Suicide Ideation

Notes:

  • Has the YP considered suicide?
  • How often ? (hours/daily/weekly)
  • How long do the thoughts last?
  • What triggers thoughts?
 Risk rating:
Ocassional and/or brief thoughts of suicide
More frequent or long-lasting thoughts
Intense, persisitent thoughts that are hard to get rid of

Method

Notes:

  • Have they identified a method?
  • If so, what methods have they identified?
  • How lethal are these methods?
 Risk rating:
Method not identified
Has identified method but of lower lethality (Example: overdose cutting)
Method identified & high lethality (Examples: hanging, jumping, firearms)

Degree of Planning

Notes:

  • Do/did they have a plan?
  • Do/did they intend carrying it out?
  • What stops them carrying it out?
 Risk rating:
No planning of how they would make attempt
Some planning with evidence but no identified time
Planning evident with intention of acting

Achievability of Plan

Notes:

  • Do they have access to method/means?
  • How likely would they be to die if they went ahead with plan?
 Risk rating:
Little or no preperatory behaviour
Some evidence of preparatory behaviour
Strong evidence of preparatory behaviour

Preparation Behaviour

Notes:

  • Have they been: writing, talking or drawing about suicide?
  • Trying out their method?
  • Getting prepared?
  • Making suicide threats /letters?
  • Making a will?
  • Giving away possessions?
  • Has there been a sudden unexplained improvement in Evidence?
 Risk rating:
Little or no preperatory behaviour
Some evidence of preparatory behaviour
Strong evidence of preparatory behaviour

Previous Suicide Attempts

Notes:

  • Have they attempted suicide/self harm before?
  • How many times?
  • For each attempt or incident of self-harm specify:
    • Their intention
    • When
    • Method
    • Trigger(s)
    • Outcome ( serious injury / admission to hospital
Risk rating:
None or one of lower lethality
More than one attempt of lower lethality
Multiple attempts of lower lethality or one or more of higher lethality

Current Emotional Distress

Notes:

What is their current emotional state?

(See Kessler screen & notes)

 Risk rating:
Little current distress
Moderate distress with some despair evident (Kessler Score)
High current distress or despair. Feels: Rejected, Unsupported, Alone (Kessler Score)

Evidence of Poor Mental Health

Notes:

  • Mood: Are they sad, irritable, anxious, guilty, angry, shut-down?
  • Thoughts: Does their talk reflect beliefs that they re worthless, hopeless or helpless?
  • Behaviour: Do they have a diagnosed mental health disorder?
  • Are there disturbances in motivation, energy levels, appetite, sleep, perception (hearing voices urging to harm self or others?
  • Have they lost interest /pleasure in life?
  • Do they show poor concentration?
  • Are they socially withdrawn?
 Risk rating:
Some evidence of low mood but little impact on their life
  • More sustained problems with low mood.
  • Feelings of sadness
  • Irritability with some other disturbances such as sleeping/being withdrawn
  • Significant periods of low mood
  • Sadness
  • Irritability
  • Negative thinking with disturbance in a number of areas of life.

Levels of Hope and Reason to Live

Notes:

(This discussion is often assessed during discussion around protective factors)
  • What keeps them going?
  • Do they see any chance of change?
 Risk rating:
  • Has some hope and can see that things can change
  • Some hopelessness & pessimism about future
  • High degree of hopelessness, helplessness
  • Lack of sense of future

Other Risk Factors

Notes:

  • Family/ peer history of suicide
  • Family/peers who support suicide
  • Family or personal history of mental health issues
  • Major loss
  • Stressors
  • Parent/caregiver not taking YP seriously
  • Parent/caregiver unable to adequately support the YP
 Risk rating:
  • Few risk factors
  • Little exposure to suicide
  • Several risk factors
  • Exposure to suicide
  • Extensive risk factors
  • Exposure to suicide

Current Protective Factors

Notes:

  • Level of problem solving ability
  • Extent of strong cultural / spiritual connections
  • Presence of family/caregiver relationship (involving warmth & belonging)
  • Extent of positive peer relationships
  • Availability & access to supports
  • Extent of areas of achievement
 Risk rating:
Numerous protective factors
Some protective factors
Minimal protective factors