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Formulating suicide risk

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.

SAFE-T risk assessment 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.)

Assessment and Interventions with Potentially Suicidal Patients

 

References

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.