Suicide Risk Management: A Manual for Health Professionals

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Activities and internal coping strategies help the person distract themselves from suicidal ideation, potentially preventing a further escalation into crisis. Just being around other people can help provide distraction from suicidal thoughts — this can include spending time with family and friends, or going to a busy park or shopping centre.

You should also remind your client about avoiding social environments where alcohol or other drugs might be involved. If the person is still in crisis after working through their internal coping and socialisation strategies, the next step in their plan involves sharing their thoughts and feelings with a trusted friend or family member. For this step, the person should think carefully about who would be helpful in a crisis, and avoid listing people who could possibly exacerbate the situation.

The final step involves listing professional support services the person can contact when they need to. Sign up below for regular emails filled with information, advice and support for you or your loved ones. Why use safety planning? Who can benefit from safety planning? Download Beyond Now. My warning signs One of the most effective ways of averting a suicidal crisis is to address difficulties before they fully emerge.

Questions to ask might include: How will you know when your safety plan should be used? What are some of the difficult thoughts, feelings or behaviours that you experience leading up to a crisis? Warning signs might include: Moods such as sadness, anxiety or irritability.

Thoughts involving hopelessness, helplessness, or self-criticism. Behaviours such as drinking more alcohol than usual, avoiding social situations, or arguing more often with friends or loved ones. My reasons to live Experiencing suicidal ideation is often mentally consuming, and it can be hard to see the positive things in life that bring joy and meaning. What things in your future do you look forward to? Reasons to live might include: family, friends or pets spiritual or religious beliefs everyday pleasures such as walking on the beach or enjoying nature life experiences such as having children or travelling.

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Questions to ask might include: Are there any specific situations or people that you find stressful or triggering, or that contribute to your suicidal thoughts? We brought Pete in to discuss a specific aspect of the paper — do any of the 5 suicide risk assessment measures predict future suicide attempts?

And, drum roll please, the answer is no, not really.

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The real gem and take away of this podcast, however, each measure is a great tool to help the patient and clinician focus in on how the patient is doing week to week and are treatment goals being met. Player FM is scanning the web for high-quality podcasts for you to enjoy right now.

Information to help health professionals support people at risk of suicide

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So, clinicians keep doing your good work and seeing the possibilities in preventing suicide. Welcome to Player FM! Take it with you. Guides you to smart, interesting podcasts based on category, channel, or even specific topics. Looking for a high-quality podcasts app on Android?

Player FM might just be it. Reflecting on clinical practice and making changes according to need are fundamental to continue improvement and quality care.

2015 DCoE Webinar: Therapeutic Risk Management of the Suicidal Patient

This audit acted as a benchmark that a more consistent approach was needed in assessment, signposting and documentation. The focus of the intervention is the questions that the OHP asks and the nature of the intervention is how the client is advised.

Featured Tool

The suicide risk assessment tool, based on a community suicide risk tool, is short and simple. It aims to identify suicide intent and psychosis; people experiencing psychosis are at high risk of suicide Power and McGowan, The previous mental health history of a client may not be known; often this is because they have not divulged this information because of fear of stigma.

Mental ill health is entrenched in stigma, and this is possibly the greatest obstacle that affects individuals in seeking help or reaching personal goals Grove, Therefore, while asking questions about suicide is often seen as difficult and perhaps even uncomfortable, it is usually a huge relief to the client to share their inner thoughts, of which many are feeling shameful.

McAuliffe and Perry found that blunt questioning regarding suicide could minimise symptoms being reported, so caring questioning should be promoted.


The SAT should be considered as a tool to guide good communication in difficult emotive circumstances, and while it is reactive in terms of mental ill health, it is proactive in suicide prevention. Documentation always needs to be clear, concise, accurate and timely. Record keeping is often the subject of professional disciplinary hearings and is an essential element to good nursing practice in all nursing disciplines.

This assists the OHP in judging and managing the identified risk. The initial risk assessment can be used as a benchmark for future assessments, which also promotes consistency and continuity of care. After a six-month period, an OHP evaluation of the tool was conducted by questionnaire. All 10 OHPs have diverse nursing experience in both acute care and community care services. Seven have an OH qualification and three have general nurse qualifications. The questionnaire asked if the OHP had found the SAT useful in practice and if it had increased their awareness of clients who presented with depression and a suicide risk.

It also asked if the OHP felt the tool had improved the way they signposted clients and if they felt more confident in their assessment of clients presenting with suicidal ideation. Finally, they had to consider if they had improved their documentation regarding the risk assessment of clients since using the SAT.

In box 1 , each of the five charts reflects the question that the OHPs were asked and demonstrates their opinion of the tool in their own practice.

Preventing suicide with a new risk assessment tool

However, the majority of OHPs found the tool to be effective and beneficial in practice. This is a key point as often the OHPs are working autonomously in clinics in a variety of situations where they need to make good clinical decisions in a timely manner.

Giving advice and signposting are a main function of the OHP role. Practitioners were asked if the tool had improved the way they had signposted their clients presenting with suicide risk. It was commented on that the inclusion of management guidance in the tool had been the main reason for this, together with improved client assessment because of specific questioning.

Other comments were that the tool encouraged partnership working with primary healthcare teams. From the positive results, the OHPs in this unit have seen that through working with other health professionals, for various reasons, joint working is endorsed as essential to employee health and wellbeing.

Suicide Risk Management: A Manual for Health Professional

The tool encouraged partnership working with primary healthcare teams. The final chart in box 1 asked practitioners directly if their documentation had improved because of using the tool. The reasons given were that the form was quick and easy to use, whereas documenting in the clinical notes often takes longer, and because of the nature of assessment sometimes gaps in information can occur.

Being able to prevent all suicides is unrealistic, but clients need to be signposted and advised appropriately to get the best care. Early intervention services studies have shown that suicide rates could be significantly reduced McGorry et al, ; Power and Robinson, ; Power, Training in suicide risk assessment has been highlighted as an area that requires attention Gask et al, While OHPs and nurses in primary care roles may not be mental health specialists, they play an important role in ensuring clients get the best possible care to achieve the best outcomes.