Assessment of suicide risk in mental health practice: shifting from prediction to therapeutic assessment, formulation, and risk management

Suicide prevention in psychiatric practice has been dominated by efforts to predict risk of suicide in individual patients. However, traditional risk prediction measures have been shown repeatedly in studies from high income countries to be ineffective. Several factors might contribute to clinicians’ preoccupation with risk prediction, which can have negative effects on patient care and […]

Suicide risk profiles and barriers to professional help-seeking among college students with elevated risk for suicide

Suicide is the second leading cause of death among college students, yet many students with elevated suicide risk do not seek professional help. This study identified suicide risk profiles among college students and examined these in relation to students’ perceived barriers to professional help-seeking. Data were obtained from college students (n = 1689) identified to be at […]

Suicide behavior results from the U.S. Army’s suicide prevention leadership tool study: The behavioral health readiness and suicide risk reduction review (R4)

Introduction The U.S. Army developed a new tool called the Behavioral Health Readiness and Suicide Risk Reduction Review (R4) for suicide prevention. A 12-month evaluation study with the primary objective of testing the hypothesis (H1) that Army units receiving R4 would demonstrate improved outcomes in suicidal-behavior measures following the intervention, relative to control, was then […]

Evaluating a recovery-oriented intensive outpatient program for veterans at risk for suicide

Background: Suicide is the 10th leading cause of death in the United States and suicide risk is elevated among military veterans. Risk for suicide is inherently transdiagnostic, complex, and multifaceted, which means a comprehensive psychotherapeutic approach to risk mitigation is required. Aims: Our aims were to summarize findings from an evaluation of an interdisciplinary, recovery-oriented intensive outpatient program […]

Real-world feasibility and acceptability of real-time suicide risk monitoring via smartphones: A 6-month follow-up cohort

Active and passive Ecological Momentary Assessment of suicide risk is crucial for suicide prevention. We aimed to assess the feasibility and acceptability of active and passive smartphone-based EMA in real-world conditions in patients at high risk for suicide. We followed 393 patients at high risk for suicide for six months using two mobile health applications: the MEmind […]

Safety planning: Why it is essential on the day of discharge from in-patient psychiatric hospitalization in reducing future risks of suicide

Individuals who suffer from mental illness are at an increased risk for suicide. That risk is substantially higher in the post-discharge period from psychiatric hospitalization. Safety planning intervention (SPI) is a common intervention tool that is utilized to mitigate the risk of suicide. Current research notes promising results of SPI use in the emergency department […]

Procedures for risk management and a review of crisis referrals from the MindSpot Clinic, a national service for the remote assessment and treatment of anxiety and depression

Background: The MindSpot Clinic (MindSpot) provides remote screening assessments and therapist-guided treatment for anxiety and depression to adult Australians. Most patients are self-referred. The purpose of this study was to report on the procedures followed to maintain the safety of patients and to examine the circumstances of urgent referrals to local services made by this remote […]

Alliance-focused safety planning and suicide risk management

Patients’ interpersonal vulnerabilities and problems represent major distal and proximal risk factors in the etiology of suicide. These can be triggered by the interpersonal demands of therapy and safety planning and impede the development of a strong therapeutic alliance, and thus, the effectiveness of safety planning. This article proposes that the principles put forth by […]

The European Human Rights system and the right to life seen through suicide prevention in places of detention: Between risk management and punishment

This paper analyses the shortcomings of European suicide prevention policy in places of detention, a topic that has been neglected in the European legal literature. Four interrelated characteristics of the suicide prevention policies developed by the European Court of Human Rights (ECtHR) are responsible for the failures of these policies. First, the risk-based approach relies […]

Building resilience, reducing risk: Four pillars to creating safer, more supportive schools for LGBTQ+ youth

In 2017 Delaware, LGBTQ+ Youth reported that almost 1 out of 3 were bullied on school grounds. Additionally, over 50% reported feeling sad/hopeless; and almost as many seriously considered suicide as an option, while 32% planned for suicide with almost 1 in 4 reporting having acted on their suicide plan at least once. Of all […]

Social service directors’ roles and self-efficacy in suicide risk management in US nursing homes

Nursing home (NH) residents have many risk factors for suicide in later life and transitions into and out of NHs are periods of increased suicide risk. The purpose of this study was to describe NH social service directors (SSDs) roles in managing suicide risk and to identify factors that influence self-efficacy in this area. This […]

Development of the U.S. Army’s suicide prevention leadership tool: The Behavioral Health Readiness and Suicide Risk Reduction Review (R4)

