Suicidal Assessment (Sad Persons)

SUICIDAL
ASSESSMENT
(sad persons)
SUICIDE
IS KILLING ONESELF.
The act constitutes a person
willingly, perhaps
ambivalently, taking his or her
own life.
SUICIDE ASSESSMENT
S: SEX Men are more likely to commit suicide than women.
A: AGE The ages which are most dangerous for suicide vary over time. You
should consult current statistics. As this is being written in 2006
individuals 15-24 have an elevated risk. Suicide is the third leading
cause of death in this age group.
Males over age 75 are also known to be at high risk. Current

demographics suggest that women in the 45 to 54 age group are
highest, but females in older or younger age ranges are not that
different. After age 65 individuals as a whole have an attempt
tovcompleted suicide rate of about 2:1. Up to age 65, it is about a 7:1
ratio.
SUICIDE ASSESSMENT
D: Depression. The suicide rate for those who are clinically depressed is about 20
times greater than for the general population. Hopelessness is one
aspect of depression that has a close tie to suicide. These two issues,
depression and hopelessness, are the strongest predictors of wishes
for a hastened death.
P: Prior History. Roughly 80% of completed suicides were preceded by a prior

attempt.
E: Ethanol abuse. Alcohol and/or drug abuse increase risk.
R: Rational Psychosis (‘I heard a voice saying I should kill myself’) increases risk.
thinking loss. Some estimates suggest that 20-40% of schizophrenics make an
attempt at some point, and the risk is highest early on in the illness.
SUICIDE ASSESSMENT
S: Support System Loss of support can vary tremendously. With kids and
Loss. adolescents it can be the break up of their first ‘puppy love’ which
they can take very seriously even though others like parents may
view it as a trivial event.
Other lost relationships for adolescents can include parents

divorcing and remarrying someone else. Even a parent who is
divorced or separated and living with a new person can be a trigger
for adolescent suicide. The death of a relative, such as grandparents,
can be another trigger for kids.
Loss of a spouse can be devastating to some. Loss of a parent

within the past 35 years increases risk of suicide. Among older
individuals, men who are widowed, and women who are divorced or
separated are at increased risk
O: Organized This speaks for itself. Having a method in mind creates more risk.
Plan.
SUICIDE ASSESSMENT
N: No Significant See ‘S’ above.
Other.
S: Sickness. Terminal illness, such as cancer and AIDS, also carries with it a 20 fold
increase in risk of suicide compared to the general population.
SUICIDE ASSESSMENT
SCORING SYSTEM
1 point for each positive answer on the table.
SCORE RISK
0–2 No real problems, keep watch
3–4 Send home, but check frequently
Consider hospitalization involuntary or voluntary, depending

5–6 on your level of assurance patient with return for another
session
7 – 10 definitely hospitalize involuntarily or voluntarily

SUICIDE ASSESSMENT
SAD PERSONS: a mnemonic for assessing suicide risk
S ex (male)
A ge (elderly or adolescent)
D epression
P revious suicide attempts
E thanol abuse
R ational thinking loss (psychosis)
S ocial supports lacking
O rganized plan to commit suicide
N o spouse (divorced > widowed > single)
S ickness (physical illness)
SUICIDE ASSESSMENT
SIGNS OF DEPRESSION
Sleep, energy, weight, or appetite changes

Decreased interest in sex and other pleasurable
activities
Feelings of helplessness and hopelessness
Social isolation and withdrawal from others
SUICIDE ASSESSMENT
SUICIDE RISK FACTORS
In addition to untreated depression, other suicide risk factors

include:
mood disorder
chronic anxiety
previous suicide attempts
genetics – family history of suicide or psychiatric
conditions
conduct disorder
child abuse
sexual assault
SUICIDE ASSESSMENT
stressful events, including relationship breakups, family problems, etc.
drug and alcohol abuse
eating disorders
being bullied
dropping out of school
taking certain medications, including ANTIDEPRESSANTS, STRATTERA
(atomoxetine), a medication for ADHD, and ACCUTANE (isotretinoin),
which is used to treat teens with severe nodulocystic acne, and
ANTISEIZURE DRUGS, such as Tegretol (carbamazepine), Depakoke
(valproate), and Lamictal (lamotrigine)
Suicide is also more common in bisexual and homosexual teens.

