1. Assessment of Suicide Risk Dr Vivien Peeler Crisis Resolution Home Treatment Consultant Psychiatrist

2. Risk Factors For Suicide Demographic factors: gender / age / race Psychiatric diagnosis: depression / bipolar / schizophrenia / adjustment disorders Co-morbidities: alcohol & substance / medical ill health Personality factors: antisocial / narcissistic / borderline / impulsivity Social factors: divorced / socially isolated / areligious / financial stressors / recent significant adverse life event / unemployment Other factors: means available / family history of suicide/ prior suicide attempts

3. Risk Factors In Depression Hopelessness Suicidal ideation Pre-meditation Planning the suicide act Tidying up affairs Writing suicide note Past serious suicide attempts Ongoing suicidal ideation after recent serious attempt

4. Is suicide prediction possible? If individual has several risk factors  markedly increase threshold of concern Is prevention possible? Not totally Possible to reduce the risk for medium to high risk individuals by -Increased community support -Hospitalisation This enables protection, treatment, mobilisation of supports, arrangements for ongoing care Recognition of and reduction of ongoing risk factors

5. Borderline Personality Disorder Frequent presentations with self harm Frequent presentations reporting suicidal intent Risk behaviours commonly escalate if not supported Seeking containment/support rather than actively suicidal Acute management to support, contain, decrease impulsive self harm acts Minimise hospitalisation Establish in stable supportive professional relationship 5% risk of completed suicide