Assessing for Suicide

Suicide Assessment Warning Signs: Warning signs should be attended to and not be ignored or perceived as an attention getter. These warning signs are a way to reach out and ask for help. Common warning signs for suicide assessment include the following signs/symptoms: A. Verbal DIRECT: “I am going to kill myself.” INDIRECT: “You are all going to be sorry, when I am no longer here.” “My life is not worth living anymore.” B. Psychological • long term depression • feeling helpless • feeling hopeless • feeling overwhelmed • feeling sad C. Emotional • pre-occupation with death • lack of appetite/overeating • sleep disturbances • poor concentration • isolation • crying D. Behavioral • low self-esteem • inability to perform daily tasks • previous suicide attempts • suicide note • engaging in risky or impulsive behavior • sudden poor school or job performance • giving away important things • lack of interest in things previously enjoyed • sudden refraining from activities with family and friends • sudden unexplained recovery from depression, sudden positive outlook- like the person is fine E. Situational • school or career problems • loss of job/career • death of a loved one or peer • suicide of a loved one or peer • relationship break-up/separation/divorce • multiple losses • terminal illness Things you should ask and do: • Are you thinking of hurting yourself (committing suicide)? • How long have you been thinking about suicide (frequency, intensity, duration)? • Do you have a plan? Get specific information if there is a plan. • Do you have the means to carry out the plan (accessibility of a weapon, pills, drugs, etc.)? • Have you attempted suicide in the past? • Has someone in your family committed suicide? • Is there anything or anyone to stop you (religious beliefs, children left behind, pets, etc.)?

Depending on the responses: o Set up a suicide contract o Provide the client with emergency/crisis numbers

Explore what resources are available, e.g. family support, friends, etc. o Develop a plan to deal with potential weapons, medications, drugs, etc I

Increase frequency of counseling sessions, possible phone check-ins o Assess the need for getting the client assessed for medications o Assess the need to contact the “crisis team” if available at your agency

Hospitalize client if necessary