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.)
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.
In the Suicide Risk Assessment Toolkit
- The Suicide Risk Assessment and Management Toolkit
- Attitudes and approach
- Understanding suicide
- Collecting accurate assessment information
- Formulating suicide risk
- Developing a treatment and services plan
- Managing care for suicide-related behaviour
- Understanding legal and regulatory issues around suicide
- Tools for assessing suicide risk and managing suicide-related behaviour