What should be assessed in a suicide risk assessment for major depressive disorder?

• A. Ideation, intent, plan, means, past attempts, protective factors, and immediacy; escalate if high risk
• B. Mood and sleep patterns only
• C. Past hospitalizations only
• D. Family history of mental illness only

Answer: (A)

A thorough suicide risk assessment for major depressive disorder focuses on what the person is thinking and doing about self-harm, not just their mood symptoms. The key elements are examining suicidal ideation (whether they’re thinking about harming themselves, how often, and how intense), intent (whether they plan to act), and plan (a specific method, timeframe, and likelihood of execution). It also asks about access to means to carry out the plan, prior suicide attempts, protective factors (reasons for living, supports, coping strategies), and immediacy (how imminent the risk is right now). This combination helps determine the level of danger and guides immediate safety actions, such as safety planning or hospitalization if risk is high. Mood and sleep patterns alone miss the risk signals; past hospitalizations alone don’t capture current intent or plan; and family history alone doesn’t reflect the person’s present risk or plan.