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Assessments and Management of Patients at Risk for Suicide


Suicide is an urgent matter that affects the US population and  according to the CDC “more than 36,000 people take their lives every day”  (CDC-WISQARS 2010).  In 2010, there was an estimated 38,000 suicides in the United States and based on the National Violent Death Reporting System ” in 16 states, 33.3% of suicide decedents tested positive for alcohol, 23% for antidepressants, and 20.8% for opiates, including heroin and prescription killers (MMWR Summary 2012).


Veterans suicide has also increase from 2009 there was 36,900 suicides compared to 2010 which was 38,600 that shows an estimated 18-22 veterans die from suicide each day.  It is still unclear if there are more suicide among veterans than the overall US population.  Approximately half of the suicide among veterans are diagnosed with a mental health condition prior to their death and those who have been recently diagnosed within the past year shows a rate of suicide is 70 per 100,000.  There are several risk factors for suicide that clinicians must assess while working with the service members and a guide was created to assist health professionals to patients at risk of suicide.

The guideline goal:

  •   To promote evidence based management of patients presenting the Suicidal Self-Directed Violent behavior
  • To promote efficient and effective assessment of patients’ risks
  • To identify efficacious intervention to prevent death in individuals presenting with Suicidal Self-Directed Violent behavior
  • To Identify the critical decision points in management of patients at risk for Suicidal Self-Directed Violence
  • To promote evidence-based management of individuals with (post-deployment) health concerns and behaviors related to Suicidal Self-Directed Violence

The guide also is divided into four Modules which includes Module A: Assessment and Determination of Risk of Suicide; Module B: Initial Management of Patient at Risk for Suicide; Module C:Treatment of the Patient at Risk for Suicide; Module D:Follow-up and monitoring of Patient at Risk for Suicide.

Factors Contributing to Risk of Suicide

  1. Warning signs of suicide- Person intends to engage in suicidal behavior
  2. Acute Risk factors- Short  and stressful episodes, illness or life events.
  3. Chronic Risk factors- Enduring or stable factors that may enhance to suicidal behaviors such as genetic and neurobiological factors, gender, personality, culture, socio-economic background and level of isolation.
  4. Pre-Existing- Environmental and personal resources that increase resilience
  5. Protective factors- A person takes the necessary steps to injury themselves; but is stopped by self or another person prior to fatal injury.




VA/DoD Clinical Practice Guideline. Assessment  and Management of Patients at Risk for Suicide.