Lesson 4 Risk Assessment

Many persons affected by mental health problems are at risk of self-harm or suicide.

Risk factors for suicide are:




Previous suicide attempt

Adverse childhood experiences such as child abuse and deglect 

Barriers to health care

Mental illness, such as depression


Cultural and religious beliefs such as a belief that suicide is noble resolution of a personal problem

Social isolation

Familiy history of suicide

Suicide cluster in the community

Criminal and/ or financial problems

Relationshio problems such as a breap- up, violence or loss

Substance abuse

Sexual violence

Impulsive or aggressive tendencies                                                                                   

Job problems or loss

Legal problems

Serious illness

Warning signs for suicide may be:


  • If a person talks about:


  • behaviours that may signal risk, especially if related to a painful event, loss or change:


  • people who are considering suicide often display one or more of the following moods:

Killing themselves

Increased use of alcohol or drugs


Feeling hopeless            

Looking for a way to ent their lives, such as searching online for methods


Having no reason to live                                                            

Withdrawing from activities

Loss of interest

Being a burden to others    

Isolating from family and friends


Feeling trapped

Sleeping too much or too little

Humiliation/ Shame

Unbearable pain

Visiting or calling people to say goodbye

Agitation/ Anger

Giving away prized possessions

Relief/ sudden Improvement



  • Coping and problem-solving skills
  • Cultural and religious beliefs that discourage suicide
  • Connections to friends, family, and community support
  • Supportive relationships with care providers
  • Availability of physical and mental health care
  • Limited access to lethal means among people at risk

Self-injurious behavior is a common symptom of mental health problems. Self-injury is primarily used to relieve tension and to feel oneself again. Because the consequences of self-injury are harmful and the intensity of self-harm can increase, it is a danger and a symptom that should be taken seriously.

There are alternative ways to deal with tension, so called “skills” are tested in therapy and applied in tension situations. Skills are mostly focused on perception and especially address the senses with strong stimuli. Skills can be, for example, eating a chili pepper, touching a sharp object or a strong smell. The skill training was developed as an intervention for borderline disorders. Medication can also be used to reduce tension.