Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Review Article Volume 4 Issue 12

Suicide Risk Assessment Must be Collaborative

Konrad Michel*

Professor of Psychiatry, University of Bern, Bern, Switzerland

*Corresponding Author: Konrad Michel, Professor of Psychiatry, University of Bern, Bern, Switzerland.

Received: November 06, 2020; Published: November 18, 2020



  When faced with a patient who may have suicide ideas or plans, clinicians usually perform a suicide risk assessment. However, short-term suicide prediction is a virtually impossible task. Suicidal individuals often deny suicidal plans, even when the issue is addressed directly by the clinician. An important aspect of the communication problem between patient and clinician is that the traditional medical model of suicide does not match with the inner experience of the suicidal patient. Here, it is argued that suicide risk assessment must be a collaborative process, in which patient and clinician together explore the individual’s actual suicide risk and jointly develop adequate measures to keep the patient safe.

Keywords: Suicide; Risk Assessment; Narrative



  1. Isometsä ET., et al. “The last appointment before suicide: is suicide intent communicated?” American Journal of Psychiatry6 (1995): 919-922.
  2. Apter A., et al. “Relationship between self-disclosure and serious suicidal behavior”. Comprehensive Psychiatry 1 (2001): 70-75.
  3. Busch KA., et al. “Clinical correlates of inpatient suicide”. Journal of Clinical Psychiatry1 (2003): 14-19.
  4. Ajdacic-Gross V., et al. “In-patient suicide--a 13-year assessment”. Acta Psychiatrica Scandinavica1 (2009): 71-75.
  5. Hunt IM., et al. “Suicide in recently discharged psychiatric patients: a case-control study”. Psychological Medicine3 (2009): 443-449.
  6. Ward-Ciesielski EF and CR Wilks. “Conducting Research with Individuals at Risk for Suicide: Protocol for Assessment and Risk Management”. Suicide and Life-Threatening Behavior2 (2020): 461-471.
  7. Jenkins GR., et al. “Suicide rate 22 years after parasuicide: cohort study”. BMJ7373 (2002): 1155.
  8. Owens D., et al. “Fatal and non-fatal repetition of self-harm Systematic review”. The British Journal of Psychiatry3 (2002): 193-199.
  9. Beautrais AL. “Further suicidal behavior among medically serious suicide attempters”. Suicide and Life-Threatening Behavior1 (2004): 1-11.
  10. Goldstein RB., et al. “The prediction of suicide. Sensitivity, specificity, and predictive value of a multivariate model applied to suicide among 1906 patients with affective disorders”. Archives of Genitic Psychiatry 5 (1991): 418-422.
  11. Posner K., et al. “The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults”. American Journal of Psychiatry12 (2011): 1266-1277.
  12. Large M., et al. “Meta-Analysis of Longitudinal Cohort Studies of Suicide Risk Assessment among Psychiatric Patients: Heterogeneity in Results and Lack of Improvement over Time”. PLoS One6 (2016): e0156322.
  13. Carter G., et al. “Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales”. British Journal of Psychiatry6 (2017): 387-395.
  14. Chan MK., et al. “Predicting suicide following self-harm: systematic review of risk factors and risk scales”. British Journal of Psychiatry4 (2016): 277-283.
  15. Pirkis J and P Burgess. “Suicide and recency of health care contacts. A systematic review”. British Journal of Psychiatry 173 (1998): 462-74.
  16. Wolk‐Wasserman D. “Contacts of suicidal neurotic and prepsychotic/psychotic patients and their significant others with public care institutions before the suicide attempt”. Acta Psychiatrica Scandinavica 4 (1987): 358-372.
  17. Hawton K and E Blackstock. “General practice aspects of self-poisoning and self-injury”. Psychological Medicine 6 (1976): 571-575.
  18. Treolar AJ and TJ Pinfold. “Deliberate self-harm: An assessment of patients' attitudes to the care they receive”. Crisis 14 (1993): 83-89.
