Suicide Risk Assessment Research Articles

Youth experiencing homelessness at risk for suicide: psychosocial risk factors and service use patterns

ObjectiveYoung adults experiencing homelessness often suffer from adverse mental health outcomes and suicide is a leading cause of death. The objective of this study is to examine service use and psychosocial risk factors for suicide, in relation to suicide risk assessment, to inform strategies for engaging youth in suicide prevention services.MethodsA cross-sectional analysis of youth enrolled in a supportive housing randomized clinical trial. We categorized suicide risk into three groups (low-, moderate-, and high-risk) based on suicidal ideation and past-year suicide attempt. The service use patterns across these groups are described, as well as other psychosocial risk factors (psychiatric comorbidity, depressive symptoms, substance use, and sleep impairment).ResultsAmong 193 enrolled youth, 126 (65.3%), 32 (16.6%), and 35 (18.1%) were categorized as low-risk, moderate-risk, and high-risk for suicide, respectively. A high proportion of youth reported ever having been diagnosed with a psychiatric disorder (57.5%) and cannabis was the most heavily used substance. However, only a minority of youth received medical care or mental health services in the past 3 months, 40% and 34%, respectively. Even fewer youth received mental/emotional health services in the past 3 months (15%), though use was highest among the high-risk group (34%).ConclusionUnderstanding the needs of youth experiencing homelessness who are at risk for suicide is critical to developing interventions to alleviate their risk for suicide. Given that the use of medical and mental health care is low among this population, more active outreach strategies may be warranted to deliver prevention interventions.

Assessment of suicide risk and nonsuicidal self-injury in college students

ABSTRACT Introduction Suicide is the third leading cause of death among individuals aged 15–29, with college students being particularly at risk. While suicidal ideation, nonsuicidal self-injury (NSSI), and psychological distress are well-known risk factors for suicide, emotional reactivity and academic satisfaction are less understood. Understanding the interaction between these factors is essential for enhancing suicide prevention. Objective Identify the strongest predictors of suicide risk among college students and evaluate the mediating roles of psychological distress and academic satisfaction in the association between emotional reactivity and suicide risk. Method Two hundred and ninety-four college students (85.4% female) aged 17–29 years were recruited through institutional email, social media, and a university crediting system. Participants completed self-report questionnaires. Results Almost 17% of students were at suicide risk. Depressive symptoms (β =.575) and lifetime engagement in NSSI (β = .175) emerged as the strongest predictors. Psychological distress and academic satisfaction emerged as significant mediators of the relationship between emotional reactivity and suicide risk – these mediation models explained 44.7% and 34.4% variability in suicide risk, respectively. Conclusions Understanding risk and protective factors can improve suicide prevention among college students. Academic satisfaction may be a promising target for future research.

The Role and Scope of Practice of Veterinary Social Workers in Animal Shelters

Animal shelters play a pivotal role in protecting pets in crisis and bringing families together. This paper adds to the work of Hoy-Gerlach and colleagues which outlined a three-tier framework for developing and training veterinary social workers (VSWs) to serve in animal shelters. Our research questions sought to explore the VSWs’ self-identified role (RQ1), and how VSWs self-identify their scope of practice (RQ2). Through these exploratory questions, our research aimed to advance knowledge about the state of VSWs in the animal-shelter setting. Methods: Using a purposive sampling strategy, an anonymous community practice survey (CPS) was emailed to VSWs working in animal shelters. Inclusion criteria included being over the age of 18, being currently employed in an animal shelter, and cognitive fluency in English. The survey yielded 25 responses with 14 included in the data analysis. Findings: The VSWs identified their role as supporting multiple groups, including clients and their practice community (i.e., colleagues). While most of their time was devoted to individuals from the community, they also supported the mental wellbeing of their team. Their work ranged from case management and psychoeducation to crisis intervention and suicide risk assessment. As there are no standards of practice for VSWs, each respondent used unique language to explain their role and scope of practice. Conclusions: The CPS was helpful in illuminating developing trends within the field, though a larger sample size is needed to gain a more nuanced understanding of self-identified needs of VSWs practicing in animal shelters and other related spaces.

Impairment in personality functioning predicts young adult suicidal ideation and suicide attempt above and beyond depressive symptoms.

