A comprehensive screening tool for assessing suicide risk

STARS is a person-centred, psycho-social needs based semi-structured interview. It was developed to provide a very initial insight into the complex world of a suicidal person to inform immediate collaborative and compassionate client care, including further examination of suicidality as necessary.

THE PURPOSE OF STARS

  • To enhance worker understanding of the client's story by enticing worker reflection on the client rated concerns of contributing factors towards the suicidal state and experience.
  • To assist and guide workers on ways to elicit key client reported concerns subjectively perceived to contribute to suicidality.
  • To provide workers with guiding domains of enquiry concerning empirically based risk and protective factor information, short-term or proximal indicators of suicide risk (e.g. warning signs), and current and past suicidality contexts (based on the subjective meaning of these factors for the client).

Client story

Recognises the narrative of the client as central to comprehensive and accurate assessment, while appreciating that the client's story must be understood before the worker can gain a picture of the individual trajectory of pain, and permission to enter into the journey of intervention and support.

Collaborative, semi-structured protocol

Allows workers to enquire about suicidality at any point of the interview protocol. Enquiry may begin at Part A (ideation, intent, planning and behaviour), Part B (individual risk factor enquiry) or Part C (protective factor enquiry).

Worker self-reflection

Seeks clinician confidence ratings against client narrative and ratings of concern about contributing factors or state of suicidality. This process encourages worker reflection and the need to provide a rationale for decision making with clients.

Protective factors

Protective factor enquiry includes client relatedness, interpersonal and intrapersonal elements, norms, spirituality, coping and problem solving, as well as esteem and cultural identity.

Client-centred

The client is considered the focus of all information gathering, so that the client takes the worker by the hand through their journey of pain. The client becomes the co-author of then moving towards a life worth 'more' living.

Team approach

Emphasises a team approach to defining a collaborative and compassionate relationship for bringing the client to a life worth 'more' living.

Safety planning

Includes a safety plan section collaboratively and individually developed (with client and carer or next of kin) in line with client-rated concerns and identified foreseeable risk, which informs the documented commensurate actions, consultation and follow-up.

Client ratings of concern

Allows subjective ratings for specific items contributing to suicidality (e.g. no concern, some concern and severe concern) rather than seeking a categorical or overall suicide risk rating; to allow for the importance of each item to be indicated according to the unique concerns of the client (e.g. something of significance as a risk factor in the literature may not necessarily be experienced by the client as such, and vice versa).

Documentation

Includes a Clinical Notes section for summarising client concerns ('some concern' and 'severe concern') as well as a section for documenting the commensurate actions, collaboratively determined for keeping the client safe and mitigating foreseeable risk.

About the training

Administration of the STARS protocol requires mandated training and involves a 2 day workshop. The program costs $770 and this includes usage of the STARS protocol for 12 months as well as all workbooks, handouts, articles and hard and electronic copies of the STARS protocol (a one-day refresher course is required for re-licensing purposes after 12 months). Please email Jacinta Hawgood at STARS@griffith.edu.au for more information.

Contact the STARS team