A printable version of the Risk Assessment Guide is available here:
This risk assessment guide is from the Mental Health in South Australia Emergency Management Policy and Procedure Series (2002) that is used by staff in mental health services. It forms part of the risk assessment, referral and follow up form developed for private practitioners.
|Risk of harm to: Self Others Both|
| None|| Low|| Moderate|| Significant|| Extreme|
|No thoughts or action of harm||Fleeting thoughts of harming themselves or harming others but no plans, current low alcohol or drug use.||Current thoughts/distress, past actions without intent or plans, moderate alcohol or drug use.||Current thoughts/past impulsive actions/recent impulsivity/some plans, but not well developed. Increased alcohol or drug use.||Current thoughts with expressed intentions/past history/plans. Unstable mental illness. High alcohol or drug use, intoxicated, violent to self/others, means at hand for harm to self/others|
|Level of problem with functioning|
| None/mild|| Moderate|| Significant impairment in one area|| Serious impairment in several areas|| Extreme impairment|
|No more than everyday problems/slight impairment when distressed.||Moderate difficulty in social, occupational or school functioning. Reduced ability to cope unassisted.||Significant impairment in either social, occupational or school functioning.||Serious impairment in several areas such as social, occupational or school functioning.||Inability to function in almost all areas.|
|Level of support available|
| No problems/highly supportive|| Moderately supportive|| Limited support|| Minimal|| No support in all areas|
|Most aspects are highly supportive. Effective involvement of self, family or professional.||Variety of support available and able to help in times of need.||Few sources of help, support system has incomplete ability to participate in treatment.||Few sources of support and not motivated.||No support available.|
|History of response to treatment|
| No problem/minimal difficulties|| Moderate response|| Poor response|| Minimal response|| No response|
|Most forms of treatment have been successful or new client.||Some responses in the medium term to highly structured interventions.||Minimal response even in highly structured interventions.||Minimal response even in highly structured interventions.||No response to any treatment in the past.|
|Attitude and engagement to treatment|
| No problem/very constructive|| Moderate response|| Poor engagament|| Minimal response|| No response|
|Accepts illness and agrees with treatment, or new client.||Variable/ambivalent response to treatment.||Rarely accepts diagnosis.||Client never cooperates willingly.||Client has only been able to be treated in an involuntary capacity.|
Is the person’s risk level changeable?
Highly changeable Yes No
Are there factors that indicate a level of uncertainty in this risk assessment? (Eg. Poor engagement, gaps or conflicting information?)
Low Assessment Confidence Yes No
Note: Risk assessment is not a precise ‘science’. Your professional judgement and experience are also crucial. Remember too, that a person’s risk of suicide may be highly changeable, fluctuating at different times and in response to certain events.