1. Assessing Suicide Risk Tonya McFarland, PsyD Licensed Clinical Psychologist
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2. How to Ask
With as many things as you have going on, I’m wondering if you have thought about hurting yourself?
Sometimes when people are in this much pain, they have thoughts about hurting themselves, has this happened to you?
Don’t ask, “You don’t have suicidal thoughts do you?”
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3. Suicidal Plan/Intent What method do they plan to use?
When do they want to do it?
Where would they do it?
Do they have the means to do it? Are there weapons in the house?
Would they do it when alone or when others are present? (likeliness of being rescued)
Do you want to kill yourself right now?
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4. Past History Have they ever attempted suicide before?
If yes, When did they attempt
How did they attempt?
What were the circumstances at that time? (look for triggers to the attempt)
Did they seek medical treatment?
Who found them, or how did they get help?
Where they hospitalized afterwards?
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5. Deterrents/ Triggers
Does the patient have any supportive people in her life? Does this person know how they are feeling?
What has kept them from acting on their suicidal thoughts so far? (religion, child)
What might lead them to attempt suicide?
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6. Risk Factors Physical illness (chronic pain)
Mental illness or substance abuse/use
Family history of mental illness
Prior suicide attempt
Level of impulsiveness, aggressiveness
Level of hopelessness
Psychotic symptoms
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7. IMPORTANT POINTS TO KEEP IN MIND
• Be clear about your ability to help her/him
• Determine whether hospitalization is required, if not sure call Colorado Crisis or 911
• Contact family members/support system to develop safety plan
• Initiate psychiatric contact
• Follow up with any and all requests (ex: weapons out of the house)
• Determine level of follow up (ex: .report in. phone calls to/from patient to assure safety)
• Do not avoid questions that make you uncomfortable
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8. Assessing for Psychosis
Have you heard voices/sounds or seen things that you don’t think really existed?
If yes: Have the voices told you to do something? When was the last time you experienced this? Has this ever happened before now? How frequently do you experience this?
Do they respond quickly to questions or do they seem distracted and unable to concentrate?
Are their thoughts logical and goal oriented or do they have difficulty explaining themselves?
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9. Safety Planning
Who can patient call if they feel overwhelmed or suicidal?
What can they do to distract themselves? (mindfulness, activities, etc)
Are there weapons in the house?
If yes, can the weapons be removed from the house by another person and verified.
Provide Colorado Crisis , Emergency rooms, others
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