Risk Management & Suicidal Ideation

Risk Management & Suicidal Ideation

The Albany Clinic • May 9, 2022

Many people think of or talk about suicide – sometimes in a non-serious manner – but such talk should never be ignored. If you or someone you know openly discusses suicide, get immediate medical care. Taking quick action to address mental health issues or other contributing factors can save lives.

What Is Suicidal Ideation?

Suicidal ideation , or suicidal thoughts, means thinking about planning suicide. Thoughts can range from a quick consideration to a detailed plan. Some people may experience suicidal thoughts once in their lifetime, while others may experience suicidal thoughts on a routine, even daily basis for a short or long period.” 

Suicidal thoughts are widespread, often driven by increased stress levels or trauma. Most people thinking of suicide don’t end their life, but some may make attempts.

What Is A Suicidal Risk Assessment?

Suicidal risk assessment is something a doctor or your mental healthcare provider will undertake during one of your visits or if you go to a hospital, emergency room, or urgent care center. 

“The number and variety of instruments to assist in the identification of suicidal persons can be confusing. In suicide screening, a standardized instrument or protocol is administered to identify persons who may be at risk for suicide. Screening may be done universally or on specific populations. An example of universal screening is the completion of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE)–Patient Safety Screener on every patient who presents to a hospital emergency department (ED), regardless of the reason for presentation.”

Depending on the assessment results, your clinician may recommend a treatment plan that could include ongoing psychotherapy, self-help, medicine, the use of ketamine therapy to reduce depression or other mental health symptoms, or, in some cases, hospitalization.

Standard tools for suicidal risk assessment

  • The Columbia Suicide Severity Rating Scale is a publicly available questionnaire “that can help screen for suicide and form a detailed account of an individual’s suicidal ideations or behaviors. It is easy to administer with minimal training, available in multiple languages, and easily included in an electronic medical record.”
  • The Patient Health Questionaire-9 is a fast, subjective reporting tool integrated into your medical record.

Risk Management & Suicidal Ideation

For risks of suicide to be managed, either in yourself or in someone else, it’s critical first to identify the warning signs of suicide.

Suicidal warning signs

  • Talking about the urge to die or take one’s life
  • Searching for the means to end life
  • Constant talk of hopelessness and lack of purpose
  • Talking about the sensation of being trapped or suffering intolerable pain
  • Talking about your burden to others
  • Increased use of drugs or alcohol
  • Anxiety, agitation, or recklessness
  • Problems sleeping
  • Self-isolation
  • Displays of rage or talking about revenge
  • Intense mood swings.

Another key in risk management and suicidal ideation is to do research and have a thorough understanding of the risk factors involved. Biological and environmental factors may be the underpinnings of suicidal ideation, but there are other risk factors to be aware of. By knowing risk factors, you or your doctor can better understand the kind of treatment that might lower the risk of suicide.

Risk factors

  • The presence of one or more mental disorders
  • Alcohol and other substance use disorders
  • Aggressive tendencies
  • A record of abuse or trauma 
  • Serious physical or long-term illnesses
  • Prior suicide attempt
  • Family history
  • Relationship difficulties, financial hardship, loss of a loved one
  • Easy access to weapons or other lethal devices
  • No social support, sense of isolation
  • Stigma linked asking for help
  • Absence of health care (particularly mental health and substance abuse care)
  • Cultural and religious beliefs
  • Exposure to someone who died by suicide (in real life or through the media and web)

Diagnosis & Treatment

Besides using the Columbia Suicide Severity Rating Scale and the Patient Health Questionaire-9 for assessment, your healthcare provider may ask specific questions about:

  • Home
  • Education and employment
  • Activities
  • Drugs
  • Sexuality
  • Suicide and safety

Understanding the state of your physical and mental health is critically important. You may undergo a thorough physical examination to see if a medical problem contributes to mental health issues that may drive suicidal ideation. Your healthcare provider may also ask to speak with family, friends, or others to provide insight.

Treatment may include ketamine therapy , antidepressants or other medicine, ongoing psychotherapy, or hospitalization.

