Suicide risk assessment: What psychologists should know

Recent increases in death by suicide in the United States have led to national calls for improvements in how suicide risk screening and assessments are conducted. As health care providers and leaders in mental health practice, psychologists should be immersed in cutting edge education and training in suicide assessment. In this article, we describe the limits of the traditional medical model approach and review modern developments in suicide risk assessment. Six important shifts in how contemporary psychologists formulate and approach suicide assessment are reviewed. These include: (a) acknowledgment that suicide risk factors are not especially helpful to psychologist-practitioners; (b) a movement away from medical model formulations and toward social constructionist and collaborative orientations; (c) progress in theoretical knowledge pertaining to suicidal individuals; (d) recognition that the clinical encounter and comprehensive suicide assessment interviews are essential to developing and maintaining a therapeutic relationship; (e) advancements in how clinicians question patients about suicide ideation; and (f) methods for monitoring suicide ideation over time. Psychologists who understand and apply these approaches to suicide risk assessment will be more capable of conducting competent suicide assessment and treatment and thereby contribute to national suicide prevention efforts.