Discuss the factors that social workers should address in a depression and suicidal risk assessment.

Answers may vary. With adults, the following factors are associated with high risk of suicide:
• Feelings of despair and hopelessness
• Previous suicide attempts
• Concrete, available, and lethal plans to commit suicide (when, where, and how)
• Family history of suicide
• Perseveration about suicide
• Lack of support systems and other forms of isolation
• Feelings of worthlessness
• Belief that others would be better off if the client were dead
• Advanced age (especially for white males)
• Substance abuse
Particular risk factors for older persons include isolation, ill health, hopelessness, and functional and social losses. Further, older clients may be reluctant to appear for mental health services, and psychiatric conditions may be overlooked by primary care providers and loved ones, or minimized as typical features of aging.
Commonly used instruments to assess depression, such as the Geriatric Depression Scale, may provide insufficient screening for suicidal ideation (Heisel, Flett, Duberstein, & Lyness, 2005). The assessment of suicidality in elder clients requires particular discernment to distinguish between suicidal intent and the awareness of mortality or preparedness for death, which may be hallmarks of that developmental phase (Heisel & Flett, 2006).
Suicidal risk is highest when the adolescent, in addition to exhibiting the symptoms of severe depression, also expresses feelings of hopelessness, has recently experienced a death of a loved one, has severe conflict with parents, has lost a close relationship with a key peer or a love interest, and lacks a support system.
Other studies have indicated that moderate to heavy drinking or drug abuse is implicated in as many as 50% of adolescent suicides and seriously increases risk for depression, suicidal ideation, and suicide attempts (Hallfors et al., 2004; Rowan, 2001).