Suicide Risks Rates and Assessments

Suicide and Risk Assessments

Overview

The topic of this paper is suicide and risk assessments. As Castaneda (2018) points out, suicide has become something of an epidemic in the US, where in 2016 alone 45,000 people committed suicide. Furthermore, from1999 to 2016, suicide rates rose in almost every US state (Castaneda, 2018). Even highly successful people like Kate Spade and Anthony Bourdain can be susceptible to suicide, which is why it is so important to be able to identify indicators of when someone is at risk. Suicide is clearly a major public health concern, and risk assessments are a key part of suicide prevention. Risk assessments help identify individuals who may be at risk for suicide and provide information about the signs and symptoms of suicide. They also help to determine the level of risk and the best course of treatment. While risk assessments are not perfect, they are an important tool in suicide prevention. By identifying those at risk, interventions can be put in place to help reduce the chances of suicide. This paper provides a literature review of sources related to this topic, summarizes the findings and methods of the sources, examines common themes, and discusses best practices that organizations might like to consider regarding suicide risk assessment going forward.

Literature Review

The article by Zalsman et al. (2016) provides a ten year systematic review of suicide prevention strategies. By looking at articles in the PubMed and Cochrane libraries, published between 2005 and 2014, the authors wanted to identify and assess seven suicide prevention strategies and what the research had to say about them. The seven strategies included: public and physician education, media strategies, screening, restricting access to suicide means, treatments, and internet or hotline support.  What they found after reviewing the literature was that no single strategy worked better than others but that combinations of evidence-based strategies can help at both the individual and population levels. They did conclude, however, that more research is needed in understanding how these strategies can best be applied.

The article by Nock et al. (2008) focused on examining government data on suicide and suicidal behavior and conducting a systematic review of studies on the causes of suicide published from 1997 to 2007. The researchers wanted to know more about how widely spread suicide was, what kind of risk and protective factors other researchers had identified, and what the trends in statistics on the problem showed. They found that successful suicides tend to be men and that unsuccessful suicides tend to be women and people who are young, unmarried or have psychiatric problems. They also found that in spite of new interventions, rates have not changed much. They conclude that more research is needed on clinical assessments so as to help bring suicide rates down more effectively.

The article by Chan et al. (2016) focused on the authors’ attempt to examine through systematic review the literature on suicide and self-harm relationships. Their goal was to see if they could find predictors to help show when people who engaged in self-harm might also be at risk of suicide. The researchers found that there are no scales sufficient for assessing suicide risk and that risk factors are common among populations. They concluded that using risk scales like the Beck Hopelessness Scale or the Suicide Intent Scale can do more harm than good because they are not proficient at indicating actual risk. Instead, the authors recommend that professionals use more comprehensive psychosocial assessments that look at each individual and are more helpful in identifying the particular needs and risks of that individual. In this way, professionals can be of more service to individuals who have engaged in self-harm and who might be in need of suicide prevention help.

Harris et al. (2019) wanted to show whether one could effectively use risk scales to predict future episodes of suicide or self-harm in adolescents and young adults who had presented themselves at a clinic for self-harm or suicide ideation. They searched online databases such as Medline and CINAHL and found that there is no indication of any scale working better than another to effectively predict future behavior. Like the study by Chan et al. (2016) they concluded that individuals have to be examined on a case by case basis after undergoing thorough psychosocial assessment.

The article by Castaneda (2018) explains that suicide is a common problem in America and that it can affect everyone, even those who appear to be highly successful and happy on the outside. The reality is that everyone has an interior life and that people can struggle with issues like depression and despair without ever really showing this struggle to the public. It is important therefore to be able to tell if there are signs or warnings that such individuals give off and if so what can be done to help these people. The article focuses on two people in particular, Kate Spade and Anthony Bourdain, who committed suicide seemingly out of the blue. The author concludes that warning sides can be seen looking back but that people need to be more careful and cautious about how they treat this subject.

Common Themes

The common themes among the articles are that there is a clear need for more understanding about how best to apply suicide prevention strategies and how to assess suicide risk at both individual and population levels. Most research shows that men tend to be more successful at suicide than others and that suicide rates have not changed much at all over the past years in spite of interventions, prevention strategies and use of risk assessments. This suggests that suicide ideation is something that builds up inside and that is not going to send off strong signals. The research suggests, too, that psychosocial assessments that are comprehensive need to be done to better understand individual needs and risks.

Future directions I would take in this research is to see if suicide rates can be reduced by taking a proactive preventive approach to education the way preventive health practitioners do when they increase peoples’ health literacy. Preventive strategies in this case could be to apply humanities teachings as part of an educative program to help give people a better or stronger foundation for and appreciation of life, no matter what the challenges and perspectives. That is one idea that I would like to see explored in more research, the question being: is there any connection or relationship between humanities-based education and suicide rates over time?

Best Practices

Best practices for suicide risk assessment and prevention are constantly evolving, but there are some general principles that remain constant. First, it is important to have a non-judgmental attitude and create a safe space for the individual to talk about their thoughts and feelings. Second, it is important to ask direct questions about suicidal ideation, as indirect questions can lead to misunderstandings. Third, it is important to assess the individual’s risk factors and protective factors for suicide. Every individual is unique and popular risk assessments are insufficient for doing the job: a strong, comprehensive psychosocial assessment is needed to identify the person’s needs and risks. Finally, it is important to develop a safety plan with the individual that includes coping strategies and emergency contacts. By following these best practices, individuals who are at risk for suicide can be more effectively assessed and supported. Recommendations for best practices include approaching the issue of suicide with caution and care, so that every individual is able to present as an individual rather than as a statistic. It is essential to helping prevent suicide to see individuals as real people with real concerns and issues that are unique to them. There is no one strategy that works better than others, but with careful combinations of strategies like hotlines, like the National Suicide Prevention Lifeline, education and screening, lives may be helped and saved.