Interpersonal factors and depression are believed to be some of the main drivers of suicidal thoughts and behaviors, but other factors may be equally or more important. Drawing on psychodynamic (mentalization) theory, we propose that personality functioning, in particular an incoherent sense of self, may be an important driver of suicidal thoughts and behaviors over and above factors of interpersonal functioning and depression. To evaluate this, we examined associations between personality functioning and suicidal ideation and suicide attempt in young adults. Participants (N=153; Mage=20.93) were recruited from a college sample (N=90) and a clinical sample with borderline personality disorder (N=63). Personality functioning (self and interpersonal components) was measured with the Level of Personality Functioning Scale - Brief Form 2.0. Suicidal ideation was measured with the Personality Assessment Inventory. Suicide attempt history was assessed with the Columbia-Suicide Severity Rating Scale. Depression symptoms were measured with the Symptom Checklist 90. Regressions examined relationships between personality functioning, depression symptoms, and suicidal ideation or attempt while controlling for age and gender. Overall personality functioning was significantly associated with suicidal ideation (β=.584, p<.001) and suicide attempt (β=.384, p<.001). Overall personality functioning was a stronger predictor than depression symptoms, age, and gender when included in the same model predicting suicidal ideation or attempt. Both the self and interpersonal components of personality functioning were significantly associated with suicidal ideation and attempt, with larger effect sizes for self-functioning. Findings underscore the importance of considering personality functioning, especially self-functioning, in suicide risk assessment and treatment.

Developing Empathy and Motivation Through an Arts-Based Project: A Mixed-Methods Study on Addressing Gaps in Nursing Education for Suicide.

The World Health Organisation (WHO) reports that 700 000 people die every year by suicide. An Arts Health education program was co-designed for pre-registration nursing students to conduct a risk assessment for self-harm and suicide with empathy and compassion. Nursing researchers collaborated with clinicians, a theatre professional and filmmakers to develop an engaging, authentic and evidence-based short film to be embedded in a nursing program. The education program was evaluated by second-year pre-registration students in a multiple-methods study. Quantitative and qualitative data were collected concurrently. Quantitative data were collected using surveys and revealed that the debriefing session which followed the education program fostered reflection, peer learning and critical thinking. To explore the students' perceptions of the short film, qualitative data were collected using five open-ended questions. This data was analysed to identify common themes from the qualitative data on student engagement with the short film. Four themes emerged: (1) The importance of asking risk assessment questions; (2) Making connections; (3) Developing empathy; and (4) Wanting to learn more. This Arts Health education program deepened the student's understanding of the importance of risk assessment and provided an opportunity to practice these skills in a safe environment. Conducting a risk assessment to identify the potential for self-harm and suicide is an important clinical skill that should be mastered by all nurses. It requires communication skills that show empathy and compassion so that the person develops trust to disclose their thoughts of harm.

Access to employee assistance programs and employee wellbeing: a cross-sectional study of employees in Southeast Asia

BackgroundThe average person spends 1/3 of their lives working. However, approximately 15% of working adults worldwide are struggling with a mental disorder at any given time. The COVID-19 pandemic has spearheaded the importance of employee mental health, highlighting the role that employers can play in preserving employee wellbeing. Although Employee Assistance Programs (EAPs) are slowly becoming an established practice, it is still a relatively new phenomenon in most of Asia. This study therefore aims to investigate the prevalence of employees in the Southeast Asian region who have access to EAPs and understand the relationship between EAP access and employee wellbeing.MethodsThis cross-sectional, online survey-based study involved 15,302 employees from Malaysia, Singapore, Philippines, Thailand, Indonesia, and Vietnam who completed the Depression, Anxiety, Stress Scales (DASS-21), Thriving from Work Questionnaire (TfWQ), and sociodemographic measures. Employee productivity and turnover intention was also measured as a secondary outcome. Hierarchical regression models were conducted to determine the influence of EAP access on employee wellbeing. Subgroup analyses were conducted on employees with access to EAPs to explore how different forms of EAP services contribute to employee wellbeing.ResultsOnly 29.04% of employees in the region reported being aware of having access to any forms of EAP services provided by their employers. After controlling for sociodemographic variables, access to EAP was significantly associated with improved mental health, thriving, and productivity, and reduced turnover intention (p < 0.001) among employees in the region. Subgroup analyses revealed that employees had access to well-being and mental health webinars, talks, or workshops (12.64%), followed by sponsored counselling, therapy or carelines (11.16%). Access to regular mental health risk assessment and screening was the form of EAP service significantly associated with the highest number of outcomes.ConclusionHaving access to EAP services alone is associated with improved employee wellbeing outcomes. However, different forms of EAP services can vary in their impact on employee wellbeing. Our findings suggest a need to improve accessibility and diversity of EAP offerings for employees in Southeast Asia post-pandemic.

