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Cited by 294Suicide and Self-Harm StudiesPsychiatric care and mental health servicesBipolar Disorder and Treatment

Suicide risk assessment and intervention in people with mental illness

Bolton, J. M., Gunnell, D., Turecki, G.·2015·BMJ
DOI 10.1136/bmj.h4978
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Abstract

Suicide is the 15th most common cause of death worldwide. Although relatively uncommon in the general population, suicide rates are much higher in people with mental health problems. Clinicians often have to assess and manage suicide risk. Risk assessment is challenging for several reasons, not least because conventional approaches to risk assessment rely on patient self reporting and suicidal patients may wish to conceal their plans. Accurate methods of predicting suicide therefore remain elusive and are actively being studied. Novel approaches to risk assessment have shown promise, including empirically derived tools and implicit association tests. Service provision for suicidal patients is often substandard, particularly at times of highest need, such as after discharge from hospital or the emergency department. Although several drug based and psychotherapy based treatments exist, the best approaches to reducing the risk of suicide are still unclear. Some of the most compelling evidence supports long established treatments such as lithium and cognitive behavioral therapy. Emerging options include ketamine and internet based psychotherapies. This review summarizes the current science in suicide risk assessment and provides an overview of the interventions shown to reduce the risk of suicide, with a focus on the clinical management of people with mental disorders.

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Crossref · 10.1136/bmj.h4978

Cites

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  • Findings underline the importance of both assessment and treatment of mental disorders in healthcare settings.

    “Our findings underline the importance of both assessment and treatment of mental disorders in healthcare settings.33”

    From Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies (2022) · cites this paper as [33]

  • Current evidence to support routine use of suicide prediction tools in emergency departments and primary care is weak.

    “Despite the putative advantages of such tools, current evidence to support their routine use in emergency departments and in primary care is weak.49”

    From Suicide (2020) · cites this paper as [49]

  • Structured tools can provide a baseline assessment, offer a checklist of risk factors, and lead to interventions for people predicted to be at high risk for suicide.

    “Nevertheless, structured tools can provide a baseline assessment during initial contact with health care providers, offer a checklist to identify risk factors, and lead to interventions for those persons who are predicted to be at high risk for suicide.49,50”

    From Suicide (2020) · cites this paper as [49]

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Authors
Bolton, J. M., Gunnell, D., & Turecki, G.
Affiliations
  • University of Manitoba (CA)
  • University of Bristol (GB)
  • McGill University (CA)
Corresponding author
Bolton, J. M.
ORCID
Venue
BMJ
Publisher
BMJ
Published
2015-11-09
Volume
351
Issue
nov09 1
Pages
h4978-h4978
ISSN
1756-1833 (ISSN-L)
DOI
10.1136/bmj.h4978
OpenAlex
W2195835703
Cited by
294
References
163
Citations by year
2026: 12 · 2025: 23 · 2024: 24 · 2023: 30 · 2022: 28 · 2021: 26 · 2020: 22 · 2019: 34 · 2018: 45 · 2017: 28 · 2016: 20 · 2015: 2
FWCI
39.32
Type
journal article
Language
en
Open access
closed
Locations
  • BMJ (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship@McGill (McGill) (submittedVersion)
Funders
  • National Institute for Health and Care Research (NF-SI-0512-10068)
  • Canadian Institutes of Health Research (MOP119430, MOP11260, MOP93775, MOP119429)
  • National Institute on Drug Abuse (R01DA033684)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords
suicide risk assessment, suicide prevention, mental illness, suicide risk prediction, Implicit Association Test, suicide intervention, lithium, cognitive behavioral therapy, ketamine, internet-based psychotherapy, post-discharge care, emergency department care
MeSH terms
Suicide Prevention, Antidepressive Agents, Anxiety, Crisis Intervention, Depression, Humans, Ketamine, Suicide, Suicide, Attempted, Antipsychotic Agents, Cognitive Behavioral Therapy, Self-Injurious Behavior, Lithium Compounds, Risk Assessment, Excitatory Amino Acid Antagonists, Substance-Related Disorders, Evidence-Based Practice

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