
How accurate are suicide risk prediction models? Asking the right questions - DanBC
https://ebmh.bmj.com/content/22/3/125
======
DanBC
Full title is "How accurate are suicide risk prediction models? Asking the
right questions for clinical practice".

Suicide prediction tools do not work and current advice is that they should
not be used to predict a person's risk.

This is for a few reasons.

Reliance on risk predictors means you don't provide services to people who go
on to take their life. It also means you "section" (detain under the mental
health act) people who are depressed but who are not going to kill themselves.
This causes harm.

~~~
brudgers
_First, findings were not compared with current clinical practice, where risk
assessment is routine_

This undermines the conclusion of the paper regarding allocation of resources.
Actual services are _exclusively_ allocated within current practice. It
advocates a policy based on logic, not field experience.

More troubling is that it misses the point that suicide risk assessment in
clinical settings is an _intervention_. Suicide risk assessment is clinicians
talking with patients about suicide. Assessment is part of treatment.

~~~
DanBC
> Suicide risk assessment is clinicians talking with patients about suicide.
> Assessment is part of treatment.

That's not the assessment they're talking about. They recommend that type of
assessment.

The assessments they're talking about are structured tools that have
checklists.

~~~
brudgers
In clinical practice, the structured tools typically are based on patient
response...a set of standard questions like a medical history or an ordinary
diagnosis by a physician. In the US a typical assessment includes "Do you have
guns in your house?" with follow up about their status, storage and use when
the answer is affirmative. Or in terms of intervention, the clinician and
patient discuss guns because firearms are a common means of suicide in the US.

See more:
[https://en.wikipedia.org/wiki/Assessment_of_suicide_risk](https://en.wikipedia.org/wiki/Assessment_of_suicide_risk)