Assessment of acute suicide risk

Assessment of acute suicide risk

Integrating Forensic Autopsies with Proteomic Profiling for Suicide Risk Assessment: A Comprehensive Review of Literature.

Suicide is a major global public health concern that affects people of all ages, with over 700000 individuals intentionally ending their lives every year. Suicide is a multifactorial event related to multiple risk factors interlocking with each other, among which neurobiological factors are considered to be an objective measure of the incidence of this phenomenon and can be used as a measurable tool for evaluating suicidal tendencies. The aim of this study is to thoroughly examine available data and assess candidate proteins as prospective biomarkers for predicting suicides and ascertaining the manner of death in forensic cases. An electronic search was conducted on PubMed, Science Direct Scopus, and the Excerpta Medica Database. The systematic review adhered to PRISMA guidelines and encompassed case series, prospective and retrospective studies, and short communications published in English. The focus was on proteomics and suicide, specifically, those studies where researchers conducted human proteomic analyses on specimens obtained from individuals who completed or attempted suicide. A total of 14 studies met the inclusion criteria, resulting in a dataset of numerous candidate protein biomarkers. These include tenascin-C, potassium voltage-gated channel subfamily Q member 3, vimentin-immunoreactive astrocytes, glutathione S-transferase theta 1, iron transport proteins, Acrystallin chain B, manganese superoxide dismutase, glial fibrillary acidic protein, various glycolytic pathway proteins, 14-3-3 eta and 14-3-3 theta proteins, specific cytoskeleton proteins, C-reactive protein, serum amyloid A protein 1, extrinsic coagulation pathway proteins, the vacuolar-type proton pump ATPase subunit, plasma apolipoprotein A-IV, and ER stress proteins. These proteins are proposed as a panel of biomarkers to be evaluated in conjunction with other clinical predictors of suicide. This review aims to provide a comprehensive summary of all proteomic studies conducted on cases of attempted or completed suicide. By doing so, it seeks to bridge existing gaps in knowledge and pave the way for future investigations. The ultimate goal is to potentially identify a suicide biomarker.

Understanding of death and related constructs in children with suicidal thoughts and behaviors: A review and future directions.

Despite rising rates of suicidal thoughts and behaviors in children, little is known about best practices for conducting suicide risk assessments in this population. The acquisition of the concept of death occurs during childhood, and thoughts and preoccupation with death can be developmentally normative. This review highlights a critical gap in knowledge about how children with suicide ideation understand death-a foundational issue in assessing suicide risk. First, we provide an overview of studies that examined the concept of death and related constructs (e.g., preoccupation with death) among children who experienced suicidal ideation or attempted suicide, many of which date back to the 1970s and '80s. We describe indirect methods of assessing death cognitions, such as the Death Implicit Association Test, representations of death/suicidal themes in play, and the role of exposure to these themes through screens (e.g., social media, videogames). Given the potential impact of sociocultural changes since the 1970s-1980s on how children understand death, gaining a contemporary perspective on how children think about death and its relationship to suicide risk is warranted. Guided by a developmental approach, we provide recommendations for future areas of research to advance this field and inform the design of developmentally appropriate risk assessments and interventions for children.

The Etiopathogenic Mosaic of Suicidal Behaviour.

Suicidality is among the most controversial concepts in multi-disciplinary studies worldwide, regardless of the form and approach. The etiopathological variability in suicidal ideation correlates with the heterogeneity of the clinical and behavioural patterns of self-harm attempts, which significantly impact the prognosis and quality of life of patients. The main objective of the present study was to identify and outline the spectrum of factors predisposing to suicide, with the whole suite of consequences and manifestations in ideation and behaviour. In this regard, the research literature of the last decade contains numerous articles dealing with the theoretical premises pertaining to both the statistical and the profoundly psychological and philosophical dimensions of suicide. The micro-environment favouring the clinical evolution of self-harm/self-destructive thoughts and attempts to the terminal, final act integrates individual medical-biological and psychological factors into the overall social reality. Knowledge of the whole etiopathogenic amalgam with clinical-evolutionary implications allows for the development of methods and tools for the early assessment and prevention of suicidal risk. At the same time, the present study aims to qualitatively focus on the subjective motivation declared by patients regarding the internal, individual catalyst of suicidal ideation and attempts on a predominantly psycho-social coordination.

The Predictive Value of Preadolescent Suicidal Ideation Reporter Discrepancies in the ABCD Study.

