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Let's talk about how you would use a screening toolkit for quantifying suicide risk. "SAD PERSONS" is a mnemonic to help you remember ten of the most common topics to cover in a suicide screening. Results of this screening will help to determine if the patient is at low to no risk or if the patient is at high risk for suicide.

S. Sex: Though women make three times as many suicide attempts as men, men are more likely to actually die by suicide than women are. Men tend to use impulsive suicide means that are lethal, such as firearms, whereas women often use less lethal means, like poison. Therefore, being male increases suicide risk.

A. Age: Suicide risk peaks in the teenage and elderly years. Most recent statistics indicate that patients most at risk for suicide are under 25 years of age or above 65 years old.

D. Depression: Depression can be a good predictor of suicide risk, specifically when it's associated with feelings of helplessness or hopelessness, significant agitation and anxiety, a loss of interest in activities that used to be pleasurable, and an inability to concentrate.

P. Previous attempt: 25%-50% of people who kill themselves have previously attempted to do so. So, a prior suicide attempt is a risk factor for suicide.

E. Ethanol abuse: Excessive use of alcohol or drugs, (including misuse of prescription medications or use of alcohol in conjunction with medications), increases suicide risk. Approximately 40% of individuals seeking treatment for an alcohol use disorder report having attempted suicide at least once. And as many as 35% of all completed suicides are carried out by alcohol-dependent individuals.

R. Rational thinking loss: If rational thought is impaired, suicide risk increases. This includes psychosis, delusions, and hallucinations, especially command auditory hallucinations telling patients to kill themselves.

S. Social support lacking: Lack of social support, such as a significant other, relatives, friends, religion/faith, or employment, is a risk factor for suicide. Risk is lowered when one or more of these supports are in place; when a patient lacks ALL of these supports, you should be concerned.

O. Organized plan: Having an organized plan and means to carry out the attempt is a risk factor for suicide. Patients should be asked if they have a plan in place and if they have access to the means necessary to carry out the plan. Additional means should also be assessed; in particular, access to highly lethal means such as firearms or supplies of pills, even if patient's stated plan does not include these means or if they do not have a definite plan. Patients who have rehearsed their plan are at higher risk; for example, patients may have practiced putting a gun to their head.

N. No spouse: Separated, divorced, or widowed patients with no significant other are at a higher risk for suicide.

S. Sickness: Chronic disease or pain, or severe sickness increases suicide risk. High-risk patients may sometimes seek medical attention just before carrying out their suicidal act.