Suicide risk assessment confidence scale (SRACS): Development and validation of a new scale

Clinicians' confidence in suicide risk assessment potentially impacts evaluation quality and patient care, yet, this concept lacks clear definition and reliable measurement. This study developed and validated the Suicide Risk Assessment Confidence Scale (SRACS) to assess clinicians' confidence in suicide risk assessment and determine its underlying structure.

The development process included focus groups with 367 clinicians to generate statements, expert panel refinement into scale items, and administration of a 73-item preliminary scale to 375 United Kingdom (UK) National Health Service (NHS) mental health professionals. Analysis involved exploratory factor analysis, item response theory refinement, and confirmatory factor analysis.

A four-factor structure: Professional Conduct, Worry, Competence, and Deference was confirmed. Moderate intercorrelations between these dimensions were not reducible to a single factor. The final 46-item SRACS demonstrated good internal consistency across all subscales, with confirmatory analysis supporting the correlated four-factor model.

The SRACS is psychometrically sound, capturing the multifaceted nature of clinicians' confidence in suicide risk assessment. The distinct yet related dimensions suggest confidence comprises ethical adherence, emotional management, perceived competence, and reliance on others. This tool can identify strengths and gaps in clinicians' confidence, guiding targeted interventions to improve suicide risk assessment practices.