Assessing suicide risk is hard in person. It is even harder remotely.
You cannot see the patient fully. You cannot remove dangerous objects from the room. You cannot call for help in the same building.
But remote suicide risk assessment is possible. You just need a clear plan.
This guide gives you a 7-step process. Follow these steps for every high-risk patient you see remotely.
Step 1: Set Up Before the Session
Do not wait for an emergency. Prepare in advance.
Before the session, have ready:
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Patient’s full name and address
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Local emergency numbers (police, ambulance, crisis team)
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A backup contact person (family member or friend)
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Your organisation’s crisis protocol
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A secure way to document everything
Keep this information on paper next to your computer. You do not want to search for it during a crisis.
Step 2: Start With a Safety Check
At the beginning of every session, ask these questions:
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"Where are you right now?"
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"Is anyone else in the house?"
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"Do you have access to anything that could hurt you?"
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"Do you feel safe staying on this call with me?"
If the patient says they have medications, sharp objects, or weapons nearby, ask them to move them to another room.
If they refuse, move to Step 5 immediately.
Step 3: Ask About Suicide Directly
Many professionals fear asking about suicide. They think it will give the patient ideas. That is not true.
Asking about suicide does not cause suicide.
Ask clearly and calmly:
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"Have you thought about ending your life?"
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"Do you have a plan?"
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"Have you taken any steps toward that plan?"
If the answer is yes, ask more:
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"What is your plan?" (method, location, time)
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"Do you have the means to carry out this plan?"
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"Have you told anyone else?"
Step 4: Assess Risk Level Remotely
Use this simple three-level system:
Low risk:
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No current thoughts of suicide
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No plan
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Feels safe
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Has support at home
Medium risk:
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Thoughts of suicide but no plan
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Wants to live but feels stuck
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Has some support but not 24/7
High risk:
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Clear plan and means to carry it out
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Intends to act soon (hours or days)
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Alone or with no support
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Feels hopeless
Step 5: Take Immediate Action for High Risk
If the patient is high risk, do not hang up. Stay on the call.
Your actions in order:
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Keep the patient talking. Do not leave them alone.
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Ask if they will agree to stay safe until help arrives.
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If they agree, call their local emergency number while staying on the line.
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If they do not agree, tell them you are calling emergency services to keep them safe.
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Stay on the call until help arrives or the patient is safe.
Do not worry about breaking confidentiality. Safety comes first.
Step 6: Create a Remote Safety Plan
For medium or low risk patients, create a safety plan before ending the call.
A remote safety plan includes:
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Warning signs – What thoughts or feelings mean they need help?
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Internal coping strategies – What can they do alone to feel better?
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Social contacts – Who can they call? Write numbers down.
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Professional contacts – Therapist, doctor, crisis line numbers.
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Environment safety – What can they remove from their home?
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Reason to live – What keeps them going?
Write the plan during the call. Send it to them by secure message or email after.
Step 7: Document Everything
Write down:
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Every question you asked
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Every answer the patient gave
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Your risk level assessment (low/medium/high)
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Actions you took
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Who you contacted
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The safety plan you made
Good documentation protects you and the patient.
What If the Patient Hangs Up?
This is every professional’s fear. If the patient hangs up and you believe they are high risk:
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Call them back immediately.
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If they do not answer, call their emergency contact.
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If you cannot reach anyone, call local emergency services. Give them the patient’s address.
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Document everything.
Do not wait. Every minute matters.
Self-Care After a Remote Crisis Call
Assessing suicide risk remotely is stressful. After a high-risk call:
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Take a 10-minute break
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Breathe deeply for two minutes
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Talk to a colleague or supervisor
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Write down how you feel
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Do not book another high-risk patient immediately
You cannot help patients if you burn out.
Learn More in Our Course
Our Remote Mental Health Risk Assessment CPD course includes a full module on suicide risk. You get video scenarios, sample safety plans, and a crisis protocol template.
Frequently Asked Questions
Q: Can I assess suicide risk by text or chat?
No. Never do crisis assessment by text. You cannot see the patient’s face or hear their voice. Always use video or phone.
Q: What if the patient is in another country?
This is very difficult. Know the emergency number for their country before the session. But ideally, do not take high-risk patients from other countries.
Q: How often should I reassess risk?
For medium risk patients, check at every session. For high risk patients, check every 24–48 hours until risk lowers.
Q: Do I need to tell the police if the patient lives alone?
Yes, if the patient is high risk and refuses safety support. Their safety is more important than privacy.