Risk Assessment Questions

Questions should be asked in the order given until the person is no longer exhibiting the increasing risk factors. Risk level is likely to increase for suicide with the more positive and detailed responses to these questions.

A printable version of the questions below is available here: Questions to Assess Suicide Risk Handout (May 2013)

These questions are an educational reference to assist Medical Practitioners to perform a history in regards to suicidality. This is not a validated risk assessment tool. This is not a replacement for an individual clinician’s judgement, responsibility and duty of care towards patients. The author takes no responsibility for the use of this guide.
© 2004 Randall Long.

Spectrum of suicidality

Suicidal intention (thoughts)

Passive suicidal thoughts

  • Do you wish you didn’t have to go on living?
  • Do you have thoughts of wanting to die?

Active suicidal thoughts

  • Do you have thoughts of wanting to take your own life?
  • Do you have suicidal thoughts?

Suicidal threats

  • Did you talk with others about killing yourself?
  • Have you told anyone that you were going to kill yourself?

Suicidal plans (details)

Decision

  • Have you decided on a method to kill yourself?

Details

  • Did you make a plan of exactly what you might do to kill yourself?

Resistance

  • Have you been able to resist carrying this out?
  • What stopped you putting the plan into action?

Preparations?

  • Have you started preparations to suicide?

Time Profile

  • For how long have you had the plan?
  • Have you set a date to kill yourself?

Affairs

  • Have you put your affairs in order?
  • Have you made arrangements for after you die?
  • Have you written a note?

Questions after a suicide attempt

Circumstances

  • What were the circumstances of this attempt?

Method

  • What did you do?

Intent

  • What did you want to achieve (to die/to sleep/euphoria)?

Lethality

  • Did you think it would kill you?

Re-attempting suicide

  • Have you ever tried to take your own life before?

Willingness for help

Desire for help

  • Do you want help to avoid killing yourself?

Acceptance of care

  • Will you accept my help to avoid suiciding?
  • Will you accept specialist mental health care?

Current safety

Immediate harm

  • Do you have thoughts of wanting to suicide immediately?

Harm in hospital or clinic

  • Do you have thoughts of wanting to suicide here in this office/clinic?
  • Are you thinking of actively wanting to hurt yourself here?

Help eliciting

  • If you feel like hurting yourself here while you are waiting for me to make some arrangements, could you come back to me and indicate this before doing anything?

Dangerous items

  • Do you have anything you can use to harm yourself?
  • Are you thinking of using something in the immediate vicinity to harm yourself with?

Homicidal thoughts

Homicidal ideation

  • Do you want to take anyone with you?
  • Do you have thoughts of harming or killing others?

Homicidal plan

  • Do you have a plan to do this?

Weapons

  • Do you have access to guns or other weapons?