For all patients with suicidal ideation, enquiry should be made regarding preparatory actions (eg obtaining a weapon, making a plan, putting affairs in order) Don’t leave the person alone if the risk of suicide is high. Remove any potential weapons or substances they have access to.

Suicide risk assessments setting have poor predictive value in identifying those at risk actually of completing suicide

• 95% of “high risk” patients will not die by suicide
• 50% of suicides are from “low risk” patients
• 50% of individuals who complete suicide have no prior history of suicide attempts
• There has been no improvement of accuracy of predicting suicides in the past 40 years

Risk factors

SAD PERSONS

bold = high risk features

• Sex (male)
• Age (risk increases with age)
• Depression
• Previous attempt (best indicator of risk)
• Excessive alcohol/drug use
• Rational thinking loss (impulsive)
• single, divorced, widowed
• Organised plan/serious attempt
• No social support