Graduate Teaching Assistant The Ohio State University Columbus, Ohio, United States
Body of Abstract: Increasing research attention has been focused on the shift toward embracing a social justice approach to suicide assessment and treatment that acknowledges the role oppression plays in suicide and actively seeks to address such injustices (Standley, 2022). This presentation proposes an updated set of social justice-oriented principles for suicide risk assessment. As Granello (2010) articulated, while content-based assessment (e.g., identifying risk factors) is crucial, there is a lack of guidance on the underlying principles that inform the assessment process. This gap can result in a rigid, checklist-style approach that may overlook the nuanced, individualized nature of each client's risk profile (Fitzpatrick & River, 2018).
Although individual-level risk factors are essential and practical, this model often overlooks broader social determinants, such as structural inequities and systemic discrimination, which play a significant role in shaping individuals' experiences and suicide risk profiles (Hjelmeland & Knizek, 2017; Button, 2016). For example, relying solely on checklist assessments can limit validity, as these tools reduce complex suicidal behaviors to binary outcomes, ignoring the variability and context surrounding suicidality (Harris et al., 2016). Concerns about the reliability and validity of this approach are further emphasized by research indicating that clients may conceal suicidal behaviors due to stigma and mistrust of mental health treatments (Blanchard & Farber, 2020). Furthermore, the ethical limitations of individual-focused assessment frameworks can unintentionally place blame on individuals, thus overshadowing the impact of systemic and policy-related factors that contribute to suicidality (Fitzpatrick, 2020).
This program will explore how current standard practices for suicide assessment may not fully capture the nuanced ways in which suicide risk manifests across diverse communities, where factors such as socioeconomic hardship, discrimination, and cultural expectations intersect with personal distress. Scholars have noted that during COVID-19, limited access to protective resources and increased racial stress significantly heightened suicide risks for communities of color, while white individuals generally had more access to supports such as telehealth and stable employment (Robinson et al., 2024). Additionally, a public health approach in Milwaukee County—a comprehensive fatality review—led to systemic recommendations to reduce suicide risk. These included proactive healthcare follow-ups, adjustments to online search results to prioritize suicide prevention, and resources for individuals involved in legal proceedings (Kohlbeck et al., 2024). Such studies underscore the importance of considering systemic inequities—including racial income disparities, discrimination, and segregation—as essential factors in conducting a thorough and accurate suicide risk assessment. As a result, while individual risk factors remain important, it is equally important to address societal risk factors like racism, homophobia, patriarchy, and classism during routine suicide risk assessment (Button, 2016).
Scholars and international organizations like the WHO have called for greater integration of universal assessments of social determinants of health within both medical and mental health care, emphasizing the importance of addressing upstream causes of distress, including suicide (Sheperis et al., 2023; Lenz & Lemberger‐Truelove, 2023). In response, this program introduces eight social justice principles designed to guide clinicians and researchers in conducting suicide risk assessments that are contextually informed and systemically aware. These principles shift focus from solely individual-level factors to an integrated approach that considers broader social influences and client empowerment.
First, “Contextualizing Risk Within Broader Social Determinants” encourages practitioners to assess systemic contributors, such as discrimination, poverty, and social isolation, that significantly impact suicide risk (Chu et al., 2010). “Decentralizing Pathology” reframes suicidality as a response to life circumstances rather than solely a mental illness symptom, reducing stigma and acknowledging the role of oppression or trauma in distress (Ben-Zeev et al., 2010). “Strengths-Based Cultural Competency” supports a culturally informed approach that values clients' cultural strengths and encourages them to draw on community and familial resources as sources of resilience (Grothaus et al., 2012).
The principle of “Equity in Access and Intervention” ensures that assessments account for clients' access to resources, whether financial, geographic, or cultural, emphasizing resource connection as part of the assessment (Langheim, 2014). “Prioritizing Lived Experience and Client Agency” respects clients’ perspectives on their experiences, valuing their insights into causes and potential solutions for their distress (Baril, 2020). “Inclusive Safety Planning” advocates for culturally relevant safety plans that incorporate clients' values, community resources, and realistic coping methods tailored to their context. “Holistic Risk Evaluation” broadens assessments to include and embrace diverse explanatory models of mental health, such as cultural and familial expectations or unique stressors for marginalized identities (Chu, 2010). Lastly, “Community-Centered Feedback and Accountability” involves regular engagement with communities most affected by suicide, adapting practices based on their input to ensure that assessments do not inadvertently reinforce oppression but instead respond to community needs (Weng & Spaulding-Givens, 2017).
Learning Objectives:
Evaluate the effectiveness of current suicide risk assessment tools in addressing the role of oppression, discrimination, and cultural context.
Apply the eight social justice-oriented principles in case scenarios to formulate contextually informed, systemically aware approaches to suicide risk assessment.
Assess the role of social determinants of health in suicide prevention efforts, and discuss how addressing these determinants in routine assessment can create more equitable mental health outcomes
