PS12.1 | Suicide Risk Assessment — Summary & Reflection

KEY TAKEAWAYS

Suicide risk assessment is a structured, six-domain clinical skill: suicidal ideation → intent → plan → means/access → past attempts → protective factors. The governing principles include: asking does not increase risk (the evidence is unequivocal); directness and empathy are not in conflict; and the Mental Healthcare Act 2017 (Section 115) decriminalised suicide attempt in India, replacing the Mental Health Act 1987. Risk factors are organised via the SAD PERSONS framework; prior attempt is the single strongest predictor. Risk stratification (low/moderate/high) is a clinical guide — not a prediction — and guides the intensity of management: safety planning (Stanley-Brown six steps), means restriction, and escalation or admission as warranted. Documentation must be thorough and specific. The skill is teachable, learnable, and — performed well — life-saving.

REFLECT

Reflect on the following as you complete this module: Have you previously avoided asking a patient directly about suicidal thoughts — and if so, what was the internal reason (discomfort, fear of planting the idea, uncertainty about how to respond)? How does knowing that asking does not increase risk change the way you will approach future clinical encounters? Consider what it means to be the person in the room when someone discloses active suicidal intent — what emotional resources will you need, and have you identified where to access supervision and support within your training context?