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Suicide Risk Screening in Healthcare Settings: Identifying Males and Females at Risk

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Abstract

Suicide is the tenth leading cause of death in the United States, accounting for more than 42,000 deaths in 2014. Although this tragedy cuts across groups defined by age, gender, race/ethnicity, and geographic location, it is striking that nearly four times as many males as females die by suicide in the U.S. We describe the current regulations and recommendations for suicide risk screening in healthcare systems and also describe the aspirational goal of “Zero Suicide,” put forth by the National Action Alliance for Suicide Prevention. We then provide information about suicide risk screening tools and steps to take when a patient screens positive for suicide risk. Given the substantially higher suicide rate among males than females, we argue that it is important to consider how we could optimize suicide risk screening strategies to identify males at risk and females at risk. Further research is needed to accomplish this goal. It is recommended that we consider multi-factorial suicide risk screens that incorporate risk factors known to be particularly important for males as well as computerized, adaptive screens that are tailored for the specific risk considerations of the individual patient, male or female. These strategies are not mutually exclusive. Finally, universal suicide risk screening in healthcare settings, especially primary care, specialty medical care, and emergency department settings, is recommended.

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Acknowledgements

Work on this manuscript was partially supported by a grant from the National Institute of Mental Health (U01 MH104311). We thank Taylor McGuire for her administrative assistance with the manuscript.

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Correspondence to Cheryl A. King.

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Dr. Cheryl King receives royalties from Guilford Press for the publication, Teen Suicide Risk: A practitioner guide to screening, assessment and care management. Mr. Horwitz, Dr. Czyz, and Ms. Lindsay have no conflicts of interest.

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King, C.A., Horwitz, A., Czyz, E. et al. Suicide Risk Screening in Healthcare Settings: Identifying Males and Females at Risk. J Clin Psychol Med Settings 24, 8–20 (2017). https://doi.org/10.1007/s10880-017-9486-y

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