Little data exist to guide suicide assessment protocols in preadolescent youth. Using the Adolescent Brain Cognitive Development (ABCD) data (N = 10,010) at baseline (ages 9-10) and 24-month follow-up (ages 11-12), this report investigates informant agreement/disagreement in caregiver- and youth- reports of suicidal ideation and their associations with youth sex assigned at birth and symptomatology across preadolescence. Using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) at both timepoints, four informant discrepancy groups were created from caregiver- and youth- reported suicidal ideation: (1) Concordant No; (2) Concordant Yes; (3) Discordant Caregiver Yes, Youth No; (4) Discordant Caregiver No, Youth Yes. Internalizing and externalizing symptoms were measured at the 24-month follow-up using the caregiver-report Child Behavior Checklist and the youth-report ABCD Brief Problem Monitor. Results indicated low-to-fair caregiver-youth agreement for youth suicidal ideation across preadolescence. Suicidal ideation reported by youth, but not caregivers, demonstrated a shift in prevalence at the follow-up, with females surpassing males in self-reported endorsements. Finally, informant groups at both time points were associated with caregiver- and youth-reported youth symptomatology at the 24-month follow-up, and associations varied by reporter. Findings demonstrate the importance of leveraging both caregiver and youth reports to assess preadolescent suicidal ideation and highlight the clinical utility of informant discrepancies in assessing suicide risk. The accurate assessment of suicidal ideation in preadolescents is essential to curb the increasing rates of preadolescent suicide and identify at-risk youth for interventions prior to even larger uptick of suicide in adolescence.

Suicide risk assessment and management protocol for research within the Department of Veterans Affairs.

Escalating rates of suicide among U.S. military Veterans have prompted the Department of Veterans Affairs to prioritize Veteran suicide as a chief clinical concern. Veterans Affairs-funded research is consistently dedicated to suicide prevention initiatives, reflecting a commitment to addressing this urgent issue. Although general guidelines have been proposed for recognizing and responding to suicide risk among research participants, to date, no guidelines have been published that are Veteran specific. Veterans exhibit unique suicide risk factors compared to civilians, including higher rates of suicide, a tendency to utilize more lethal means when attempting suicide, and substantial stigma surrounding mental health and help seeking, underscoring the need for Veteran-specific suicide risk assessment and management protocols (SRAMs). This article offers a comprehensive SRAM to guide research with Veteran participants. The protocol provides guidance on (a) accurate assessment of suicide risk, (b) risk management strategies commensurate to presenting risk, and (c) tailoring SRAMs for diverse study designs and contexts. By introducing this standardized, Veteran-focused SRAM, we aspire to bolster ongoing research dedicated to saving the lives of Veterans. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Supplemental Material for Suicide Risk Assessment and Management Protocol for Research Within the Department of Veterans Affairs

Supplemental Material for Suicide Risk Assessment and Management Protocol for Research Within the Department of Veterans Affairs

Assessment of acute suicide risk in life crises.

Assessment of acute suicide risk in life crises.

Suicide risk assessment: A diagnostic perspective

Suicide risk assessment: A diagnostic perspective

Systematic Review: A 25-Year Global Publication Analysis of the Role of Spirituality and Religiosity in Suicidal Risk Assessment in Adolescents

Systematic Review: A 25-Year Global Publication Analysis of the Role of Spirituality and Religiosity in Suicidal Risk Assessment in Adolescents

Enhancing suicidal behavior detection in EHRs: A multi-label NLP framework with transformer models and semantic retrieval-based annotation

