Page 112 - 2022 Ranger Medic Handbook

Assessment & Management of Suicidal Risk (cont.)

Table 2: Risk Factors
Acute Risk Factors: Acute (of brief duration) and stressful episodes, illnesses, or life events. While not usually
internally derived, these events can build on and challenge a person’s coping skills.
Chronic Risk Factors (Preexisting): Relatively enduring or stable factors that may increase a person’s suscep-
tibility to suicidal behaviors, such as genetic and neurobiological factors, gender, personality, culture, socioeco-
nomic background, and level of isolation.
Psychological Factors:
• Suicide of relative, someone famous, or peer
SECTION 3 • Suicide bereavement
• Loss of loved one (grief)
• Loss of relationships (divorce, separation)
• Loss of status/respect/rank (public humiliation, being bullied or abused, failure work/task)
Social Factors:
Stressful Life Events (acute experiences) Legal Problems (difficulties)
• Breakups and other threats to prized relationships • DUI/DWI, lawsuit, criminal offense, incarceration
• Other events (e.g. fired, arrested, evicted, Lack of Social Support
assaulted) • Poor interpersonal relationships (partner, parent,
• Chronic stressors (ongoing difficulties) children)
Financial Problems • Geographic isolation from support
• Unemployment, underemployment • Recent change in level of care (discharge from
• Unstable housing, homeless inpatient psychiatry)
• Excessive debt, poor finances (foreclosure, alimony,
child support)
Medical Conditions:
• History of traumatic brain injury • Mood or affective disorder (major depression,
• Terminal disease bipolar disorder)
• HIV/AIDS • Personality disorder (especially borderline)
• New diagnosis of major illness • Schizophrenia
• Having a medical condition • Anxiety
• Worsening of chronic illness • PTSD
• Intoxication • Panic disorder
• Substance withdrawal (alcohol, opiates, • Substance use disorder
cocaine, etc.) • Eating disorder
• Use of prescription medication with warning for • Insomnia or other sleep disorder
increased risk of suicide
• Chronic pain
Military Specific: Preexisting & Nonmodifiable:
• Disciplinary actions (UCMJ) – Reduction in rank • Gender (male)
• Career-threatening change in fitness • Race (white)
for duty • Marital status (divorce, separate, widowed)
• Perceived sense of injustice or betrayal (unit/ • Family history of suicide/attempt or mental illness
command) • Child maltreatment (physical/psychological/sexual)
• Command/leadership stress, isolation from unit • Sexual trauma
• Transferring duty station • Lower education level
• Administrative separation from service/unit • Same-sex orientation (LGBT)
• Adverse deployment experience • Cultural or religious beliefs

98 SECTION 3 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) & SICK CALL