Toward a Standardized Suicide Risk Assessment in Psychotic Disorders: A Delphi Study With Mental Health Experts: Vers une évaluation standardisée du risque de suicide chez les personnes atteintes de troubles psychotiques : étude Delphi auprès d’experts en santé mentale

Abstract

Background:

Individuals with psychotic disorders face an elevated risk of suicide, yet current assessment tools often lack adaptations for this population's unique clinical realities. No standardized guidelines exist specifically for assessing suicide risk in psychosis, contributing to variability in clinical practice.

Methods:

A two-round Delphi survey was conducted with 42 professionals specializing in suicide prevention or psychotic disorders. Participants rated the relevance of 100 items related to suicide risk assessment and potential systemic facilitators. The top 35 items from the first round were retained for further prioritization in the second round. Descriptive statistics were used to analyze consensus levels.

Results:

Only eight out of 29 systemic factors received strong support, mostly related to the availability of practical tools and structural supports. Of the 71 risk assessment items, 35 surpassed the 4.25/5 relevance threshold. Highest consensus was found for items related to suicidal ideation and planning, such as intent, method, and access to means. Protective factors were also endorsed, while psychological/internal states (e.g., burdensomeness) were rated less relevant.

Discussion:

Findings underscore clinicians’ emphasis on immediate risk and practical tools over abstract internal states. Results advocate for developing standardized, population-specific assessment protocols that balance risk and protective factors in individuals with a psychotic disorder.