Suicide Risk Assessment: Myth and Reality

M. Large; C. Ryan


Int J Clin Pract. 2014;68(6):679-681. 

In This Article


To be, or not to be, that is the question –
Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And by opposing end them? To die, to sleep;…
Hamlet, III i

Hamlet's soliloquy is surely the most famous expression of suicidal ideation in English literature. However, by the end of the play, it is not Hamlet, but Ophelia who has taken her own life, even though she gave no prior hint of self-destruction.

Most clinicians appear to regard the presence or absence of suicidal ideation as a crucial sign in making some estimate of a patient's likelihood of future suicide. In this editorial, we challenge this notion and two related myths of suicide risk assessment: that gathering more information can meaningfully improve a suicide risk assessment; and that classifying patients into groups at higher or lower risk of suicide can provide a useful guide to the use of interventions that are aimed at preventing suicide.