What are the key components of a suicide risk assessment in primary care?

In primary care, the key components of a suicide risk assessment include:

• Establishing the means of self-harm and discussing removal or restriction of access to these means collaboratively to enhance safety.
• Assessing the severity of any injury and determining the urgency of medical treatment needed.
• Evaluating the person's emotional and mental state, including levels of distress and presence of depression, cognitive impairment, or physical ill health.
• Identifying immediate concerns about safety, including suicidal thoughts, plans, or intentions.
• Considering safeguarding concerns and the person's capacity, competence, and consent.
• Reviewing the person's social and home situation, including support networks, loneliness, isolation, and any caregiving roles.
• Seeking consent to liaise with family, carers, and other healthcare professionals to gather contextual information and coordinate care.
• Developing or reviewing a care plan and safety plan collaboratively with the person and their support network, focusing on immediate and long-term psychological and physical safety.
• Carrying out concurrent physical healthcare and psychosocial assessment as soon as possible after a self-harm episode.
• Recognising higher suicide risk in specific populations, such as older adults and people with learning disabilities, and ensuring assessments are conducted by appropriately experienced professionals.
• Not relying on risk assessment tools or global risk stratification to predict future suicide or to determine treatment or discharge decisions.

These components ensure a comprehensive, person-centred approach to suicide risk assessment in primary care, focusing on safety, support, and appropriate referral when needed.

All recommendations are based on NICE guideline NG225 on self-harm assessment and management in primary care.