Year: 2023 Source: Crisis. (2016). 37(4), 251–255. DOI: 10.1027/0227-5910/a000440 SIEC No: 20231533
The low base rate of suicide makes it particularly difficult to accurately predict suicide risk, and thus to identify suicidal individuals. Improvement in the sensitivity of suicide risk tools has only led to increased rates of false positives, while increased specificity of suicide risk tools has led to increased rates of false negatives, whereby individuals who are at risk have not been detected as such. An obvious challenge in gaining reliable data on a person’s suicidal status is the fluctuating nature of suicidality. If we cannot reliably predict suicide in those presenting in vulnerable suicidal states, why should we spend time, resources, and energy in trying to do so? These and similar questions have become increasingly frequent among mental health professionals and researchers. While the use of suicide prediction scales remains unsatisfactory, there is growing support for a renewed risk assessment approach that is collaborative, client-centered, and needs-based for uncovering the suicidal status of a person. Some suicidologists of the Australian Institute for Suicide Research and Prevention at Griffith University, Queensland, have compiled a protocol for screening potential suicidal persons, named the “Screening Tool for Assessing Risk of Suicide” (STARS). Rather than a quantitative instrument, STARS privileges a qualitative dimension aimed at gaining data based on the client’s narrative around current suicidal state, to inform needs-based commensurate care responses. STARS provides an opportunity for collaboratively and compassionately engaging a client in discussion about some of the most hidden or least communicated experiences of his/her life. It offers the clinician a timely opportunity to access information on a range of risk, protective, and circumstantial elements known to potentially contribute to suicidality, to delicately explore important personal areas that may require further support and intervention. With the use of STARS, it is hoped that clinician anxiety may be reduced, while more reliable and meaningful documentation and effective client care may increase.