Suggested Guidelines for Assessment and Prevention of Suicide

Assess lethality. The following factors are important in determining if an individual is likely to actually attempt suicide and how lethal the attempt may be:

  • The level of detail to which the individual has planned the act.
  • The dangerousness and availability of the method.
  • The level of isolation.
  • The number and seriousness of previous attempts.
  • The level of stress and the number of concurrent stressors.
  • The intensity and duration of depression.
  • The individuals "normal" ability to cope with lifeís ups and downs.
  • The personís physical health.
  • Active symptoms of psychosis (especially command hallucinations).
  • The level of external support available to the individual.
  • Impulsivity/absence of protective factors.
  • Alcohol and/or drug use.

From the beginning of your interaction with the individual, begin to ask for contracts or little agreements.
For example:

  • "I know you feel lousy right now, but would you agree to talk with me just for half an hour?"
  • "It is very hard to make decisions when you are feeling this bad. Can you let us help you with decisions until you are feeling better?"
  • Develop a strategy. Help the person make a decision on a specific, short-term plan. You wonít resolve all problems; stick to an issue that is doable.

Develop a strategy

  • What resources does he or she have?
  • What resources can you offer?
  • What has this individual already tried?
  • Offer options, not solutions. Choices empower a person to make decisions and can help create a plan that is specific, doable and short-term.