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Prevention-Oriented Risk Formulation

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Suicide Risk Assessment and Prevention

Abstract

In this chapter, we review the background to prevention-oriented risk formulation Pisani et al., Acad Psychiatry 40(4):1–7, 2016 and provide updates about its implementation. Section “The Background: From Prediction to Prevention” begins with a critical examination of traditional approaches to suicide risk assessment which seek to stratify those at risk into categories based on likelihood of future suicidal behavior. Responding to the limitations of such approaches, we set out the criteria for a clinically useful “prevention-oriented” approach. Section “Prevention-Oriented Risk Formulation” outlines a framework for prevention-oriented risk formulation, originally published by Pisani et al. Acad Psychiatry 40(4):1–7, 2016, which seeks to meet these criteria. Since its publication, this framework has gained increasing traction in clinical settings around the world. Section “Updates and Modifications” examines what we have learned from the different contexts in which the model has been applied and how we have modified the model itself and methods for teaching it. Section “Prevention-Oriented Risk Assessment for Violence” then turns to the case for applying prevention-oriented risk formulation to risks other than suicide. Starting with a review of the science concerning co-occurrence of different types of risk, we argue that a unified approach to risk formulation may provide deeper insights into an individual’s risk. At the same time, such an approach also has the potential to streamline the risk formulation process to make its clinical application more efficient.

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Author information

Authors and Affiliations

  1. Psychiatry and Pediatrics, University of Rochester, Rochester, NY, USA

    Anthony R. Pisani

  2. Institute of Law, Psychiatry, and Public Policy, University of Virginia, Charlottesville, VA, USA

    Daniel C. Murrie

  3. Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia

    Kathryn Turner

  4. Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Morton Silverman

Authors
  1. Anthony R. Pisani
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  2. Daniel C. Murrie
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  3. Morton Silverman
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  4. Kathryn Turner
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Corresponding author

Correspondence to Anthony R. Pisani .

Editor information

Editors and Affiliations

  1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy

    Maurizio Pompili

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Pisani, A.R., Murrie, D.C., Silverman, M., Turner, K. (2022). Prevention-Oriented Risk Formulation. In: Pompili, M. (eds) Suicide Risk Assessment and Prevention. Springer, Cham. https://doi.org/10.1007/978-3-030-42003-1_13

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