SUICIDE ASSESSMENT
Suicide Warning Signs
According to the American Association of Suicidology, the warning signs

of suicide can include:
Having thoughts of committing suicide, threatening to hurt himself,

looking for a way to hurt himself, writing about dying, and other types of
suicidal ideation
Increased substance abuse, including abuse of alcohol and drugs
Feelings of purposelessness or that they have no reason to live
Anxiety symptoms
Feeling trapped, like there is no way out of current situations or problems
Feelings of hopelessness
SUICIDE ASSESSMENT
A withdrawal from friends and family and usual activities
Feeling uncontrolled anger and rage or wanting revenge against
someone
Acting reckless and impulsive
Having dramatic mood changes
If you think that your teen has any of the warning signs for suicide,
don't ignore them. Trust your instincts and either try to get more
information or seek additional help.

SUICIDE ASSESSMENT
SUICIDE PREVENTION
Recognizing the risk factors and warning signs for suicide
Seeking professional help
Making sure that GUNS and medications aren't easily available in your
home if your teen might be suicidal
Getting teens professional help if they have depression and/or anxiety,

which are often thought to be the biggest risk factors for suicide
SUICIDE ASSESSMENT
Questions to Ask
Do you have thoughts of suicide?

Are they related to current stressors going on in your life, or have you had
such thoughts before?
Do you have a plan? Tell me.
If you died in your sleep, would that be all right with you?
Ask if they have access to the components of their plan, like a gun, pills, etc…
SUICIDE ASSESSMENT
LEVEL OF RISK
None - no suicidal ideation

Mild - some ideation, no plan
Mod - ideation, vague plan, low on lethality, wouldn't do it
Severe - ideation, plan specific and lethal, wouldn't do it
Extreme - ideation, plan specific and lethal, will do it
Highest risk group has suicidal ideation (thoughts of killing self), a plan
(any plan so long as it is definite and detailed is high risk), high lethality
(guns and walking in front of busses are more serious than overdosing on
Tylenol and slashing wrists), few inhibitors (few reasons not to kill self),
low self-control (especially drinking or using drugs - can decide not to kill
self but fail to act to reverse events and accidentally kill themselves)
SUICIDE ASSESSMENT
SUICIDAL ASSESSMENT
FIRST, remember to do three things:
1. CONSULT
2. DOCUMENT
3. EVALUATE THE CLIENT’S RISK
 Empathize with the client
 Make a No-Suicide Contract
 Family Intervention
 Hospitalization
SUICIDE is never the
solution. Eternal life
comes after physical
death. where would u
go?

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SUICIDAL

Males over age 75 are also known to be at high risk. Current

P: Prior History. Roughly 80% of completed suicides were preceded by a prior

E: Ethanol abuse. Alcohol and/or drug abuse increase risk.

Other lost relationships for adolescents can include parents

Loss of a spouse can be devastating to some. Loss of a parent

0–2 No real problems, keep watch

3–4 Send home, but check frequently

Consider hospitalization involuntary or voluntary, depending

7 – 10 definitely hospitalize involuntarily or voluntarily

Sleep, energy, weight, or appetite changes

In addition to untreated depression, other suicide risk factors

Suicide is also more common in bisexual and homosexual teens.

According to the American Association of Suicidology, the warning signs

Having thoughts of committing suicide, threatening to hurt himself,

Feeling uncontrolled anger and rage or wanting revenge against

Acting reckless and impulsive

Having dramatic mood changes

information or seek additional help.

Recognizing the risk factors and warning signs for suicide

Seeking professional help

Getting teens professional help if they have depression and/or anxiety,

Do you have thoughts of suicide?

None - no suicidal ideation

FIRST, remember to do three things:

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