Gaining confidence in understanding risk in context: risk status and risk state

When using the SafeSide Framework, we work to understand a person’s risk for suicide in their own personal context. We think of that context using two related dimensions: risk status and risk state. 

It can take some practice to feel confident using risk status and risk state when you are used to describing risk as “low,” “medium,” and “high.” This is because we naturally want to get our description of risk “right.” 

So, what’s the best way to build confidence in describing risk status and risk state? Thousands of people have told us that, here as in developing any other new skill, the best way is to practice and work with others, like your team and supervisor. 

How do we define risk status and risk state? 

Risk status refers to a person's risk relative to others in a given setting. The setting is often the setting the person is being seen in, such as an outpatient clinic, a community setting, or a hospital, but it can also be a setting that is being considered for that person. We often consider and name more than one context, depending on the purpose of the assessment or who we’re communicating with. 

Bottom line: It’s usually helpful to anchor our assessment in both the current context and one that might be under consideration for the future.  

Risk state describes the current risk compared to the baseline or another point in time. This concept focuses on changes over time. For example, if a person’s risk state is higher than it has ever been in their lifetime, the safety plans and other supports in place should also be as robust as they’ve ever been. The plans and supports can be lessened as the risk state returns closer to baseline. 

Key Takeaways:

1. When describing risk status and risk state, the ‘Why’ is just as important as the ‘What’ so make sure to include your rationale alongside your description.
2. Describing risk status and risk state helps us think through how many and what kind of supports are needed to meet the current risk. Plans that target foreseeable changes and incorporate available resources should change based on risk status and state.