Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) offers a straightforward framework for evaluating a patient for suicide risk. It was conceived by Dr Douglas Jacobs with work done by Screening for Mental Health Inc and the Suicide Prevention Resource Center.
5 Steps:
(1) identify risk factors (history of suicidal behavior, psychiatric disorders, alcohol or substance abuse, family history, triggering events, medical illness, change in treatment, access to lethal means)
(2) identify protective factors (ability to cope with stress, religious beliefs, frustration tolerance, social supports, feeling of responsibility, positive therapeutic relationships)
(3) ask about suicidal thoughts, plans, behavior and intent
(4) determine risk level (low, moderate, high) and need for intervention
(5) document the assessment of risk, rationale, intervention and follow-up.
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Status
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Suicide Risk Level
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no plan to commit suicide, no intent or behavior, strong protective factors
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low
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suicidal ideation with plan but no intent or behavior; multiple risk factors and few protective ones
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moderate
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persistent ideation with strong intent or suicide rehearsal; potentially lethal suicide attempt; multiple risk factors
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high
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