Q.  My nephew has been hospitalized for weeks after a horrible vehicle accident in which he sustained a concussion. His girlfriend recently asked if I thought my nephew was suicidal. I had no idea. What would I look for?

A. According to data released by The Joint Commission, nearly 1,500 suicides take place annually in the United States—by patients who are in hospital units. About three-fourths of these cases involve hanging followed by about 20% who jump from a roof or window. Not surprising, most patients who commit suicide in a hospital setting were admitted for mental disorders, but not all. A traumatic accident often can alter brain function, at least temporarily.

Patients who are at greatest risk of committing suicide include the following:

• Male
• Single status
• Unemployed
• Suffered a recent loss
• Displayed previous suicidal behavior
• Family history of suicide
• Poor physical health
• History of violence or impulsivity
• Lack of social support
• Feelings of hopelessness
• History of substance abuse
• History of depression

You may want to speak with your nephew's physician and explain your concerns. Depending on your relationship with the young man, one of the simplest and often most effective things you can do is just to ask him if he has thoughts of dying or of helping himself to die. If you go this route, it is important to do so without judgment or criticism. Just ask the question and then listen carefully. You may have some follow-up questions. You can certainly ask what he thinks would improve his quality of life and if there is something you can do.