This page is also available as a pdf: riskAssessment.pdf
All patients with depression should be assessed for possible risk of self-harm or suicide.
Risk factors for suicide identified through research studies are:
Risk factors specific to depression
- Family history of mental disorder.
- History of previous suicide attempts (this includes self-harm).
- Severe depression.
- Feelings of hopelessness.
- Personality disorder.
- Alcohol abuse and/or drug abuse.
- Male gender.
Other risk factors for consideration
- Family history of suicide or self-harm.
- Physical illness (especially when this is recently diagnosed, chronic and/or painful).
- Exposure to suicidal behaviour of others, either directly or via the media.
- Recent discharge from psychiatric inpatient care.
- Access to potentially lethal means of self- harm/suicide.
Possible protective factors
- Social support.
- Religious belief.
- Being responsible for children (especially young children).
In assessing patients’ current suicide potential, the following questions can be explored:
- Are they feeling hopeless, or that life is not worth living?
- Have they made plans to end their life?
- Have they told anyone about it?
- Have they carried out any acts in anticipation of death (e.g. putting their affairs in order)?
- Do they have the means for a suicidal act (do they have access to pills, insecticide, firearms...)?
- Is there any available support (family, friends, carers...)?
- Where practical, and with consent, it is generally a good idea to inform and involve family members and close friends or carers. This is particularly important where risk is thought to be high.
- When a patient is at risk of suicide this information should be recorded in the patient’s notes. Where the clinician is working as part of a team it is important to share awareness of risk with other team members.
- Regular and pro-active follow-up is highly recommended.