Suicide Risk Screening

What is a suicide risk screening?

Every year nearly 800,000 people around the world take their own lives. Many more attempt suicide. In the United States, it’s the 10th leading cause of death overall, and the second leading cause of death in people aged 10-34. Suicide has a lasting impact on those left behind and on the community at large.

Although suicide is a major health problem, it can often be prevented. A suicide risk screening can help find out how likely it is that someone will try to take their own life. During most screenings, a provider will ask some questions about behavior and feelings. There are specific questions and guidelines that providers can use. These are known as suicide risk assessment tools. If you or a loved one is found to be at risk for suicide, you can get medical, psychological, and emotional support that may help avoid a tragic outcome.

Other names: suicide risk assessment

What is it used for?

A suicide risk screening is used to find out if someone is at risk for trying to take their own life.

Why do I need a suicide risk screening?

You or a loved one may need a suicide risk screening if you notice any of the following warning signs:

Feeling hopeless and/or trapped
Talking about being a burden to others
Increased use of alcohol or drugs
Having extreme mood swings
Withdrawing from social situations or wanting to be alone
A change in eating and/or sleeping habits

You may also need a screening if you have certain risk factors. You may be more likely to try to harm yourself if you have:

Tried to kill yourself before
Depression or other mood disorder
A history of suicide in your family
A history of trauma or abuse
A chronic illness and/or chronic pain

A suicide risk screening can be very helpful for people with these warning signs and risk factors. Other warning signs may need to be addressed immediately. These include:

Talking about suicide or wanting to die
Searching online for ways to kill yourself, getting a gun, or stockpiling medicines such as sleeping pills or pain medicines
Talking about having no reason to live

If you or a loved one has any of these warning signs, seek help right away.

What happens during a suicide risk screening?

Screening may be done by your primary care provider or a mental health provider. A mental health provider is a health care professional who specializes in diagnosing and treating mental health problems.

Your primary care provider may give you a physical exam and ask you about your use of drugs and alcohol, changes in eating and sleeping habits, and mood swings. These could have many different causes. He or she may ask you about any prescription drugs you are taking. In some cases, antidepressants can increase suicidal thoughts, especially in children, teenagers, and young adults (under the age of 25). You may also get a blood test or other tests to see if a physical disorder is causing your suicidal symptoms.

During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Your primary care provider or a mental health provider may also use one or more suicide risk assessment tools. A suicide risk assessment tool is type of questionnaire or guideline for providers. These tools help providers evaluate your behavior, feelings, and suicidal thoughts. The most commonly used assessment tools include:

Patient Health Questionnaire-9 (PHQ9). This tool is made up of nine questions about suicidal thoughts and behaviors.
Ask Suicide-Screening Questions. This includes four questions and is geared toward people aged 10-24.
SAFE-T. This is a test that focuses on five areas of suicide risk, as well as suggested treatment options.
The Columbia-Suicide Severity Rating Scale (C-SSRS). This is a suicide risk assessment scale that measures four different areas of suicide risk.

Will I need to do anything to prepare for a suicide risk screening?

You don’t need any special preparations for this screening.

Are there any risks to screening?

There is no risk to having a physical exam or a questionnaire. There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If the results of your physical exam or blood test show a physical disorder or a problem with a medicine, your provider may provide treatment and change or adjust your medicines as necessary.

The results of a suicide risk assessment tool or suicide risk assessment scale can show how likely it is you will attempt suicide. Your treatment will depend on your risk level. If you are at very high risk, you may be admitted to a hospital. If your risk is more moderate, your provider may recommend one or more of the following:

Psychological counselling from a mental health professional
Medicines, such as antidepressants. But younger people on antidepressants should be closely monitored. The medicines sometimes increase suicide risk in children and young adults.
Treatment for addiction to alcohol or drugs

Is there anything else I need to know about a suicide risk screening?

If you feel you are at risk for taking your own life seek help right away. There are many ways to get help. You can:

Call your health care or mental health provider
Reach out to a loved one or close friend

If you are worried that a loved one is at risk for suicide, don’t leave them alone. You should also:

Encourage them to seek help. Assist them in finding help if needed.
Let them know you care. Listen without judgement, and provide encouragement and support.
Restrict access to weapons, pills, and other items that could cause harm.

References

American Psychiatric Association [Internet]. Washington D.C.: American Psychiatric Association; c2019. Suicide Prevention; [cited 2019 Nov 6]; [about 3 screens]. Available from: https://www.psychiatry.org/patients-families/suicide-prevention
Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Mental health providers: Tips on finding one; 2017 May 16 [cited 2019 Nov 6]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/mental-health-providers/art-20045530
Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Suicide and suicidal thoughts: Diagnosis and treatment; 2018 Oct 18 [cited 2019 Nov 6]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/suicide/diagnosis-treatment/drc-20378054
Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Suicide and suicidal thoughts: Symptoms and causes; 2018 Oct 18 [cited 2019 Nov 6]; [about 4 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/suicide/symptoms-causes/syc-20378048
National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2019 Nov 6]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
National Institute of Mental Health [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Ask Suicide-Screening Questions (ASQ) Toolkit; [cited 2019 Nov 6]; [about 3 screens]. Available from: https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials/index.shtml
National Institute of Mental Health [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Suicide in America: Frequently Asked Questions; [cited 2019 Nov 6]; [about 3 screens]. Available from: https://www.nimh.nih.gov/health/publications/suicide-faq/index.shtml
National Institute of Mental Health [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Suicide Risk Screening Tool; [cited 2019 Nov 6]; [about 4 screens]. Available from: https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials/asq-tool/screening-tool_155867.pdf
Substance Abuse and Mental Health Services Administration [Internet]. Rockville (MD): U.S. Department of Health and Human Services; SAFE-T: Suicide Assessment Five-step Evaluation and Triage; [cited 2019 Nov 6]; [about 4 screens]. Available from: https://store.samhsa.gov/system/files/sma09-4432.pdf
UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida; c2019. Suicide and suicidal behavior: Overview; [updated 2019 Nov 6; cited 2019 Nov 6]; [about 2 screens]. Available from: https://ufhealth.org/suicide-and-suicidal-behavior
Uniformed Services University: Center for Deployment Psychology [Internet]. Bethesda (MD): Henry M. Jackson Foundation for the Advancement of Military Medicine; c2019. Columbia Suicide Severity Rating Scale (C-SSRS); [cited 2019 Nov 6]; [about 4 screens]. Available from: https://deploymentpsych.org/system/files/member_resource/C-SSRS%20Factsheet.pdf
UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Psychiatry and Psychology: Suicide Prevention and Resources; [updated 2018 Jun 8; cited 2019 Nov 6]; [about 5 screens]. Available from: https://www.uwhealth.org/mental-health/suicide-prevention-and-resources/50837
World Health Organization [Internet]. Geneva (SUI): World Health Organization; c2019. Suicide; 2019 Sep 2 [cited 2019 Nov 6]; [about 5 screens]. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide
Zero Suicide in Health and Behavioral Health Care [Internet]. Education Development Center; c2015–2019. Screening for and Assessing Suicide Risk; [cited 2019 Nov 6]; [about 2 screens]. Available from: https://zerosuicide.sprc.org/toolkit/identify/screening-and-assessing-suicide-risk