Final Thoughts

Suicide is the 10 th leading cause of death in America . If you have mental health issues or frequently talk about wanting to die or take your own life, reach out for help. A family member may offer support, but there are national and local organizations to lean on, too.

Book Your Free Initial Consultation
By Kimberly Mercille September 4, 2025
Living with post-traumatic stress disorder (PTSD) can be debilitating. Nightmares, flashbacks, and a constant sense of being “on edge” can interfere with work, relationships, and overall quality of life. If you’ve tried therapy or medications without lasting relief, you’re not alone—and there may be another option. At the Albany Clinic in Carbondale, Illinois, we specialize in ketamine therapy as a promising treatment for PTSD. Understanding PTSD Post-traumatic stress disorder (PTSD) develops after experiencing or witnessing trauma. While everyone responds to trauma differently, common symptoms include: Intrusive memories or flashbacks Avoidance of reminders of the trauma Emotional numbness or detachment Heightened anxiety , irritability , or trouble sleeping Some people also develop complex PTSD (CPTSD) , which stems from repeated or prolonged trauma. CPTSD often comes with additional challenges, such as difficulty regulating emotions or maintaining healthy relationships. Current Treatments and Their Limitations The most common treatments for PTSD include cognitive behavioral therapy (CBT) , eye movement desensitization and reprocessing (EMDR) , and antidepressant medications . For many people, these treatments can be helpful. However, they also come with challenges: Medications may take weeks to work and don’t help everyone. Therapy can take months or years to create lasting change. Therapies can be difficult to engage with, as they involve discussing the trauma, which can be distressing or may cause someone to shut down emotionally. Some individuals continue to experience severe symptoms despite treatment. This is where ketamine therapy offers a new avenue of hope. How Ketamine May Help PTSD Ketamine works differently from traditional antidepressants. Instead of gradually altering brain chemistry, ketamine acts quickly on key brain circuits involved in mood and fear. Rebalancing brain activity : Ketamine boosts activity in the prefrontal cortex , the part of the brain that helps regulate emotions. It also decreases activity in the amygdala , the brain’s fear center, helping reduce anxiety and hypervigilance. Promoting neuroplasticity : Ketamine encourages new connections between brain areas, helping “rewire” pathways associated with PTSD symptoms. Supporting fear extinction : Ketamine supports fear extinction, the process by which the brain ‘unlearns’ fearful responses to things it expects to be threatening. This is especially important in PTSD, where people may react to safe situations or cues as if they were actual threats. Benefits of Ketamine for PTSD Research continues to grow, but studies and clinical experience have shown several promising benefits: Rapid relief : Many patients notice improvements within hours to days, rather than weeks. This can be especially important during a mental health crisis or for those struggling with suicidal thoughts. Effective when other treatments have failed : Ketamine can offer relief even for people who haven’t responded to medications or therapy. Sustained improvement : With a series of treatments, many patients experience lasting relief from PTSD symptoms. Increases the benefits of other therapies : Ketamine may speed up the outcomes of other trauma-based therapies, such as prolonged exposure therapy . In a 2021 study , people with severe PTSD received either ketamine or a comparison drug over two weeks. Those given ketamine showed much faster and greater improvement in PTSD and depression symptoms. About 67% had significantly improved symptoms , with the biggest differences in intrusive memories, avoidance, and negative thoughts and mood. The treatment was also well-tolerated with few adverse effects. Ketamine Treatment for PTSD at the Albany Clinic At the Albany Clinic in Carbondale, Illinois, we are dedicated to providing safe, effective ketamine therapy for people with PTSD and other psychiatric disorders. We administer ketamine intravenously to support a rapid reduction in symptoms. Here’s what you can expect: A thorough medical and psychiatric evaluation before treatment begins Comfortable, private treatment rooms Careful monitoring by experienced medical professionals throughout each session A personalized treatment plan designed around your needs During your treatment, you’ll have a small plastic catheter inserted into a vein in your arm, which will deliver ketamine straight into your bloodstream. You may experience mild side effects, such as dizziness and dissociation , which can make you feel disconnected from your body and the world around you. These typically wear off after the session is finished. The infusion takes 45 minutes to one hour , and you’ll be closely monitored by staff during the infusion and afterwards to ensure your safety. We’ll provide you with guidance on aftercare once you’re done and how to make the most of your new headspace. Most people with PTSD require multiple infusions to experience sustained, meaningful changes. However, the treatment plan will be tailored according to your unique needs. Get in Touch Today If you or a loved one is struggling with PTSD and current treatments haven’t provided the relief you need, ketamine therapy may be an option worth exploring. At the Albany Clinic, we are here to answer your questions and guide you through every step of the process. Get in touch to find out more.
