Sunday, January 10, 2010

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”


“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.


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


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


Extremely low

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


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)



  1. Yeah, I guess death is quite a scary topic. Especially when it comes to the toxins we use to kill ourselves every day. Perhaps it's far easier to pretend that we don't know the truth - that our actions do carry consequences and that some of those consequences may not be nice ones.

    Because a lot of the things on the list are the type of things that one has no power over at all (ie... Meteroites, volcanoes, umm... UFO's), it makes one wonder why we aren't asked to give permission before we're born as to whether we want to be born or not.

    Umm, yeah... that didn't make much sense did it? It just popped into my head and i wrote it down. If we were talking (you know... just chatting or something) I probably would have said it out loud, so i left it here because once it's out, it can never be 'unsaid'. A wise psychotherapist once told me that. Well, I think it was you who said it - can't remember now.

    I'm a little bit wound up tonight so i'm just raving. Hate that, don't you? Well, i'll probably never find out anyway so what the heck *shrugs*.

    For some insane reason i've chewed off all my finger nails again. Eww! I dare not go to bed and just ly there tossing and turning - that will just make it worse i suppose. Don't you just hate when that happens? I do.

    We went to Canberra today. Man it was hot! Well, not as hot as some places I guess. Met a lady in Macca's who had been to the 'summer nat' (a car show type thing) in the ACT who came from Adelaide. We were only sitting in 37 degree heat and if she went home today, she would have to face 45 or so heat.

    While we were coming home, i told my hubby that i'd met here and some of what she chatted about while we were waiting for our coffee's to me made, and something occurred to me. Once the weather gets hot, it hot. Like if i turn on the bbq so that it is hot enough to cook something, then its hot and if you touch the plate and burn yourself it will hurt regardless of how hot the plate is. A burn is a burn - don't you think?

    So 35 degrees or 40 degrees - hot is hot and it's hot no matter what. Does that make sense? I think it does - well it did in the car on the way home anyway.

    I just had - well about an hour ago - a lovely salad. That's lovely isn't it? Yes, it is (just incase you didn't know).

    Its dark and i can hear the washing machine emptying the washing cycle - water makes the weirdest sound doesn't it? I love it when lying in bed while it's raining though. We (in this house now) some down pipes that make the loudest plopping sounds when it rains. Like dripping water only from a great height. Well, it is from a great height so that's probably why it sounds like it's falling from a great height... because it is...


    Ok then.

    I need to have a shower before i go to bed though. I might watch a movie or something to bore me to sleep. Every watched 'surf's up'? So cute!! Ohh, that's probably not boring enought. Bumma!


    Maybe i'll watch an interesting movie so that i'll have to fight off sleep in order to stay awake to watch it to the end and finally i won't beable to stay awake and while i roll over to go to sleep i'll just absent mindedly turn off the telly. Sounds like a plan! Yep.

    Problem is... i can't delete this comment after i press the 'post comment' button...

    Quite frankly i couldn't give a stuff.

    Yeah... i'm angry. Yeah, i assume you know it.

    Yeah - i'm going to bed to give the movie plan a go. Wouldn't it be nice if it worked?

    By the way... the answer to that question would be 'yes'. Well, the answer I want to hear would be 'yes'. Well, I think it is.

    Better leave you alone for now then. Nighty night Mr Graffiti. See you some time.

    Over and out... roses

  2. Well that wasa good comment Roses.
    As I said before I like the angry Roses.

    Excessive nail biting certainly is a form of self harm Roses, so maybe we can add self harmer to your list.

    Have a good night


  3. Very interesting. Three of my phobias are air travel, drowning and choking on food, and those are apparently all a very low risk. Same as playing rugby, which I have never played but I wouldn't be afraid to play. Although I would feel better if they were considered extremely low rather than quite low.

    And I would be terrified of a helicopter ride, but it holds the same risk as childbirth, which I have been through twice and lived to tell about it.

