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Suicide Assessment Scales

By Dennis Brumbles posted 01-01-2010 11:00 AM

  

I was wondering, what suicide assessment scales are used by the members and their organizations? Which have you found to be the most reliable?

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05-20-2010 03:29 PM

we use the Columbia Suicide Assessment Scale in our Psych emergency eval ctr. As i understand it was valid and reliable for research and a study on the unit several years ago (prior to my arrival) reinforced its applicability for the setting so we continue to use.
However, i found nursing staff don't use for ultimate decision - training has not been reinforced so I am pursuing reiforcing.
Rita Mack

01-07-2010 04:25 PM

As I'm sure you know, suicide is remarkably difficult to predict with or without scales. I tend to go with simply asking the question (Are you having thoughts about hurting or killing yourself?) In spite of some statisticians squeamishness about the reliability of one item scales, there is some evidence that the answer to this question is as predictive as anything that is out there. The American Association of Suicidology promotes the use of the acronym IS PATH WARM to assess for presence of risk factors. (See www.suicidology.org ) I see the SAD PERSONS scale was also suggested. There is a revised version of that scale. that takes into account other risk factors. (Sorry, I don't have a reference available right now.) Some hospitals simply use the Beck Depression Inventory and pay special attention to the item regarding thoughts about the future (hopeful vs hopeless). Good luck with your search.

01-07-2010 03:56 PM

At my rural hospital we use the SAD persons scale which is free resource, although many facilities purchase specific scales. I agree with Debi that it definitely sounds like a systematic review would be helpful, especially for effficacy.

01-07-2010 01:56 PM

There are several available, I can share those that the VA has spearheaded in recent years. Those that I share has the basic components of identifying risk and protective factors with the aim to modify these factors to decrease one's overall risk.
1) You can find the SAFE-T (Suicide Assessment Five-step Evaluation and Triage) at www.stopsuicide.org or www.sprc.org. The SAFE-T was drawn upon the APA guidelines for the Assessment and Treatment of Patient with Suicidal Behaviors (www.psychiatryonline.com/pracGuide/pracGuideTopic_14.aspx).
2) There is a Safety Plan Quick Guide for Clinicians that one can use with their clients and that is located at that two urls listed below. It is a safety plan developed in collaboration with the client in their own words.
3) Resources that I kept from my alma mater is a chapter on how to document suicide risk: their citation is as follows--
Simpson, S., & Stacy, M. (2004). Avoiding the malpractice snare:Documenting suicide risk assessment. Journal of Psychiatric Practice, 10 (3), 1-5.
Shea, S. (2002). How to document a suicide assessment (pp. 229-286). In The practical art of suicide assessment: A guide for mental health professionals and substance abuse counselors. Hoboken, NJ: John Wiley & Sons Inc.
Apparently there are numerous scales to choose form (just google suicide scales) but I cannot attest to the specificity and sensitivity of each scale. Looks like fodder for a systematic review on suicide scales, any volunteers :)