Use of risk assessment tools by counsellors and psychotherapists
In 2022 the NICE clinical guidelines were updated following a review process, the new guidelines and who and what they relate to can be found here on the NICE website. Helpful guidance and application advice is also available on the NICE website under resources.
The research underpinning the NICE guidelines also underpin the Suicide Strategies of Scotland and Northern Ireland, the recommendations are the same across the UK.
The guidelines are based on research showing that comprehensive, client-centred risk assessment formulation and safety planning is more effective in preventing suicide than the use of risk assessment tools, so these assessment tools should not be used to determine risk of suicide or repetition of self-harm. They should not be used to categorise service users into 'low', 'medium' or 'high' risk, or to decide who gets, or is prioritised, for services. The guidance doesn't state or recommend the cessation of assessment tools in other aspects of therapy and counselling just in reference to risk management and provision of service.
1.6 Risk assessment tools and scales
The following information is taken from the NICE guidelines section about recommendations, risk assessment tools and scales.
1.6.1 Do not use risk assessment tools and scales to predict future suicide or repetition of self-harm.
1.6.2 Do not use risk assessment tools and scales to determine who should and should not be offered treatment or who should be discharged.
1.6.3 Do not use global risk stratification into low, medium or high risk to predict future suicide or repetition of self-harm.
1.6.4 Do not use global risk stratification into low, medium or high risk to determine who should be offered treatment or who should be discharged.
1.6.5 Focus the assessment (see the section on principles for assessment and care by healthcare professionals and social care practitioners) on the person's needs and how to support their immediate and long-term psychological and physical safety.
1.6.6 Mental health professionals should undertake a risk formulation as part of every psychosocial assessment.
Working with suicidal risk
Evidence shows that counselling people who are suicidal can be an important and effective way of offering support and helping them make sense of their feelings. Considering the therapeutic process around working with suicidal risk is a critical consideration for every practitioner.
Balancing client safety and confidentiality
Working ethically around risk in counselling and psychotherapy is an imperative. These resources consider how we might respond to suicidal risk, ethically balancing the safety of the client alongside their autonomy and right to confidentiality.
Strategies for self-care
Working with suicidal potential can challenge even the most experienced practitioner, and research shows how demanding such work can be on the mental health of the counsellor. These resources offer thoughts and ideas about strategies for self-care, to support practitioner wellbeing and ensure best practice for the client.
General BACP journal articles
Scroll to the article: Shades of meaning, Thresholds, July 2024.
Scroll to the article: Roots exposed, University and College Counselling, May 2024
BACP events
For more information...
This is just a small selection of our content. To see more, search the BACP website for suicide-related resources.
World Suicide Prevention Day is organised every year by the International Association for Suicide Prevention (IASP). It aims to provide the opportunity for people, across the globe, to raise awareness of suicide and suicide prevention.
If you have any comments or feedback on this page, please email communications@bacp.co.uk.