Last reviewed: 29 Dec 2021
Last updated: 08 Dec 2020



History and exam

Key diagnostic factors

  • current suicidal intent
  • access to lethal means
  • risk factors

Risk factors

  • current suicidal plan
  • self-harm
  • history of mental illness, including substance misuse
  • availability of lethal means
  • history of childhood abuse or neglect
  • family history of death by suicide
  • male sex
  • prison inmate
  • family history of psychiatric illness
  • physical illness
  • marital status (divorced, single, widowed)
  • professions/occupations (unemployed, self-employed, agricultural workers, medical and dental professionals)
  • psychosocial stressors

Diagnostic investigations

Treatment algorithm


Expert advisers

Alys Cole-King, MB, BCh, DGM, MSc, FRCPsych

Consultant Liaison Psychiatrist

Liaison Team

Glan Clwyd Hospital

Betsi Cadwaladr Health Board

St Asaph





ACK is an employee and director of 4Mental Health and, in this capacity, has received funding for designing and delivering training. ACK is an author of references cited in this topic.

Alice Oates,

ST6 General Adult Psychiatry

South London and Maudsley NHS Foundation Trust




AO declares that she has no competing interests.


BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Angharad de Cates, BMBCh, BA Hons (Oxon), MSc (Warw), MRCPsych

Wellcome Trust Clinical Doctoral Fellow

Department of Psychiatry

University of Oxford

Warneford Hospital

Honorary Clinical Fellow Oxford Health NHS Foundation Trust



Disclosures: AdeC is in receipt of a clinical doctoral training fellowship from the Wellcome Trust (since October 2018) and a travel fellowship from the Royal College of Psychiatrists/Gatsby Foundation. All are external bodies that fund research into and/or release information that includes suicide prevention.

Peer reviewers

Peter Aitken, MB ChB

Director of Research & Development

Devon Partnership NHS Trust

Honorary Associate Professor

University of Exeter Medical School




PA is Clinical Lead for the NHS SW Strategic Clinical Network, and Trust Lead for Suicide Prevention, Devon Partnership NHS Trust. He is a also a trustee of the Lions Barber Collective Charity and chair of the Royal National Lifeboat Institution Medical Committee.


Annabel Sidwell,

Section Editor, BMJ Best Practice


AS declares that she has no competing interests.

Susan Mayor,

Lead Section Editor, BMJ Best Practice


SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Rachel Wheeler,

Lead Section Editor, BMJ Best Practice


RW declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice


AM declares that he has no competing interests.

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