Child and Adolescent Suicide Risk Factors and Warning Signs

There are different approaches to conducting suicide assessments, but all approaches acknowledge the need to be familiar with suicide risk factors. The good news is that there have been many suicide risk factors identified through research and clinical work. The bad news is that suicide is essentially unpredictable. Despite this bad news, you should definitely be familiar with the following risk factors and warning signs. Generally, the risk factors are more research based, and the warning signs are more clinical based.

 

Suicide Risk Factors

 

___ 1. Vulnerable group due to age/sex/ethnicity

 

___ 2. Previous suicide attempt

 

___ 3. Using alcohol/drugs excessively or abusively

 

___ 4. DSM diagnosis

 

___ 5. School problems

 

___ 6. Isolated or harassed

 

___ 7. Physical health problems

 

___ 8. Recent significant personal loss (of ability, objects, or persons)

 

___ 9. Struggling with sexuality issues

 

___ 10. Victim of childhood or current abuse

 

___ 11. Diagnosis of depression

 

___ 12. If depressed, the teen is also experiencing:

 

____ Panic attacks

 

____ General psychic anxiety

 

____ Lack of interest and pleasure

 

____ Alcohol abuse increase

 

____ Diminished concentration

 

____ Global insomnia

 

___ 13. Significant hopelessness, helplessness, or excessive guilt

 

___ 14. Suicidal thoughts are present.

 

Note: Evaluate for:

 

____ Frequency of thoughts (How often do these thoughts occur?)

 

____ Duration of thoughts (Once they begin, how long do the thoughts persist?)

 

____ Intensity of thoughts (From 1 to 10, how compelling are the thoughts?)

 

___ 15. There is a history of impulsive behavior.

 

___ 16. A suicide plan is present (evaluate the plan based on the SLAP acronym, which refers to specificity, lethality, accessibility of means, and proximity of social support).

 

___ 17. There is a moderate to high intent to kill self (or a previous lethal attempt).

 

___ 18. Recent prescription of an SSRI and associated disinhibition or agitation

 

___ 19. Possession of or access to firearms

 

Suicide Warning Signs

 

___ 1. Suicide threats, both direct and indirect

 

___ 2. Obsession with death

 

___ 3. Sudden or abrupt loss of interest in usual activities

 

___ 4. Sudden social withdrawal

 

___ 5. An increase in dangerous or illegal or risk-taking activities

 

___ 6. Poems, essays, and drawings that refer to death

 

___ 7. Dramatic change in personality or appearance

 

___ 8. Irrational, bizarre behavior

 

___ 9. Overwhelming sense of guilt, shame, or rejection

 

___10. Severe drop in school or work performance 

 

___11. Giving away or throwing away important possessions

 

___12. Recent extreme stress (e.g., romantic breakup, parental abandonment, parental/sibling/friend suicide)

 

___13. Possession (often secretive) of a dangerous weapon

 

___14. Recent and significant increase in drug or alcohol use

 

___15. An unexplained surge of cheerfulness or energy following a prolonged period of depression