

Reliability And Validity ◽

Future Research ◽

Assessment Instruments ◽

Suicide Risk Assessment ◽

Starting Point ◽

Clinician Judgment

Background: This study evaluates the psychometric properties and factor structure of two clinician-judgment suicide risk assessment instruments – the Suicide Assessment Checklist developed by Yufit and the other developed by Rogers. Methods: As an archival study, 85 client records were obtained through a university psychology clinic. Results: Internal consistency was high for only one subscale of the Yufit checklist after deleting items for factor analyses, whereas internal consistency was high for the overall Rogers checklist after deleting items. Interrater reliability was excellent for both instruments. Both checklists correlated with self-reported suicidality on the Personality Assessment Inventory. Preliminary analyses indicated that data from the Yufit checklist are unsuitable for factor analysis, whereas factor analysis of the Rogers checklist identified one depressive factor. Conclusions: These findings provided evidence supporting the reliability and validity of the Rogers checklist. The findings also provided a good starting point for future research of the Yufit checklist.

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Assessment of Suicide Risks During the First Week Immediately After Discharge From Psychiatric Inpatient Facility

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.643303 ◽

2021 ◽

Vol 12 ◽

Author(s):

Trine Madsen ◽

Eybjørg Egilsdottir ◽

Chanette Damgaard ◽

Annette Erlangsen ◽

Merete Nordentoft

Keyword(s):

Risk Assessment ◽

Suicide Risk ◽

Psychiatric Inpatient ◽

Elevated Risk ◽

Suicidal Risk ◽

Suicide Risk Assessment ◽

Patient Will ◽

History Of ◽

Reason For Admission

Background: The suicide rate in first week after psychiatric discharge is alarmingly high. Although a risk assessment prior to discharge is standard praxis, it can be difficult to take into consideration the obstacles that patient will meet once discharged. A follow-up-visit during the first week after discharge is an opportunity to reevaluate whether a person may be at risk of suicide.Aim: To determine how many patients, of those who were assessed, were evaluated to be at elevated risk of suicide during the first week after psychiatric discharge and secondarily to identify predictors of this and predictors for receiving a follow-up visit during first week after discharge.Methods: All patients discharged between March 1st 2018 to January 17th 2019 were offered a home visit including a systematic risk assessment. Socio-demographics and clinical variables were obtained from medical records and logistic regression analyses were used to identify predictors of a higher suicide risk assessment as well as receiving a follow-up visit.Results: Information from 1905 discharges were included. Of these, 1,052 were seen in follow-up meetings. Risk assessments was conducted in a total of 567 discharge procedures, of which 28 (5%) had an elevated risk of suicide. A history of suicide attempt, suicide risk having been the reason for admission, a first diagnosis of a psychiatric disorder was associated with an elevated risk of suicide after discharge.Conclusion: Follow-up visits could serve as an important tool to identify people whose suicidal risk were overlooked at discharge or exposed to severe stressors after discharge.

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