The nursing diagnosis Risk for Suicide is one of the most urgent and critical diagnoses in psychiatric and mental health nursing. Suicide is a multifactorial issue influenced by psychological, biological, social, and environmental factors. According to the World Health Organization (WHO), suicide is among the leading causes of death worldwide, with more than 700,000 deaths annually. Nurses, especially in emergency departments, mental health units, and primary care settings, are often the first healthcare providers to recognize signs of suicidal risk. Their role is essential in assessment, prevention, intervention, and patient safety monitoring.
This extended article provides an in-depth exploration of the nursing diagnosis Risk for Suicide, including risk factors, assessment cues, evidence-based interventions, expected outcomes, and a complete NANDA–NIC–NOC table. The goal is to support nursing students and clinicians in understanding how to apply this diagnosis in real clinical settings.
Definition (NANDA-I)
Risk for Suicide: “At risk for self-inflicted, life-threatening injury.”
This diagnosis focuses on vulnerability rather than actual suicidal behavior. Early identification ensures timely and life-saving intervention.
Risk Factors (Etiological Factors)
Risk factors do not directly cause suicide but significantly increase vulnerability. They include biological, psychological, environmental, and social factors.
- Mental disorders – depression, bipolar disorder, schizophrenia, PTSD.
- Previous suicide attempts – strongest predictor of future attempts.
- Substance use – alcohol, opioids, recreational drugs.
- Hopelessness and helplessness.
- Chronic pain or terminal illness.
- Impulsivity or aggression.
- Family history of suicide.
- Job loss, financial problems, homelessness.
- Relationship conflicts or social isolation.
- Trauma history including abuse or violence.
The nurse should evaluate risk within the patient’s context, considering cultural, social, and personal background.
Assessment Focus
Nurses must conduct a thorough and empathetic assessment, observing verbal expressions, emotional responses, behaviors, and environmental risks.
1. Verbal Indicators
- “I wish I could disappear.”
- “Life is pointless.”
- “I’m a burden to everyone.”
2. Behavioral Indicators
- Withdrawal from social interactions.
- Giving away personal belongings.
- Writing goodbye letters or searching suicide methods online.
- Increased substance use.
3. Emotional Indicators
- Severe anxiety or agitation.
- Hopelessness, guilt, or shame.
- Sudden mood improvement after deep depression.
4. Environmental Indicators
- Access to weapons.
- Unsupportive or violent household.
- Recent major loss or crisis.
Nursing Outcomes (NOC)
Expected outcomes for patients at risk for suicide focus on immediate safety, emotional stabilization, and development of coping mechanisms.
- Suicide Self-Restraint – patient refrains from self-harm.
- Emotional Control – patient identifies and verbalizes feelings.
- Coping Strategies – patient demonstrates healthy coping skills.
- Anxiety Level – reduced tension and worry.
- Social Support – patient identifies support systems.
Nursing Interventions (NIC) with Rationales
The following interventions are evidence-based and widely used in psychiatric nursing practice.
1. Suicide Prevention
- Implement constant observation to ensure safety.
Rationale: Continuous monitoring reduces the chance of self-harm. - Remove potentially harmful objects.
Rationale: Restricting access decreases the ability to act on impulses.
2. Safety Enhancement
- Place patient in a room close to nurses’ station.
Rationale: Improves visibility and rapid response time. - Use safe, non-punitive precautions.
Rationale: Supports dignity while maintaining safety.
3. Active Listening
- Allow patient to express feelings openly.
Rationale: Verbalization reduces internal tension. - Use non-judgmental communication.
Rationale: Builds trust and therapeutic alliance.
4. Cognitive Behavioral Interventions
- Identify negative thinking patterns.
Rationale: Helps restructure harmful thoughts. - Teach coping strategies.
Rationale: Strengthens emotional resilience.
5. Medication Management
- Administer antidepressants or mood stabilizers as prescribed.
Rationale: Stabilizes mood and reduces suicidal ideation. - Monitor for early SSRI side effects.
Rationale: Early improvement in energy may increase risk.
6. Family Involvement
- Educate family about signs of suicide risk.
Rationale: Family plays a key role in long-term prevention. - Encourage supportive interactions.
Rationale: Social connection protects against suicide.
7. Safety Planning
- Assist patient in creating a written safety plan.
Rationale: Provides immediate steps during crisis. - Include hotline and emergency contacts.
Rationale: Ensures rapid access to help.
NANDA – NIC – NOC Table (Complete)
| NANDA Diagnosis | NOC Outcomes | NIC Interventions | Rationales |
|---|---|---|---|
| Risk for Suicide At risk for self-inflicted, life-threatening injury. |
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|
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Ethical Considerations
Nurses must maintain patient dignity, confidentiality, and cultural sensitivity while ensuring safety. Documentation must be clear, timely, and accurate. Mandatory reporting applies when the patient’s safety is at risk.
Conclusion
The nursing diagnosis Risk for Suicide requires immediate attention, skilled assessment, and evidence-based intervention. Nurses play a life-saving role in suicide prevention through risk identification, therapeutic communication, continuous monitoring, and collaboration with interdisciplinary teams. With proper training and effective nursing care, the likelihood of suicide can be significantly reduced, and patients can be guided toward safety, stability, and recovery.
References
- NANDA International. (2021–2023). NANDA International Nursing Diagnoses: Definitions and Classification.
- World Health Organization (WHO). Suicide data and prevention resources. https://www.who.int
- American Psychiatric Association. (2022). Practice Guideline for the Assessment and Treatment of Patients With Suicidal Behaviors.
- SAMHSA (Substance Abuse and Mental Health Services Administration). National Suicide Prevention Resources.
- Columbia University. Columbia-Suicide Severity Rating Scale (C-SSRS).
- Stanley, B., & Brown, G. K. (2012). Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk.
