Formulating suicide risk

You are here:

Suicide risk assessment and formulation is best determined through clinical judgment. The following materials have been adapted from the Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) pocket card for clinicians and the Suicide Prevention Toolkit for Rural Primary Care Practices. They serve only as a guide to assessing suicide risk and interventions.

Risk level	Risk/protective factors	Suicidality	Possible interventions
High	Psychiatric disorders with severe symptoms, or acute precipitating event	Potentially lethal suicide attempt or persistent ideation with strong intent or rehearsal	Admission generally indicated unless a significant change reduces risk. take suicide precautions.
Moderate	Multiple risk factors, few protective factors	Suicidal ideation with plan, but no intent or behaviour	Admission may be necessary depending on risk factors. Develop crisis plan. Give emergency/crisis numbers.
Low	Modifiable risk factors, strong protective factors	Thoughts of death, no plan, intent or behaviour	Outpatient referral, symptom reduction. Give emergency/crisis numbers.

Assessment and interventions with people at risk of suicide

(To expand the visual guide, click on the image.)

Substance Abuse and Mental Health Services Administration. (2009). Suicide Assessment Five-Step Evaluation and Triage (SAFE-T): Pocket Card for Clinicians. Rockville, MD: Author.

Western Interstate Commission for Higher Education & Suicide Prevention and Resource Center. (2011). Suicide Prevention Toolkit for Rural Primary Care Practices. Boulder, CO: Western Interstate Commission for Higher Education.

In the Suicide Risk Assessment Toolkit