Suicide: Assessment and Interventions

General Guidelines
■ If, at any time, Pt is threatening suicide, get help, call 911.
■ Provide safe environment.
■ Always take overt or covert suicide threats or attempts seriously.
■ Observe Pt closely.
■ Encourage expression of feelings.
■ Assign tasks to increase feelings of usefulness.
■ Provide full schedule of activities.
■ Show acceptance, respect, and appreciation.
■ Do not argue with Pt.
■ Remind Pt that there are alternatives to suicide.

Groups at Increased Risk for Suicide
■ Adolescent and young adult Pts (ages 15–24).
■ Elderly Pts.
■ Terminally ill Pts.
■ Patients who have experienced stress or loss.
■ Survivors of persons who have committed suicide.
■ Individuals with bipolar disorder or schizophrenia.
■ Pts coming out of depression.
■ People who abuse alcohol or other drugs.
■ Patients who have previously attempted suicide.
■ More women attempt suicide; however, more men actually complete suicide.

Lethality Assessment
■ Intention: Ask Pt if he or she thinks about and/or intends to harm self.
■ Plan: Ask Pt if he or she has formulated a plan. What are the details; where, when, and how will the plan be carried out?
■ Means: Check availability of method to commit suicide. Does Pt have access to gun, knife, pills, etc?
■ Lethality of Means: Pills vs. gun; jumping vs. slitting wrist.
■ Rescue: Possibility of rescue.
■ Support or lack of support.
■ Availability of alcohol or drugs.
■ Anxiety level.
■ Hostility.
■ Disorganized thinking.
■ Preoccupation with thought of suicide plan.
■ Prior suicide attempts.