Developing a trauma-informed model of suicide risk management

Suicide risk management is a core function of Western mental health services. Traditionally, approaches to suicide risk management have privileged physical over psychological safety. However, some mental health service users and staff have called for alternative approaches, and research points to a changing landscape in the culture of risk management. The current paper sought to gain a broad overview of the positions taken in relation to the clinical practice of suicide risk management. The review adopted a scoping methodology and identified 29 articles that documented approaches to suicide risk management that have been put forward in Western2 mental health settings. In reviewing the literature, four approaches were identified: The technical approach, the technical-collaborative approach, the relational approach, and the self-determining approach. For each approach, the paper explores the underlying theoretical assumptions, clinical practices, and
relational processes between service users and staff. In outlining and explaining the wider range approaches, this analysis allows questioning of the taken-for-granted assumptions of mainstream services, that arguably keep services stuck, and hopefully frees up space for different approaches