This site is intended for health professionals only

Suicide risk scale is flawed, researchers claim

The SADPERSONS Scale, used to determine suicide risk in patients who have self harmed should be ditched, a study has suggested. 

The technique, which uses ten yes or no answers, fails to identify who should be admitted to a psychiatric unit or community psychiatric aftercare, researchers discovered. 

Researchers from the Centre for Suicide Research at Warneford Hospital recorded SADPERSONS scores for 126 admissions to a general hospital emergency department. Outcomes including psychiatric hospital admission, community psychiatric aftercare and repetition of self-harm were then recorded for the following six months. 

Admission to a psychiatric unit was required in five cases (4%) and community psychiatric aftercare in just over half (55%). One in four patients (24.6%) self harmed again at least once

The SADPERSONS Scale only picked up 2% of those requiring admission to a psychiatric unit, around 6% of those needing community psychiatric aftercare, and just over 6.5% of those likely to self harm again.

However, the researchers did point out that the small number of patients in the survey “don't allow any conclusions to be drawn about the Scale's usefulness in predicting suicide risk”. 

Lead author, Professor Keith Hawton said: “Arguably, our results show that reliance on the scale for determining who should receive a psychosocial assessment or otherwise using it for prediction is not only misleading, it could be dangerous. 

“A greater focus on clinical judgement is needed, accompanied by the necessary education, training and supervision, if we are to more accurately fully identify and intervene with those who are at greatest risk following self harm.”

A synopsis of the study is available on the Emergency Medical Journal website, with the full study behind a paywall.