Clinical Utility of Suicide Behavior and Ideation Measures: Implications for Military Suicide Risk Assessment

To date, the field has been unable to provide a definitive answer on which suicide risk assessment measure or set of measures is most useful in applied clinical settings. This study pits several psychometrically sound suicide risk assessment measures against one another, to determine which tool optimally assesses the likelihood of future suicide-related outcomes over a 3-month period, in a large sample of military personnel seeking and/or referred to services due to suicide risk concerns. The risk assessment measures were (a) Columbia-Suicide Severity Rating Scale; (b) Self-Harm Behavior Questionnaire; (c) Suicidal Behaviors Questionnaire-Revised; and (d) Beck Scale for Suicide Ideation. A total of 1,044 suicidal military service members completed baseline assessments, of whom 758 (72.6%) completed 3-month follow-up assessments. The data indicate that there is no best measure for suicide risk assessment and clinicians are therefore encouraged to select the measure, from among the four studied, for use in regular practice that best suits the demands of their setting. Public Significance Statement This study looked at four widely used suicide risk assessment measures in a large sample of active duty U.S. service members identified through typical screening approaches to be at higher risk of suicide. It was determined that no measure is superior to any other, and that clinicians can rely on whichever of the four tools they prefer when caring for at-risk for suicide service members.