What are signs and risk factors of suicide potential?

Updated: Aug 29, 2019
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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The following is a list of 12 things that should alert a clinician to a real suicide potential:

  • Patients with definite plans to kill themselves - People who think or talk about suicide are at risk; however, a patient who has a plan (eg, to get a gun and buy bullets) has made a clear statement regarding risk of suicide

  • Patients who have pursued a systematic pattern of behavior in which they engage in activities that indicate they are leaving life - This includes saying goodbye to friends, making a will, writing a suicide note, and developing a funeral plan

  • Patients with a strong family history of suicide - Family history of suicide is especially indicative of suicide risk if the patient is approaching the anniversary of such a death or the age at which a relative committed suicide.

  • The presence of a gun, especially a handgun

  • Being under the influence of alcohol or other mind-altering drugs - Drug abuse is especially significant if the drugs are depressants.

  • If the patient encounters a severe, immediate, unexpected loss - Eg, when a person is fired suddenly or left by a spouse

  • If the patient is isolated and alone

  • If the person has a depression of any type

  • If the patient experiences command hallucination - A command hallucination ordering suicide can be a powerful message of action leading to death.

  • Discharge from psychiatric hospitals - Patients are at suicide risk upon discharge from a psychiatric hospital, which is a very difficult time of transition and stress; the structure, support, and safety of the institution are no longer available to the patient; the patient feels apprehension and is confronted with the reality of change, which translates into fright and vulnerability.

  • Anxiety - Anxiety in all of its forms leads to a risk for suicide; the constant sense of dread and tension proves unbearable for some

  • Clinician's feelings - As mentioned earlier, regardless of what the patient says or does, it matters if the clinician has a feeling that patient is going to commit suicide; such perceptions are part of clinical judgment and are an important part of the suicide assessment and intervention.

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