Suicide Risk Assessment

Suicide risk assessment and management is a core psychiatric competency that is important for both the proper treatment of patients and for medicolegal reasons. The standard of care for suicide risk assessment and management has progressed a great deal in recent years and points toward an approach that is patient-centered and that affirms the therapeutic relationship. Principally, a therapeutic suicide risk assessment should inform treatment. Key components of a clinical risk assessment include conducting and documenting a psychiatric assessment, augmenting the psychiatric assessment with structured instruments, stratifying risk in terms of severity and temporality and engaging in safety planning. To mitigate risk, individualized safety plans that are created in collaboration between clinician and patient should address access to lethal means and should outline a series of steps that the patient can engage in to manage a suicidal crisis.