Background:Suicide is a leading cause of death worldwide, making early identification of suicidal behaviors crucial for clinicians. Current Natural Language Processing (NLP) approaches for identifying suicidal behaviors in Electronic Health Records (EHRs) rely on keyword searches, rule-based methods, and binary classification, which may not fully capture the complexity and spectrum of suicidal behaviors. This study aims to create a multi-class labeled dataset with annotation guidelines and develop a novel NLP approach for fine-grained, multi-label classification of suicidal behaviors, improving the efficiency of the annotation process and accuracy of the NLP methods. Methods:We develop a multi-class labeling system based on guidelines from FDA, CDC, and WHO, distinguishing between six categories of suicidal behaviors and allowing for multiple labels per data sample. To efficiently create an annotated dataset, we use an MPNet-based semantic retrieval framework to extract relevant sentences from a large EHR dataset, reducing annotation space while capturing diverse expressions. Experts annotate the extracted sentences using the multi-class system. We then formulate the task as a multi-label classification problem and fine-tune transformer-based models on the curated dataset to accurately classify suicidal behaviors in EHRs. Results:Lexical analysis revealed key themes in assessing suicide risk, considering an individual’s history, mental health, substance use, and family background. Fine-tuned transformer-based models effectively identified suicidal behaviors from EHRs, with Bio_ClinicalBERT, BioBERT, and XLNet achieving the F1 scores (0.81), outperforming BERT and RoBERTa. The proposed approach, based on a multi-label classification system, captures the complexity of suicidal behaviors effectively particularly “Suicide Attempt” and “Family History” instances. The proposed approach, using task-specific NLP models and a multi-label classification system, captures the complexity of suicidal behaviors more effectively than traditional binary classification. However, direct comparisons with existing studies are difficult due to varying metrics and label definitions. Conclusion:This study presents a robust NLP framework for detecting suicidal behaviors in EHRs, leveraging task-specific fine-tuning of transformer-based models and a semi-automated pipeline. Despite limitations, the approach demonstrates the potential of advanced NLP techniques in enhancing the identification of suicidal behaviors. Future work should focus on model expansion and integration to further improve patient care and clinical decision-making.

Insight and suicidality in first-episode psychosis: The mediating role of depression.

Understanding the relationship between insight, depression, and suicidality in first-episode psychosis (FEP) is crucial for improving clinical outcomes and preventing suicide during early treatment stages. This longitudinal cohort study examined 264 participants enrolled in coordinated specialty care (CSC) services for FEP to investigate how insight and depression at admission impact suicidality at 6 and 12months, assess the mediating role of depression at admission between insight and suicidality, and evaluate the persistence of depression over time. Regression analyses assessed the relationships among these variables, while mediation analyses explored the mediating effect of depression at admission. Significant predictors of suicidality at 6months were insight (OR 0.71, 95% CI: 0.53-0.94), depression (OR 5.40, 95% CI: 2.45-12.61), and previous suicide attempts (OR 2.91, 95% CI: 1.21-7.00). At 12months, insight (OR 0.70, 95% CI: 0.52-0.92) and depression (OR 2.82, 95% CI: 1.26-6.50) remained significant. Depression at admission mediated 27.32% of the effect of insight on suicidality at 6months and 19.76% at 12months. Despite a general decrease in depression, a subset of participants remained persistently depressed. The study highlights the significant mediating role of depression at admission in the relationship between insight and suicidality, identifying it as the strongest predictor of suicidality. Early detection and treatment of depression in FEP should be prioritized, and further research should focus on targeted interventions within CSC.

Examining Gender Differences in Aggression as a Predictor of Anxiety, Depression, and Suicide in a Cross-Sectional French Sample.

The expected outcomes of the Covid-19 pandemic have a supposedly worsened impact on mental health and suicidal risk. Traditionally, males were supposed to have heightened Aggression and impulsivity in stressful times. We aim to measure the actual differences that existed during the COVID-19 pandemic across male and female participants. An overall number of 288 females/95 males (mean age: men = 34.97; women = 32.90 years) participants were recruited. The protocol included questionnaires about suicidal risk, anxiety, depression, impulsivity, aggression, hopelessness, and demographics. Differences exist in the sense of loneliness, the number of persons being isolated with, anxiety, and several impulsivity subdimensions. A correlation existed for both men and women for anxiety and depression, revealing the impact of aggression. Suicide men's scores correlated with anxiety and depression, lack of premeditation, and hopelessness. Women also had such correlation, except for lack of perseverance, social dimensions, and aggression. Analyses reveal the predictive impact of hopelessness and aggression on anxiety, depression, and suicidal risk predominantly in females. Our results contradict common ideas that men have heightened aggression and impulsivity. Further research needs to address aggression issues.

Advances in suicide prevention: critical overview of the gaps in suicide risk assessments, multimodal strategies, medicolegal risks, and the emerging evidence.

The CDC reports that the United States has the highest suicide rates in over 80years. Numerous public policies aimed at reducing the rising suicide rates, such as Aetna's partnership with the American Foundation for Suicide Prevention (AFSP) and the zero-suicide initiative, continue to challenge these attempts. It, therefore, remains imperative to explore the shortcomings of these efforts that hamper their efficiency in reducing suicide rates. Advancements in research over time have sparked scientific skepticism, encouraging re-evaluation of established concepts. The current paper tests prevalent assumptions and arguments to uncover a scientifically informed approach to addressing rising suicide rates in clinical settings.