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For each risk factor found, score the patient with one point. If the patient scores from 1 to 4, he or she is low risk. If the patient scores from 5 to 10, the patient is high-risk for suicide, and you should strongly consider hospitalization.

SAD PERSONS is just one of many suicide screening toolkits available. No one screening tool can indicate future suicide attempts or completions, and while useful in detecting suicide risk, these tools cannot be substituted for a thoughtful, clinical evaluation. Hospitals may differ in their recommendations, and different patients may warrant specific tools depending on their age, sex, and culture.

Remember the general risk factors we spoke about earlier? You should ask specifically about any of these risk factors in addition to the SAD PERSONS' risk factors because SAD PERSONS does not specifically cover them, and they're equally important. These factors are:

• A history of psychiatric illness
• A family history of suicide or psychiatric illness
• Chronic illness or chronic pain
• Social stressors, like unemployment or financial loss, that lead to a sense of worthlessness
• Substance abuse
• Tendency toward impulsive behavior, and,
• The recent death of a loved one.

Additionally, keep in mind that when screening patients, if they indicate suicidal thoughts, you can be direct in asking about thoughts of hurting themselves. If you've gained their trust and they are at-risk, they may confide in you. As you continue to practice these types of screenings, your experience and intuition will help identify at-risk patients.