    And being a farmer has the same risk as skin cancer? What if one is a farmer with skin cancer?

    So if marijuana is illegal, perhaps playgrounds and dogs should be also. Oh the possibilities!

  4. Hi Harriet. I love going in helicopters. Don't do it all that often but it is exciting. And you are right those farmers need to watch out. Those dogs and cats are deadly things!

    Drowning and choking on food they say are 1 in 100,000 chance, so if the US has 300 million people that means this year 3,000 will die from choking on food. I am sure you will be fine.


  5. Wow! Bitting nails would have to be the least painful 'self harm' there is then. You must be pulling my leg. If you don't mind me saying, I think if you pull my other leg, it plays advance australia fair - little bit of info there... like you'd need more info.

    I did the washing this morning and decided to sit out the back on the verandah and read (usually i read on the front verandah). It was a good idea. The verandah was very co-operative as was the chair and book. I co-operated too... by sitting and reading of course!

    Hubby went fishing with some other guys so i had the morning to myself. It was nice. Supposed to go and scrub walls but i figure the walls will be there tomorrow, unless the house burns down or something like that, no more walls to scrub! Yay! Sometimes my imagination can be by greatest friend.

    Thank you imagination - that was lovely. I really appreciate you. (Wouldn't want to take my imagination for granted now would I? The answer to that question is 'no' - just incase you were wondering)

    So... then when i got home again - oops, missed abit of info there. Got a call to drive out and take some stuff to hubby and so dropped everything and went (as you do), but when i arrived home, the washing was on the line. Yeah, the 'washing hanging out fairies' called by. They're such good value don't you think? (Its'yes' - 'yes' is the answer for that one.)

    You are going to do so well with the exam - i've been giving you all the answers to the questions.

    1) I don't think that nail biting is self harm. and 2) I've never been in a helichopper - yes, i know i spelled it wrong, it's supposed to be cute, used to make the kids giggle. But you're not a kid are you. Hmm, you can't pretend can you? Imagination can be fun you know.

    Have to go again - not so angry today - don't know why.

    Who even cares! Sheesh!

    Happy day to you...

  6. informative and nice...

    good luck with the book thing..i tried to make that diagram you...but it did not come out good!

  7. Yes Roses you seem less angry today, maybe it was doing all that washing.

    It depends how much you bite your nails Roses. If it gets to be quite painful or causes bleeding then maybe it is getting close to self harm.

    Have a good day


  8. It is progressing quite well Shraddha and is over half done. I anticipate a couple of more months to completion. The contract says it has to be done by October 31st but it will be done long before that.

    Thanks for trying the diagram. It is proving a difficult thing to get but I will keep trying



  9. I dont think I quite got this post G.

    Are you saying someone who has cancer is of higher risk of suicide than someone who has leprosy?


  10. You are right Kahless that does not seem to be what I am saying.

    What it is saying. In the UK
    1 in 10,000 die of skin cancer
    1 in 100,000,000 die of lerosy
    1 in 10,000 die by suicide

    I am sure 2010 will will be good one for smokers


  11. People just die it seems. Not everyone engaging in risky behaviours wish to die. Nor do they have an unconscious desire to die or get killed in some manner.They are just driving along one day and BAM!

    If a person has had a few heart attacks and they are over weight and not addressing their concerns then I can see that could be death by avoidence.

    Perhaps the dead person will be then be recognised for all their good points at their funeral? The desire for post humous strokes is one benefit of death by misadventure/accident or avoidance.

    One would think its easy to accept the strokes while one is alive?


  12. Kenoath what heresy!!!

    We are Transactional analysts!

    No one ever does anything with out some kind of unconscious motivation whether that be smoking cigarettes, drving cars fast, dying or even being born.


  13. That is Funny. I was always a rebel Tony. There are a few myths going around and one of them is that there is a reason for everything. Maybe I will email Mythbusters.