Assessment and Management of Suicide Risk: What Psychiatrists Should Know

Abstract

Suicide is a major public health issue worldwide, and scholars now recognise the multifactorial perspective of this phenomenon. However, psychiatric disorders are often considered the main determinant of suicide risk, and psychiatrists are commonly requested to assess and manage such a risk. The establishment of the medical model suggests that treating mental disorders prioritises reducing the probability of a suicidal gesture. However, this model appears obsolete and implies that the entire management of such a complex phenomenon relies on psychiatrists’ treatments. In their central role, psychiatrists and other figures can reasonably anticipate the future by proper suicide risk assessment and appropriate documentation of therapeutic plans. In its unpredictability, clinicians should relate the suicidal phenomenon to foreseeability, with proper implementation of the standard of care, which ensures adequate protection from medical-legal instances. Psychiatrists should be trained to assess and manage suicide risk through clinical skills while fostering alliances with patients, families, and other clinicians. The article introduces the importance of suicide risk formulation, the correct categorisation of each patient by an in-depth study of the suicidal scenario, and the role of mental pain as a critical factor for reducing the main sources of suffering in each unique patient.

Keywords:

• Suicide
• psychiatry
• assessment
• management
• standard of care

Disclosure statement

The author declares no conflicts of interest. He wishes to disclose that in the last two years, he has received lecture and advisory board honoraria or has engaged in clinical trial activities with Angelini Pharma, Janssen, Lundbeck, MSD, Otsuka, Rovi, Pfizer, Fidia, Viatris and Recordati, all of which are unrelated to this article.