The Royal College of Psychiatrists is urging mental health providers in England and Wales to phase out the use of “fundamentally flawed” suicide risk assessments as soon as possible. Mental health teams have traditionally employed ‘tick box’ suicide risk assessments to evaluate a patient’s likelihood of attempting suicide. However, studies have shown that these risk assessments fail many individuals, categorising 80-90% as “no risk” or “low risk,” potentially causing them to miss out on life-saving support.


The College is concerned that these assessments are still in use by mental health teams despite new guidelines from the National Institute of Health and Care Excellence (NICE) in September 2022. These guidelines advised clinicians not to use risk assessment tools and scales to predict future suicide.


On World Suicide Prevention Day, the Royal College of Psychiatrists is calling on mental health services to ensure that every patient presenting with suicidal thoughts or engaging in self-harm receives a thorough psychosocial assessment and a structured dynamic clinical formulation that includes a co-produced Safety Plan. A Safety Plan is an agreed set of activities, strategies, people, and organisations that a person can rely on if they become suicidal or if their suicidal feelings intensify. Evidence suggests they are effective in supporting people with suicidal thoughts.


NHS mental health services will also require additional funding and resources to transition away from suicide risk assessments more swiftly.


Dr. Rachel Gibbons, Chair of the Royal College of Psychiatrists’ Patient Safety Group, emphasised, “With more than 100,000 registered deaths by suicide over the last 20 years, it’s crucial that mental health services do all they can to train staff to therapeutically work with those in suicidal distress. Good therapeutic clinical care is very likely to reduce the chance of suicide by supporting patients to put their painful feelings into words. This helps them tolerate and understand their distress and reduces the chance of action.”


She also stressed the need to improve access to care and develop confidence in emotional engagement, as only one in four individuals who die from suicide have been in contact with mental health services. Dr. Gibbons highlighted the necessity for personalised care and safety plans tailored to individual needs and called on the government to provide NHS mental health services with additional resources to facilitate the transition away from suicide risk assessments.


Suicide resources from the Royal College of Psychiatrists’ can be found here:

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