Mastering Suicide Assessment: Tools for Insight and Intervention
Abstract:
Suicide
is a profound public health issue globally, prompting healthcare systems and
accreditation bodies like The Joint Commission (TJC) to emphasize the necessity
of suicide risk screening in clinical settings. Healthcare providers and
administrators tasked with implementing screening programs must choose from
several validated tools, considering factors such as ease of administration,
the age groups they are intended for, and the reliability of supporting data. This
review aims to summarize the characteristics of concise suicide risk screening
tools found in the literature. While these tools can
effectively identify potential risks, they may not comprehensively identify all
individuals at risk of suicide, highlighting the importance of complementing
screening with thorough clinical assessments by trained professionals. Therefore, while brief screening tools provide valuable initial
insights, their integration into hospital protocols should be accompanied by
awareness of their limitations and the implementation of comprehensive suicide
risk management strategies. The 9-item Patient Health Questionnaire (PHQ-9), Ask Suicide-Screening
Questions (ASQ), Suicide Behaviors Questionnaire–Revised (SBQ-R) and
Columbia-Suicide Severity Rating Scale (C-SSRS triage version) scales are the
great tools in examining the suicide risk. The Columbia-Suicide
Severity Rating Scale (C-SSRS) has become a widely utilized tool for evaluating
suicidal ideation and behavior across diverse populations, including
adolescents and adults.
References:
[1]. World
Health Organization. Depressive disorder (depression) (who.int) Updated 31
March 2023. Date of access: 11/9/2024. https://www.who.int/news-room/fact-sheets/detail/depression
[2]. World
Health Organization. Suicide (who.int) Updated 29 August 2024. Date of Access:
11/9/2024. https://www.who.int/news-room/fact-sheets/detail/suicide
[3]. Powsner
S, Goebert D, Richmond, J. S, Takeshita J. 2023, Suicide Risk Assessment,
Management, and Mitigation in the Emergency Setting. Focus.
Jan;21(1):8-17.
[4]. World
Health Organization. Suicide prevention (who.int). Date of access: 11/9/2024. https://www.who.int/health-topics/suicide#tab=tab_1
[5]. Tishler C.
L., Reiss N. S., 2009, Inpatient suicide: preventing a common sentinel event. Gen
Hosp Psychiatry; 31:103–109.
[6]. Oakbrook
Terrace, I. L, 2015, National Patient Safety Goals Effective January 1, 2015:
Hospital Accreditation Program, The Joint Commission, https://www.masimo.com/siteassets/us/documents/pdf/2015_npsg_hap.pdf.
Accessed March 24, 2024
[7]. Oakbrook
Terrace, IL, 2019, National Patient Safety Goal for Suicide Prevention. The
Joint Commission, https://www.joint-commission.org/-/media/tjc/documents/standards/r3-reports/
r3_18_suicide_prevention_hap_bhc_cah_11_4_19_final1.pdf. Accessed Aug 27, 2024
[8]. United
States Preventive Services Taskforce. Recommendation: Depression and Suicide
Risk in Adults: Screening. Date of access: 8/8/2024. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-adults
[9]. Na, P. J,
Yaramala, S. R, Kim, J. A, et al, 2018, The PHQ-9 item 9 based screening for
suicide risk: a validation study of the Patient Health Questionnaire (PHQ)29
item 9 with the Columbia Suicide Severity Rating Scale (C-SSRS). J Affect
Disord; 232:34–40.
[10]. Thom, R.,
Hogan, C. and Hazen, E., 2020. Suicide risk screening in the hospital setting:
a review of brief validated tools. Psychosomatics, 61(1), pp.1-7.
[11]. Osman,
A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A. and Barrios,
F. X., 2001. The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation
with clinical and nonclinical samples. Assessment, 8(4), pp.443-454.
[12]. Bethesda,
M. D, 2022, Patient Health Questionnaire–9. National Institute on Drug Abuse. https://nida.nih.gov/sites/default/files/Patient-HealthQuestionnaire9.pdf.
Accessed Oct 23, 2022
[13]. Horowitz,
LM, Bridge JA, Teach SJ, et al, 2012,
Ask Suicide-Screening Questions (ASQ): A Brief Instrument For The Pediatric
Emergency Department. Arch Pediatr Adolesc Med; 166:1170–1176.
[14]. Horowitz
LM, Snyder DJ, Boudreaux ED, et al., 2020, Validation of the Ask
Suicide-Screening Questions for adult medical inpatients: a brief tool for all
ages. Psychosomatics; 61:713–722.
[15]. Osman,
A., Bagge, C. L., Gutierrez, P. M., Konick, L.C., Kopper, B.A. and Barrios,
F.X., 2001. The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation with
Clinical and Nonclinical Samples. Assessment, 8(4), pp.443-454.
[16]. Linehan,
M.M. and Nielsen, S.L., 1981. Assessment of suicide ideation and parasuicide:
hopelessness and social desirability. Journal of Consulting and Clinical
Psychology, 49(5), p.773.
[17]. Meyer,
R.E., Salzman, C., Youngstrom, E.A., Clayton, P.J., Goodwin, F.K., Mann, J.J.,
Alphs, L.D., Broich, K., Goodman, W. K., Greden, J. F. and Meltzer, H. Y.,
2010. Suicidality and risk of suicide—definition, drug safety concerns, and a
necessary target for drug development: a brief report. The Journal of
Clinical Psychiatry, 71(8), p.20322.
[18]. Posner,
K., Brown, G.K., Stanley, B., Brent, D.A., Yershova, K.V., Oquendo, M.A.,
Currier, G.W., Melvin, G.A., Greenhill, L., Shen, S. and Mann, J.J., 2011. The
Columbia–Suicide Severity Rating Scale: initial validity and internal
consistency findings from three multisite studies with adolescents and adults. American
Journal of Psychiatry, 168(12), pp.1266-1277.
[19]. Goldston,
D.B., 2000. Assessment of suicidal behaviors and risk among children and
adolescents. Bethesda, MD: National Institute of Mental Health.
[20]. Brown, G.
K., 2001. A review of suicide assessment measures for intervention research
with adults and older adults. Philadelphia, PA: GK Brown.
[21]. Perlman, C., Hirdes, J., Martin, L., Neufeld, E. and Goy, M., 2011. Inventory and resource guide development for the assessment and prevention of suicide risk.
