Cited by 196Suicide and Self-Harm StudiesPsychiatric care and mental health servicesPsychopathy, Forensic Psychiatry, Sexual Offending

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Assessment of suicide risk in mental health practice: shifting from prediction to therapeutic assessment, formulation, and risk management

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Hawton, Keith, Lascelles, Karen, Pitman, Alexandra, Gilbert, Steve, Silverman, Morton·2022·The Lancet Psychiatry

DOI 10.1016/s2215-0366(22)00232-2

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Abstract

Suicide prevention in psychiatric practice has been dominated by efforts to predict risk of suicide in individual patients. However, traditional risk prediction measures have been shown repeatedly in studies from high income countries to be ineffective. Several factors might contribute to clinicians' preoccupation with risk prediction, which can have negative effects on patient care and also on clinicians where prediction is seen as failing. The model of therapeutic risk assessment, formulation, and management we outline in this article regards all patients with mental health problems as potentially at increased risk of suicide. It is aimed at reducing risk through use of a person-centred approach. We describe how a move towards therapeutic risk assessment, formulation, and risk management, including collaborative safety planning, could help clinicians develop a more tailored approach to managing risk for all patients, incorporating potentially therapeutic effects as well as helping to identify other risk reduction interventions. Such an approach could lead to enhanced patient safety and quality of care, which is more acceptable to patients.

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The interpersonal theory of suicide.
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Authors: Hawton, K., Lascelles, K., Pitman, A., Gilbert, S., & Silverman, M.
Affiliations: Oxford Health NHS Foundation Trust (GB)
University College London (GB)
Medical College of Wisconsin (US)
ORCID: Hawton, Keith
Lascelles, Karen
Pitman, Alexandra
Silverman, Morton
Venue: The Lancet Psychiatry
Publisher: Elsevier BV
Published: 2022-11
Volume: 9
Issue: 11
Pages: 922-928
ISSN: 2215-0366 (ISSN-L)
DOI: 10.1016/s2215-0366(22)00232-2
OpenAlex: W4298159159
Semantic Scholar: a878d9367a25aae908dc8d4297cffd649a094150
Cited by: 196
References: 68
Citations by year: 2026: 51 · 2025: 61 · 2024: 44 · 2023: 34 · 2022: 6
FWCI: 6.05
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: The Lancet Psychiatry (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
Keywords: suicide risk assessment, suicide prevention, risk management, clinical formulation, person-centred care, risk prediction, mental health services, patient safety
MeSH terms: Suicide Prevention, Humans, Mental Health, Risk Management, Risk Assessment, Patient Safety

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Assessment of suicide risk in mental health practice: shifting from prediction to therapeutic assessment, formulation, and risk management

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