Risk Factors for Suicide
Suicide risk assessment is a fundamental clinical skill. Risk is assessed based on a combination of predisposing (static) and precipitating (dynamic/acute) factors. Use the mnemonic SAD PERSONS for rapid screening.
SAD PERSONS Mnemonic
| S – Sex (Male) | A – Age (<19 or >45) | D – Depression |
| P – Previous Attempt | E – Ethanol/Substance abuse | R – Rational thinking loss |
| S – Social support lacking | O – Organized plan | N – No spouse |
| S – Sickness | — | — |
High-Yield Clinical Notes:
- The Single Strongest Predictor: A prior suicide attempt is the most consistent and powerful predictor of a future completed suicide.
- Clinical Assessment: Always directly ask about ideation (“Have you had thoughts of hurting yourself?”), intent (“Do you have a plan?”), and lethality/accessibility of the means.
- Protective Factors: Assess for reasons for living, such as strong family ties, pregnancy, religious beliefs, or therapeutic alliance.
- Action: When high risk is identified, immediate hospitalization or supervised safety planning (removing means, ensuring 24/7 supervision) is required.