Suicide risk monitoring: The missing piece in suicide risk assessment.

Suicide is the second leading cause of death among youth aged 10–25 years and approximately 1-in-6 adolescents reported serious suicidal ideation in the past year. Schools are a unique environment in which to identify and respond to youth suicide risk. Although there are screening tools for identifying which youth are at risk and assessment measures for establishing the severity of suicide risk, an essential aspect of risk management is excluded: monitoring youth suicide risk. It is likely that this gap exists because most of the development and research on screening and assessment is in settings such as outpatient mental health clinics or hospitals where routine monitoring is difficult. The Suicide Risk Monitoring Tool (SMT) was developed so that school mental health professionals could quickly track changes in youth already identified at-risk for suicide, including youth who are assessed but remain in school, or those who are re-entering school after a hospitalization. The SMT includes factors known to correlate with youth suicide risk. This paper will review the research on suicide screening and risk assessment, identify and describe the empirical and theoretical basis for the SMT, relate monitoring to the comprehensive risk assessment within a school’s overall framework for suicide risk assessment procedures, and provide a detailed case study that demonstrates how the SMT can be used with students in a school setting. Implications for research and practice are included.