Assessing suicide risk
When to assess suicide risk
Women who appear to have suicidal thoughts (e.g. have a positive response on Q10 of the EPDS) should be asked about suicidal thinking and self-harm behaviour. Such enquiry does not induce thoughts of suicide, rather it provides an opportunity to ensure the safety of the woman and arrange appropriate follow-up care.
Assessing the risk of suicide
Assessing risk involves asking about the frequency and persistence of suicidal thoughts, whether the woman has planned her suicide, what method she has chosen and how lethal it is and whether she has the means to carry this out.
Consideration should also be given to risk and protective factors, mental state, history of suicidal behaviour, substance use, strengths and available supports.
Whenever assessing a woman for risk of suicide, enquiry should be made about her risk to the infant.
Responding to risk
| Low risk | Possible risk | Possible high risk |
|---|---|---|
| Passing thoughts of self-harm or suicide but no plans or means | Suicidal thoughts and intent but no plan or immediate means | Continual/specific suicidal thoughts, intent, plan and means |
| - Discuss support and treatment - Arrange follow up | - Discuss support and treatment - Develop safety plan with the woman including rapid re-assessment if symptoms escalate - Provide support/crisis numbers - Arrange re-assessment with 1wk | - Ensure woman is in a safe and secure environment with social/professional supports - Arrange re-assessment within 24hrs - Provide crisis contact numbers - Assess risk to infant - Contact appropriate crisis support - Consider hospital admission |
Developing a safety plan
A safety plan is a prioritised list of coping strategies and sources of support that women can use when they experience suicidal thoughts. Safety plans should be frequently revisited and modified as needed.
The development of a safety plan involves assisting the woman to identify warning signs, coping strategies, people who can assist at times of need and health professionals and agencies that can be contacted for help.
Useful tools and templates
Guides:
Templates:
- Download Treatment Plan Template
- Download Sample Collaborative Management Plan
- Download Safety Plan Template
Further information
The Australian National Suicide Prevention Strategy (NSPS) website includes comprehensive resources on suicide prevention strategies, risk and protective factors, the relationship between mental health and suicide and issues specific to certain groups, such as residents of Aboriginal and Torres Strait Islander communities and rural and remote communities.