DCIB Suicide Risk Assessment

Introduction

The DCIB Suicide Risk Assessment follows the new standards of the National Suicide Prevention Lifeline (Joiner, et. al., 2007). The result of the research and expert consensus was the following core principles and subcomponents, listed below. If you prefer to watch, you can see a video below.

Components of the DCIB Risk Assessment

Suicidal Desire

• Suicidal Ideation (Desire to kill self/others)
• Psychological Pain
• Hopelessness
• Helplessness
• Perceived Burden on Others
• Feeling Trapped
• Feeling Intolerably Alone

Suicidal Capability

• History of Suicide Attempts
• Exposure to Someone Else’s Death by Suicide
• History of/Current Violence to Others
• Available Means of Killing Self
• Currently Intoxicated
• Substance Abuse
• Acute Symptoms of Mental Illness (e.g. recent dramatic change in mood, out of touch with reality)
• Extreme Agitation (Increased anxiety, decreased sleep)

Suicidal Intent

• Attempt in Progress
• Plan to Kill Self/Other (method known)
• Preparatory Behaviour
• Expressed Intent to Die

Buffers/Connectedness

• Immediate Supports
• Social Supports
• Planning for the Future
• Engagement with Helper
• Ambivalence for Living/Dying
• Core Values/Beliefs
• Sense of Purpose

Example of DCIB Assessment

One suicide risk assessment example using the DCIB Standard comes from the Hospital Association of Southern California (HASC) and has also been adopted by the iCarol helpline management software. In the HASC example specific, concrete elements are given to determine the Low, Moderate or High Risk for each element.

Scoring the DCIB Assessment

If the majority of the elements in each category (Desire, Capability, Intent or Desire) are Moderate or High, the element is scored as present. The HASC example of the DCIB Risk Assessment is scored on the following 5-point scale:

• 5 – Suicide Attempt in Progress of Imminent
• 4 – Desire/Capability/Intent ALL Present regardless of buffers
• 4 – Desire/Intent or Desire/Capability with few/no buffers
• 3 – Desire/Intent or Desire/Capability or Capability/Intent with many buffers
• 3 – Capability alone / Intent alone with many buffers
• 2/1 – Desire alone, many buffers
• 0 – No  Desire, Capability or Intent

Bibliography

Joiner, T., Kalafat, J., Draper, J., Stokes, H., Knudson, M., Berman, A.L., McKeon, R. (2007) Establishing Standards for the Assessment of Suicide Risk Among Callers to the National Suicide Prevention Lifeline. Suicide and Life Threatening Behaviour. 37(3). 353-365