By Matt Rodriguez September 2, 2025
Depression is one of the most common mental health conditions, affecting millions of people across all walks of life. While many find relief through traditional methods, they don’t work for everyone. Some people can struggle with depression for nearly a lifetime, and in severe cases, may even consider taking their own lives. At The Albany Clinic, we specialize in innovative, evidence-based treatments that can help patients overcome depression, even when other therapies haven’t worked. In this article, we’ll discuss these treatments and how clinics such as our own are saving lives.
By Kimberly Mercille July 9, 2025
As ketamine therapy becomes increasingly popular for treating mental health conditions like depression and PTSD, more people are exploring their options. At-home ketamine therapy gained traction during the pandemic for its convenience, but without medical supervision, this approach may come with elevated risks. In this article, we’ll explore some of the key differences and pros and cons of in-clinic versus at-home ketamine therapy. What Is In-Clinic Ketamine Therapy? IV Ketamine Treatment In-clinic ketamine therapy involves receiving treatment at a licensed medical facility, such as The Albany Clinic , where professionals monitor and administer the medication under strict protocols. This ensures your safety, especially during your initial sessions. At The Albany Clinic, we specialize in intravenous (IV) ketamine infusion therapy , which has been most well-researched when it comes to treating mental health disorders. IV ketamine bypasses the digestive system, delivering the medication directly into the bloodstream. IV ketamine can help relieve symptoms of various mental health disorders, including depression , anxiety , post-traumatic stress disorder (PTSD) , and more. During an infusion at our clinic, you’ll rest in a calm, controlled environment while ketamine is delivered into a vein through a catheter. Our trained staff will closely monitor your vital signs and mental state throughout the session, adjusting the dose of ketamine if needed. We’ll observe you after treatment to ensure any side effects are managed promptly and effectively. Spravato We also offer Spravato (esketamine) at our clinic, a nasal spray based on ketamine. Unlike other forms of ketamine treatment, Spravato is approved by the FDA and is specifically for adults with treatment-resistant depression or major depressive disorder with suicidal thoughts . Spravato is only approved for in-clinic use under professional supervision and cannot be administered at home, making clinical oversight a legal and medical necessity for this treatment option. During a Spravato session, you’ll self-administer the medication under the supervision of our medical staff. We’ll then closely monitor you for a couple of hours to ensure you’re safe and all side effects have subsided before leaving. What Is At-Home Ketamine Therapy? At-home ketamine therapy allows patients to self-administer the ketamine, typically in the form of lozenges or nasal sprays, delivered via mail. While this option offers flexibility, it usually involves minimal supervision , often limited to virtual check-ins with healthcare providers. Some at-home providers offer optional video support during sessions, but this is not always the case. Patients are largely responsible for monitoring their own physical and emotional reactions, without the benefit of immediate medical intervention if adverse effects occur. At-home treatment often includes supplementary materials , such as guided meditations or journaling tools. However, the lack of real-time clinical oversight makes this option less ideal for those with complex or severe mental health needs. Safety Considerations: In-Clinic vs. At-Home While ketamine therapy is considered safe for most patients, it does come with potential physical and psychological side effects , including: Physical Risks: Elevated blood pressure or heart rate Nausea or vomiting Sedation or dizziness Impaired coordination Rare allergic reactions Psychological Risks: Hallucinations or dissociation Temporary confusion or anxiety Emotional vulnerability during treatment Risk of misuse or dependency The FDA has issued warnings about at-home ketamine use due to its potential for abuse and lack of medical supervision . Without proper monitoring, the risk of addiction and long-term complications, such as bladder damage and cognitive decline, may increase. Key Differences Between In-Clinic and At-Home Ketamine Therapy