Understanding and exploring a young person’s suicidality is essential to gauge his/her current risk of suicide. The most effective way to understand and assess a young person’s suicidality is to directly ask about their suicidality, and then engage them in a conversation to explore the extent and seriousness of their suicidality. The goal is to reach a shared understanding of his/her suicidality. This information will best inform the development of a suicide safety support plan that is personalised for each young person.
A common trap for professionals working with suicidal young people is to ask questions like a checklist without engaging in a deeper discussion with the young person. This can make the young person feel like they are being interrogated.
Instead, adopt a narrative style in questioning which allows the young person to explain their suicidality in the context of their life experiences. Many young people who become suicidal are reacting to negative events or stressors that overwhelm their capacity to cope. In order to best support them, it is important to understand what elicits their suicidal thoughts and the context of their suicidality.
The following questions can help you understand and assess a young person’s risk for suicide:
- Do you have thoughts of taking your life?
- If so, how often do you have these thoughts?
- What is going on in your life that makes you think about suicide?
- Do you intend to act on these thoughts and take your life?
- What has stopped you from acting on these thoughts so far?
Based on the young person’s response(s), you may then want to proceed with more specific questions:
- Have you thought about how you would end your life?
- If so, what would you do? Where do you think you would do it?
- How often do you think about your plan?
- Do you have what you need to carry out your plan (e.g. pills, rope)?
- If not, have you planned how you will get the means? Is it easy for you to get?
- Have you thought about when you would complete suicide?
- Has anyone close to you attempted or completed suicide?
- How close have you come to acting on your suicidal thoughts?
- Have you ever planned or attempted suicide before?
- If so, what did you do to hurt yourself? How long ago did this occur?
- What was happening at that time that led you to attempt suicide?
Current emotional well-being:
- What things would make you feel more/less hopeful about the future?
- What things would make you more/less likely to want to die?
- What are the main things causing you distress at the moment?
- Are you relying on alcohol or drugs to help with your feelings?
- Have you ever been given a diagnosis of mental illness?
- Tell me about your family and friends. Who is supportive for you?
Consideration should also be given to:
- How detailed and realistic the plan is
- The likelihood of the method being lethal
- Any risk factors the young person has
- Precipitating factors or events
- Any protective factors the young person has
- Supports available to the young person (e.g. family, health professionals)