3: Assessment of Risk Factors
Screening and Evaluation » Evaluation
3: Assessment of Risk Factors
We recommend an assessment of risk factors as part of a comprehensive evaluation of suicide risk, including but not limited to: current suicidal ideation, prior suicide attempt(s), current psychiatric conditions (e.g., mood disorders, substance use disorders) or symptoms (e.g., hopelessness, insomnia, and agitation), prior psychiatric hospitalization, recent bio-psychosocial stressors, and the availability of firearms.
Strength:
Strong for
Category:
ReviewedNew-replaced
Grades and Definitions
- Strong for
- or "We recommend offering this option …"
- Weak for
- or "We suggest offering this option …"
- No recommendation
- or "There is insufficient evidence …"
- Weak against
- or "We suggest not offering this option …"
- Strong against
- or "We recommend against offering this option …"
Categories and Definitions |
||
---|---|---|
Evidence Reviewed* | Recommendation Category* | Definition* |
Reviewed | New-added | New recommendation following review of the evidence |
New-replaced | Recommendation from previous CPG that has been carried over to the updated CPG that has been changed following review of the evidence | |
Not changed | Recommendation from previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed but the recommendation is not changed | |
Amended | Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed and a minor amendment has been made | |
Deleted | Recommendation from the previous CPG that has been removed based on review of the evidence | |
Not reviewed | Not changed | Recommendation from previous CPG that has been carried forward to the updated CPG, but for which the evidence has not been reviewed |
Amended | Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has not been reviewed and a minor amendment has been made | |
Deleted | Recommendation from the previous CPG that has been removed because it was deemed out of scope for the updated CPG | |
*Adapted from the NICE guideline manual (2012): The guidelines manual. London: National Institute for Health and Care Excellence;2012. and Martinez Garcia L, McFarlane E, Barnes S, Sanabria AJ, Alonso-Coello P, Alderson P. Updated recommendations: An assessment of NICE clinical guidelines. Implement Sci. 2014;9:72. |
Recommendation Resources
Findings suggest that a comprehensive suicide risk evaluation should include a clinical assessment of risk factors. Factors that increase risk for suicidal thoughts and/or behaviors with the most evidence were organized into categories including: current suicidal ideation, prior suicide attempt(s), current psychiatric conditions (e.g., mood disorders) or symptoms (e.g., hopelessness), prior psychiatric hospitalization, recent bio-psychosocial stressors, and the availability of firearms.
Training Resources
This section includes links to recommended trainings about the assessment of risk factors.
- VA Comprehensive Suicide Risk Assessment (CSRE) printable worksheet
- The Suicide Prevention Resource Center
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The Columbia Risk and Protective Factors Page provides a checklist of risk and protective factors for suicide that can be used with any version of the Columbia Suicide Severity Rating Scale (C-SSRS)
Webinars
This section includes links to recommended webinars about the assessment of risk factors.
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Evidence-Based Practice in Suicide Risk Screening and Evaluation: Why, What, How and When? Presented by Dr. Nazanin Bahraini
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Suicide Risk Factors Research & Clinical Implications Presented by Dr. Megan Harvey and Christie Machan, LCSW
Articles
This section includes links to recommended articles about the assessment of risk factors.
- 2014). The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis. Annals of internal medicine, 160(2). 101-110. https://doi.org/10.7326/M13-1301 (
- 2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological bulletin, 143(2). 187-232. https://doi.org/10.1037/bul0000084 (
- 2018). Understanding suicide risk within the Research Domain Criteria (RDoC) framework: A meta-analytic review. Depression and anxiety, 35(1). 65-88. https://doi.org/10.1002/da.22686 (
- 2016). Suicide prevention strategies revisited: 10-year systematic review. The lancet. Psychiatry, 3(7). 646-659. https://doi.org/10.1016/S2215-0366(16)30030-X (
Podcasts
This section includes links to recommended podcasts about the assessment of risk factors.
- Rocky Mountain MIRECC Short Takes on Suicide Prevention
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Risk Factors, Warning Signs, and Drivers of Suicide with Dr. Peter Gutierrez
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Suicide Risk Assessment: A new look at an old tool and why it remains essential with Dr. Peter Gutierrez