2. “The common purpose of suicide is to seek a solution.
Suicide is not a random act. It is never done pointlessly
or purposelessly. It is a way out of a problem, a
dilemma, a bind, a crisis, an unbearable situation. It has
an inexorable logic and impetus of its own… Every
suicide makes this statement:‘This far, and no further.’”
Edwin Scheidman, Ph.D.
3. I find hope in the
darkest of days,and
focus in the brightest.
I do not judge the
universe.
~Dalai Lama
80 Million Reasons
4. To seek a solution to one or more seemingly insoluble
problems
Bad grades
Failed relationship
Not getting accepted to college
A personally humiliating exposure
No suicide is a random act; all have purpose and
meaning
Solve the problem and suicide loses it appeal
5. Helplessness
“I can’t do anything to fix what is wrong.”
Hopelessness
The utter belief that nothing will ever be right or well or
bright again forever and ever.
7. Escape
Suicide provides a way out when none is
otherwise perceived.
For humans, there is always a well lighted exit
sign over the door to death.
8. A previous suicide
Talking about being dead or wishing they were dead
Repeatedly engaging in very risky or dangerous thrill
seeking behavior.
"Getting the house in order"
Extreme mood swings
Regular expressions of worthlessness, helplessness,
sadness and/or loneliness.
9. Drastic changes in habits, friends, or appearance, ie;
new friends, skipping school, dropping out of favorite
activities, and no longer caring about appearance or
cleanliness.
Changes in weight, sleeping habits, and physical
activity.
Withdrawing from friends, family, or activities that
once gave the person pleasure or a sense of identity
10. Sex (male)
Age (younger than 19 or older than 45 years of age)
Depression (severe enough to be considered clinically
significant)
Previous suicide attempts or received mental health
services of any kind
Excessive alcohol or other drug use
11. Rational thinking lost
Separated, divorced, or widowed (or other ending of
significant relationship)
Organized suicide plan or serious attempt
No or little social support
Sickness or chronic medical illness
Retrieved from Medicinenet.com
12. Assessment is based on:
How much we learn from the person
The context in which suicide is being considered
Recognition of warning signs
Presence of risk factors
Presence of protective factors
What the suicidal person is willing to do to help us save his or
her life
13. Have you had thoughts of killing yourself?
Are you considering suicide?
Are you contemplating ending your life?
Have you had any personal thoughts of death or
suicide?
14. Q for Question the person about suicide
P for Persuade the person to get help
R for Referring the person to someone who
can help
15. What is wrong?
Elicits the person’s narrative explanation or
“story.”
Person’s perspective
Value in story telling/emotional release
Clarify and understand
16. Elicits the precipitating event or events
Current crisis
Hopeless a long time
Magnitude of change event doesn’t matter
No reserves left
Hair trigger condition
Final straw
“I just can’t take it anymore.”
17. Elicits methods of suicide under
consideration
Only so many ways to die
How (name them)
Access to means
More than one method
Degree of lethal planning
Backup plan
18. Elicits possible location and timing of a
suicide attempt
Lethal planning (less is good)
Soon, Next week, Next year
Anniversary date
Uncontrolled contingency, e.g.,“If she leaves.”
Home or work
Chance of rescue
19. Elicits important suicide history
Past attempts
Past suicidal ideation
Rescue sought or avoided
Timing of attempt
Social response to attempt
What saved them
New method vs. old method
20. Elicits protective factors
Reasons for living
Spiritual or religious prohibitions
Duties to others/pets
Tidying up or‘to do list’ before dying
Fear of death
More reasons is good, none is bad
Low risk does not equal no risk
21. Your active listening and questions may have already
won the battle
Find life-affirming solutions
Greater risk
Refusal to seek help
Angry
Unwillingness to give up means
Refuse help- reassess risk
23. Suicide risk is
determined, in large
part, by the person’s
willingness to assume
personal
responsibility for his
or her own safety.
24. What do you do if it is an emergency, life or death,
situation?
If possible, call the parents, inform them of what is
going on
Have emergency personnel transport person to the
Emergency Room. The ER will do a complete
evaluation:
Physician’s Evaluation
Mental Health Evaluation
Admit to the hospital or refer to services in the Community
25. The most authentic
thing about us is our
capacity to create, to
overcome, to endure,
to transform, to love,
and to be greater than
our suffering.”
Ben Okri