  19. Robins, E., et al. “Suicide and Attempted Suicide. England: Penguin Books Ltd. 1967. Pp. 135. $1.25”. American Journal of Clinical Hypnosis4 (1971): 289-290.
  20. Harris EC and B Barraclough. “Suicide as an outcome for mental disorders. A meta-analysis”. British Journal of Psychiatry3 (1997): 205-228.
  21. Borges G., et al. “Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys”. Journal of Clinical Psychiatry12 (2010): 1617-1628.
  22. Bertolote JM., et al. “Suicide and mental disorders: do we know enough?” British Journal of Psychiatry 183 (2003): 382-383.
  23. De Leo D. “Why are we not getting any closer to preventing suicide?” British Journal of Psychiatry 181 (2002): 372-374.
  24. Van Praag HM. “A stubborn behaviour: the failure of antidepressants to reduce suicide rates”. World Journal of Biological Psychiatry 4 (2003): 184-191.
  25. Maltsberger JT. “The descent into suicide”. The International Journal of Psychoanalysis4 (2004): 653-668.
  26. Tornblom AW., et al. “Shame behind the masks: the parents' perspective on their sons' suicide”. Archives of Suicide Research3 (2013): 242-261.
  27. Gollwitzer PM. “The volitional benefits of planning, in The psychology of action. Linking cognition and motivation to behavior, P.M. Gollwitzer and J.A. Bargh, Editors. The Guilford Press: New York (1996).
  28. Carver CS and M Scheier. “Principles of self-regulation: Action and emotion, in Handbook of motivation and cognition: Foundations of social behavior”. E.T. Higgins and R.M. Sorrentino, Editors. 1990, Guilford Press: New York (1990): 3-52.
  29. Michel K and L Valach. “Suicide as goal-directed action”. Archives of Suicide Research3 (1997): 213-221.
  30. Michel K., et al. “Therapist sensitivity towards emotional life-career issues and the working alliance with suicide attempters”. Archives of Suicide Research3 (2004): 203-213.
  31. Alexander., et al. The Penn Helping Alliance Scales, in The Psychotherapeutic Process: A Research Handbook (1986): 325–366.
  32. Michel K., et al. “Discovering the truth in attempted suicide”. American Journal of Psychotherapy3 (2002): 424-437.
  33. Gysin-Maillart, A., et al. “A Novel Brief Therapy for Patients Who Attempt Suicide: A 24-months Follow-Up Randomized Controlled Study of the Attempted Suicide Short Intervention Program (ASSIP)”. PLoS Medicine3 (2016): e1001968.
  34. Park AL., et al. “Cost-effectiveness of a Brief Structured Intervention Program Aimed at Preventing Repeat Suicide Attempts Among Those Who Previously Attempted Suicide: A Secondary Analysis of the ASSIP Randomized Clinical Trial”. JAMA Netw Open6 (2018): e183680.
  35. Michel K and L Valach. “The Narrative Interview with the Suicidal Patient”. in Building a Therapeutic Alliance with the Suicidal Patient, K. Michel and D.A. Jobes, Editors. American Psychological Association APA Books: Washington, DC. (2011): 63-80.
  36. Warren MB and LA Smithkors. “Suicide Prevention in the U.S. Department of Veterans Affairs: Using the Evidence Without Losing the Narrative”. Psychiatric Service4 (2020): 398-400.
  37. Teismann T and W Dorrmann. “Suizidalität”. Psychotherapeut3 (2013): 297-311.
  38. Jobes DA. “The Collaborative Assessment and Management of Suicidality (CAMS): An Evolving Evidence‐Based Clinical Approach to Suicidal Risk”. Suicide and Life-Threatening Behavior6 (2012): 640-653.
  39. Vannoy SD and LS Robins. “Suicide-related discussions with depressed primary care patients in the USA: gender and quality gaps. A mixed methods analysis”. BMJ Open2 (2011): e000198.
  40. McCabe R., et al. “How do healthcare professionals interview patients to assess suicide risk?” BMC Psychiatry1 (2017): 122.
  41. Barzilay S., et al. “Determinants and Predictive Value of Clinician Assessment of Short-Term Suicide Risk”. Suicide and Life-Threatening Behavior2 (2019): 614-626.


Citation: Konrad Michel. “Suicide Risk Assessment Must be Collaborative". Acta Scientific Medical Sciences 4.12 (2020): 38-43.


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