Introduction Although numerous efforts have aimed to reduce suicides in the U.S. Army, completion rates have remained elevated. Army leaders play an important role in supporting soldiers at risk of suicide, but existing suicide-prevention tools tailored to leaders are limited and not empirically validated. The purpose of this article is to describe the process used […]

Welfare checks for suicide risk management: Risks and benefits

In clinical practice, welfare checks have become a fairly common aspect of suicide prevention. At the same time, there is almost no guidance in the medical literature to inform clinicians under what circumstances welfare checks should be requested, how best to go about placing those requests, or how to document decision-making around this important subject. […]

Implementation of a community-partnered research suicide-risk management protocol: Case study from community partners in care

Objective: Suicidality is common among participants in clinical trials and health services research, but approaches to suicide risk assessment and mitigation vary widely. Studies involving vulnerable populations with limited access to care raise additional ethical concerns. The authors applied a community-partnered approach to develop and implement a suicide-risk management protocol (SRMP) in a depression study […]

Suicide attempts and suicidal ideation in patients with obsessive-compulsive disorder: A systematic review and meta-analysis

Introduction: There is controversy on the magnitude of suicide risk in OCD and on the psychopathological features that raise the risk. This systematic review and meta-analysis aims to estimate the pooled prevalence of suicide attempts and suicidal ideation (current/lifetime) in subjects with OCD and identify sociodemographic and clinical factors associated with greater risk. Methods: We conducted a […]

The benefits and risks of asking research participants about suicide: A meta-analysis of the impact of exposure to suicide-related content

One obstacle potentially hindering research on suicide is the assumption that assessing suicide may make individuals more likely to engage in suicidal thoughts or behaviours; a concern expressed by ethics committees, researchers, and clinicians. However, decisions which are overly cautious and restrictive when approving research proposals will hinder important research in this area. The present […]

Suicide, self-harm, & traumatic stress exposure: A trauma-informed approach to the evaluation and management of suicide risk

Suicide and self-harm are major public health problems. Individuals who die by or attempt suicide and those who self-harm have elevated rates of traumatic stress exposure, underscoring the importance of a trauma-informed approach to suicide prevention. Rooted in the evidence on care for traumatic stress and suicide prevention, and our collective experience as clinicians and […]

Methodology of the U.S. Army’s Suicide Prevention Leadership Tool Study: The Behavioral Health Readiness and Suicide Risk Reduction Review (R4)

Introduction The Secretary of the U.S. Army issued two directives in late 2017 to directly combat the problem of suicide in the U.S. Army. The first was to develop an Army tool to assist commanders and first-line leaders in preventing suicide and improving behavioral health (BH) outcomes, which has been previously published as the BH […]

To treat or not to treat: The effect of hypothetical patients’ suicidal severity on therapists’ willingness to treat

Therapists’ intense negative emotional responses regarding suicidal patients raise questions about therapists’ willingness to treat them; however, this issue has yet to be investigated. The aim of the current study is to examine to what extent the severity of suicidality of a hypothetical patient will influence therapists’ willingness to treat and the likelihood of their […]

Is COVID-19 pandemic creating a perfect storm for suicide in vulnerable population? Possible ways for patients to cope and measures to mitigate risk

The COVID 19 pandemic has taken the world by storm and is on an unabated path of destruction. Its manifestations are farfetched. From disruption of normalcy to an economic slowdown, it has impacted people from all walks of life. There is increasing evidence regarding a spike in depression and anxiety in the general public due […]

Implementation determinants and outcomes of a technology-enabled service targeting suicide risk in high schools: Mixed methods study

Background: Technology-enabled services (TESs), which integrate human service and digital components, are popular strategies to increase the reach and impact of mental health interventions, but large-scale implementation of TESs has lagged behind their potential. Objective: This study applied a mixed qualitative and quantitative approach to gather input from multiple key user groups (students and educators) and […]

The utility of artificial intelligence for mood analysis, depression detection, and suicide risk management

Mood disorders are often an indication or a sign of depression, and individuals suffering from mood swings may face higher probability and increased suicidal tendencies. Depression—also called “clinical depression” or a “depressive disorder”—is a mood disorder that adversely impacts how an individual feels, thinks, and handles daily activities, such as sleeping, eating, or working. To […]

Evaluation of official procedures for suicide prevention in hospital from a forensic psychiatric and a risk management perspective.

ABSTRACT Background: Suicide is a severe public health problem, in 2008 the Italian ministerial recommendation n 4 on the management of suicide defined key areas for the identification of suicidal risk in hospital wards. The guidelines are important in defining professional liability issues, in line with Law 24 of 8/3/ 2017 ‘Gelli-Bianco’. Our study aimed […]