SAD PERSONS

Suicide risk assessment is a structured approach used by healthcare professionals to identify individuals at risk of committing suicide. More than 700,000 people die every year by suicide, which is one person every 40 seconds. In people aged 15 to 34, it is the second cause of death after unintentional injuries; and it is also among the leading causes of death in older people. 

 Usually, prior to any suicide or attempted suicide, a person has what is known as suicidal ideation, which refers to thinking about, considering, or planning suicide. Fortunately, most people with suicidal ideation never attempt suicide, but there is no reliable way to identify those who will. The goal of suicide risk assessment is to identify individuals at risk of suicide and to implement suicide prevention strategies to reduce that risk.  

The “A” in SAD PERSONS means age younger than 19 or older than 45. Young people face specific risk factors that elevate their suicide risk, including higher rates of bullying, social media pressures, feelings of isolation, and impulsive decision-making, which can lead to self-harming behaviors without fully considering the consequences. 

On the other hand, older individuals may experience other risk factors, like extreme loneliness and lack of social support. Things like declining health and loss of independence may lead to concerns about being a burden to others, resulting in feelings of worthlessness. Finally, older individuals may have easier access to lethal means, such as firearms or poisons, making them more likely to die in suicide attempts. 

The “D” in SAD PERSONS means depression. Approximately 90% of people who die by suicide have a mental health disorder, the most common of which is depression. Clinical depression is a relatively common but serious condition that interferes with someone’s day-to-day life, essentially leading to anhedonia, which is the lack of interest, enjoyment or pleasure from activities normally found enjoyable. Sometimes, this feeling is so intense that a person loses hope or meaning in life or starts believing that the world would be a better place without them. 

All individuals with depression should be asked about possible thoughts of self-harm or suicide, as there is no evidence that asking about suicidal ideation will increase suicide risk.