CLINICAL-EVALUATION OF SUICIDE RISK

Suicide risk assessment may well be the most complex clinical task tha t mental health professionals face. Tests have shown to be of little u se. To confront this complexity, assessment and prediction are best se en as interwoven with understanding suicide, a multi-dimensional malai se. With the essential concepts of lethality and perturbation, a clini cal theory of suicide is presented. Intrapsychic aspects (i.e., unbear able psychological pain, cognitive constriction, indirect expressions, inability to adjust, and ego) as well as interpersonal aspects (i.e., interpersonal relations, rejection-aggression, identification-egressi on), are outlined to aid in assessment. Transference and countertransf erence issues in assessment are noted. A case illustration to aid in c linical insight is provided. It is concluded that all assessment and p rediction of suicide risk ultimately depends on the skill of the clini cian.