Identifying drivers of suicidal thoughts and actions

Professor Rory O’Connor, President of the International Association for Suicide Prevention, recently said:

"We need to look at all the different factors we know that lead to people feeling defeated, humiliated and trapped.”

Mental illness can contribute to a person’s suicidal behaviour. But life events and circumstances can also drive suicidal thoughts and actions. 

The goal of the SafeSide Framework’s Assess task is understanding all the drivers that contribute to a person’s suicidal thoughts and behaviours. 

• Long-term risk factors: Factors that affect people for a long time can lead to feelings of hopelessness. Listen for past trauma, cultural factors, family history, health conditions, or other sources of pain. Phrases might begin: “When I was a child…” or “In the past it has felt like…”.
• Stressors/precipitants: Listen for and be curious about recent stressors or precipitants to suicidal thinking that could drive the pain, such as job loss, legal action, relationship breakups, or loss of housing. 

It’s especially important to listen for feelings of hopelessness, humiliation, rejection, or being trapped or a burden to others. 

• Symptoms, suffering, and recent changes: We can target drivers through mini-interventions in the moment; providing or referring to a suicide-specific treatment like CAMS or DBT; or referring to other services that address the specific driver (e.g., referral for job coaching for unemployment concerns, to housing support for instability, or to a medical specialist for health concerns). 

RESOURCES:   

The Defence Risk Assessment Mind Map and Mental Health Risk Assessment Aid can help you organise assessment data and maintain focus on what to listen for.