Understanding and managing suicide risk

Abstract

Background: Suicidal behaviours and non-suicidal self-harm (NSSH) are global public health concerns that affect millions of lives.

Sources of data: This review is a narrative synthesis of systematic reviews, meta-analyses of randomized control trials (RCTs) and landmark studies published in scientific journals.

Areas of agreement: Restricting access to lethal means reduces the likelihood of future suicide deaths.

Areas of controversy: Our ability to predict future suicidal behaviour is no better than chance. No individual risk prediction instrument offers sufficient sensitivity and specificity to inform clinically useful decision-making.

Growing points: Different types of psychosocial interventions may be effective in preventing future suicide attempts; such interventions include clinical assessment, tailored crisis response and safety plans and follow-up contact.

Areas timely for developing research: Whilst some psychosocial interventions can be effective in reducing suicide risk, little is known about the mechanisms of recovery from suicidal thoughts and behaviours.

Keywords: suicidal behaviour; suicide science; treatment.