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Suicide Awareness
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The true tragedy of suicide is the devastatingly painful emotional state—often caused by depression— that leads a person to consider and then attempt the act. Suicide does not have just one victim. The pain and suffering of suicide resonates deeply with the family and friends of the deceased. Each suicide intimately affects many other people. 1
Most suicides are preventable. Many patients may not share their thoughts about suicide unless asked directly. 2 Primary care managers (PCMs) and other medical professionals are a first line of defense in the potential prevention of a suicide. Studies have shown that up to 45 percent of victims had visited their PCM within one month before committing suicide. Recognizing the many warning signs is the main step to preventing suicide and saving lives.
Risk Factors for Suicide
A scale for assistance in identifying those at greater risk of suicide has been developed.
This scale, which has items that spell out the acronym SAD PERSONS, assigns one point to each of 10 items identified as risk factors for suicide:
Sex (male)
Age (less than 19 or greater than 45 years)
Depression (patient admits to depression or decreased concentration, sleep, appetite and/or libido)
Previous suicide attempt or psychiatric care
Excessive alcohol or drug use
Rational thinking loss: psychosis, organic brain syndrome
Separated, divorced or widowed
Organized plan or serious attempt
No social support
Sickness, chronic disease or pain
A score of one or two points indicates low risk, three to five points indicates moderate risk and seven to 10 signals high risk.3,4 If you identify someone with significant depression, refer that patient for appropriate behavioral health services.
If the patient is in imminent danger of self-harm, ensure his or her safety and provide for immediate intervention.
References1 Achieve Solutions®, ValueOptions, Inc.; John McKinsey, M.D., 1999 University of Florida Brain Institute.
2 Suicide Prevention Resource Center
3 “Let’s Not Talk About It: Suicide Inquiry in Primary Care”; Peter Franks, M.D., Department of Family and Community Medicine, University of CaliforniaDavis.
4 APA: Simple Screen Improves Suicide Risk Assessment. Neil Osterweil Reviewed by Robert Jasmer, M.D.; Associate Clinical Professor of Medicine, University of California, San Francisco Primary Source: American Psychiatric Association 2007 Annual Meeting, presented May 21, 2007 “Creating a Suicide Risk Assessment Tool for use in the Emergency Department.” Miller BP and Giordano R. Abstract NR391.
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