Emergency Medical Evaluation of Dangerousness

eMed International Inc

Suicidal and Homicidal Assessments

Related Links
  • Standardization sample included 182 adults 25-65 years and consisted of four study groups: (a) non-threat, (b) suicide threat, (c) homicide threat, and (d) homicide-suicide threat.
  • Internal consistency coefficients range from .70 to .80. 
  • Test-retest reliability coefficients range from .71 to .90.
  • Interrater reliability coefficient:  .92.
  • Concurrent validity with Beck's Suicide Intent Scale (SIS™),and Beck's Suicide Intent Scale (SIS™),short version, Adult Suicidal Ideation Questionnaire (ASIQ™)
  • Sensitivity 83.3; specificity 87.7.
Technical Information
  • Assists clinicians in the evaluation of adults regarding near-future (hours to days) risk for violent or suicidal behaviors in a variety of diagnostic categories, for example depressive, psychotic, and personality clusters.
  • Provides clinicians with meaningful information beyond traditional risk evaluations that can be used in a variety of settings (ED, General Practice, and Mobile Crisis Units).
  • Can be used as part of a threat assessment; as a tracking tool to help determine risk levels in association with treatment plans, patient settings, and social and family situations; or to assess transitions from inpatient to outpatient care following hospital discharge or following an adverse drug reaction.
  • Particularly useful for improving diagnosis and treatment of unusual side effects older patients receiving selective serotonin reuptake inhibitor (SSRI) antidepressant medication or experiencing acute adjustment disorder (AD) when used in combination with the Violence Ideation and Suicidality Treatment Algorithm (VISTA™), standardized for adults with a positive Likelihood Ratio (+LR) = 10.
  • A detailed Professional Manual offers guidance and a standardized methodology to evaluators.
  • Smartphone or tablet application permits records to be emailed or uploaded directly to electronic medical record (EMR) system.
  • "Do-able" in minute’s cross- checks.  For example, paper-and-pencil total elapsed test time required is less than that to order, escort, and administer a chest x-ray in the ED or to wait for the processing of cardiac enzymes.  Electronic platform administration elapsed time equivalent to asking a patient a few symptom questions and taking and recording patient’s vital signs.

Purpose: Intake universal assessment for suicide, homicide, or suicide/homicide chief complaints.  Identify near-future adult suicidality and/or homicidally.

Age:  25 to 65 years

Admin:  Completed by examiner

Time:  Paper-and-pencil: 10-20 minutes

           Electronic: 2-5 minutes

Qualification Level:  B, C, or S and/orworkshop training certification

Features and Benefits
Test Structure

Evaluate an adult’s actual, attempted, or threatened act to harm him- or herself or others with this 29-item structured assessment. Based on information obtained through various sources, including patient interview, chart review, and family interview, the ACTA™ provides an overall threat classification (extreme, high risk, moderate, or low clinical risk factors) as well as cluster scores, including Precipitating Factors, Early Precipitating Factors, Late Precipitating Factors, Predisposing Factors, Impulsivity, and the ACTA™ Total score.

At a Glance

ACTA™ SUicide and Violence Assessment

Adult Critical Threat Assessment