In severe depression, which critical question should be asked to assess risk?

In severe depression, which critical question should be asked to assess risk?

• A. Do they have thoughts of harming others?
• B. Are they currently suicidal?
• C. What is their sleep pattern?
• D. Have they recently had a fall?

Answer: (B)

Assessing imminent danger in severe depression hinges on directly determining whether the patient is currently suicidal. The best single question is to ask about current suicidal intent and plans. This directly reveals the level of immediate risk and signals whether urgent safety actions are needed, such as one-to-one observation, removing means, contacting the mental health team, or considered hospitalization. If the patient acknowledges ongoing thoughts of suicide or a concrete plan, you escalate safety measures right away. If there is no current intent, you continue to assess for evolving risk—Explore how often such thoughts occur, whether there’s a plan, and what would prevent them from acting—while maintaining close monitoring and support. Other inquiries, like thoughts of harming others, sleep patterns, or recent falls, provide useful context about the patient’s condition and overall risk factors, but they do not alone establish the immediacy of self-harm risk. The immediate safety concern is whether self-harm is actively being considered or planned.

Assessing imminent danger in severe depression hinges on directly determining whether the patient is currently suicidal. The best single question is to ask about current suicidal intent and plans. This directly reveals the level of immediate risk and signals whether urgent safety actions are needed, such as one-to-one observation, removing means, contacting the mental health team, or considered hospitalization.

If the patient acknowledges ongoing thoughts of suicide or a concrete plan, you escalate safety measures right away. If there is no current intent, you continue to assess for evolving risk—Explore how often such thoughts occur, whether there’s a plan, and what would prevent them from acting—while maintaining close monitoring and support.

Other inquiries, like thoughts of harming others, sleep patterns, or recent falls, provide useful context about the patient’s condition and overall risk factors, but they do not alone establish the immediacy of self-harm risk. The immediate safety concern is whether self-harm is actively being considered or planned.