Suicide Prevention Blog Series: Clinical Tip #4

by Staff and Faculty of the QPR Institute Wednesday, November 6, 2013

In honor of the launch of the HelpPRO Suicide Prevention Therapist Finder (see Press Release) we bring you this five part series of clinical tips with the most up to date research and thinking on suicide prevention.

Paul Quinnett, PhD, President and CEO, The QPR Institute, Inc., says 22 veterans will take their own lives today.  So will someone's daughter, a brother, a co-worker, and far too many working men and grandfathers. According to the Centers for Disease Control and Prevention, in just one day, more then 105 of our fellow Americans will die by suicide. Perhaps this clinical tip will save just one.

Clinical tip #4 -- Reassessing suicide risk


Suicide risk changes with time and circumstances.  A single, initial assessment of suicide risk is seldom adequate for safe practice.  Suicide risk assessments should be repeated both a fixed intervals and during times of increase stress. Based on the literature and the clinical experience of several of the QPR Institute faculty, we suggest four non-exhaustive circumstances where re-evaluating suicide risk is indicated:


Changes in health status, e.g., diagnosis of a life-threatening illness, exposure to HIV, continued experience of chronic pain, and when the consumer is faced with significant surgery or has suffered a significant physical injury.

Stressful life-transitions, e.g., loss of a major relationship, change in living arrangements, treatment transitions (between therapists or programs), threats to housing, income or access to care.

Response to treatment, to include side effects of psychotropic medications, non-therapeutic response to medication or other intervention failures, including impasse in therapy or conflict with therapist

Substance abuse dramatically increases suicide risk.  Relapse from recovery, binge drinking or drugging, relapse of one’s sponsor, and any significant use of intoxicants, even by non-addicted consumers.


A number of other circumstances suggest the need for a reassessment of suicide risk.  These include reports by third parties that suicide warning signs have been observed, any report of violent behavior, the sudden loss of a loved one through death, divorce, desertion and especially suicide.  Finally, anytime a consumer of any age is facing what may be a personal and public humiliation, suicide risk may be sharply elevated.


Basically, suicide risk increases dramatically with multiple successive losses, co-morbidity of illnesses, acute environmental stressors, and anytime the consumer begins to feel he or she is becoming a burden on others or care providers.  If in doubt, reassess!


The QPR Institute ( provides Online Advanced Suicide Prevention Courses for a wide range of professionals includingMental health professionals, school counselors, crisis line workers, substance abuse professionals, EMS/firefighters, law enforcement, primary care providers, nurses and correctional workers. For more information please visit our full library of advanced courses!

Paul Quinnett, PhD., Founder & CEO QPR Institute,


relationships, friendships | Self-Care | Social Work | Suicide Bereavement | Suicide Prevention | Treatment Modalities

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