Suicide risk assessment

In suicide risk assessment one of the factors that is commonly reviewed is what high risk behaviour does the individual engage in. If the person repeatedly engages in in high risk behaviour then that can indicate some degree of suicidal intent particularly with the two suicide decisions of

“I will kill myself by accident”

or

“I will get you to kill me”

In high risk behaviour often drug use is considered. However this is a problematic concept to consider because it is a highly politicised area and it is also an area where people can very easily respond to from their Parent ego state. Some have strong opinions about drugs and drug use and these they can at times mistake as being based on fact when it is opinion.

Risky?

If one is wanting to do a suicide risk assessment one needs to be very clear about the facts of the risk, not the politics or opinions about drug use risk. If not then one is going to make more faulty judgements about the suicide risk level for a person which obviously is a very undesirable thing.

The Australian Psychological Society in its position statement on drug use is clear that decisions about which drugs should be legal and illegal drugs are mainly political decisions not decisions based on health. This creates a problem for governments in that it has to pretend to the public that it is making a decision based on health and not for political expediency.

A good example of this comes with party drugs like ecstasy. When a young girl dies by overdose of ecstasy at a dance party it often is highly publicised and the face of a young girl gets shown over and over in the press. At the same time one hears public statements by police and senior health department officials. They will state that such drugs are risky because they are made in backyard laboratories with no control over what goes in them.

This is the truth, but not the whole truth. Thus we get the government spin on the risks of drug use, something that the suicide risk assessor must avoid. What they do not say is that the risk of taking ecstasy involves the same level of risk as getting on a plane and having it blown up by terrorists. It is low risk but the government can not let this be said.

However in my studies of this area I came across a very interesting risk assessment model developed by two academics at a London university. They have developed the following risk assessment model. These are based on UK annual mortality rates, so one could assume they would be relatively similar to countries like Australia and the United States.

Extremely high

Russian roulette.

Very high risk

Tobacco, methadone, injecting drug use, BASE jumping, grand prix racing, cancer, heart disease, space travel

Quite high

Heroin, Morphine, barbiturates, alcohol, hang gliding, parachuting, motorbike racing, sudden infant death, working in mining, Asbestos, strokes, prostrate cancer, shaking of babies, off shore oil work

Medium

Solvents, benzodiazepines, motor sports, water sports canoeing, diabetes, skin cancer, influenza, suicide, giving birth, helicopter travel. liposuction. working in farming, being in police custody, working in construction

Quite low

Ecstasy. MDMA, speed, cocaine, contraception pill, GBH, fighting sports, snow sports soccer & rugby, Asthma, AIDS. meningitis, cervical cancer, food poisoning, air travel, being murdered, chocking on food, electrocution, drowning, passive smoking, factory work

Very low

LSD, magic mushrooms, viagra, fair ground rides, swimming, riding sports, food allergies, syphilis, malaria, appendicitis, pedestrian crossings, clothes catching fire, falling out of bed, vaccination, abortion, storms, terrorism

Beauty

Extremely low

Marijuana, cannabis resin, indoor sports, playgrounds, peanut allergy, measles, insect stings, copulation, starvation, dogs, lightening, nuclear radiation, police shootings

Negligible

Caffeine, nitrous oxide, ketamine, computer games, masturbation, small pox, leprosy, sharks, UFOs, cats, meteorites, executions, volcanoes

Thus if a government was to make high risk or more lethal drugs illegal and the low risk drugs legal, like they claim to be, them one would see some significant legislative changes indeed! (And please don’t mention to me about marijuana induced psychosis as the science on it is very dodgy at best, see the blog postings on my website. Another major area of government spin)

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