Psy 468: sample suicide inquiry

Have you ever thought about killing yourself?

if "No": Have you ever tried to kill yourself?

if "No": If you ever did try, how would you do it?

Why wouldn't you kill yourself, what would stop you?

if "Yes" or no response or evasive response:

When was the last time you thought about killing yourself?

Tell me about that.

What did you think about doing?

How would you do that?

Do you have [access to means]?

What would stop you, why wouldn't you kill yourself?

assess current circumstances, sources of support, knowledge and access to emergency help

Have you ever tried to kill yourself?

How many times?

What did you do the last time? When was that? What happened? What were you thinking, what did you want to happen?

What did you do the first time? How old were you? What happened?

assess other attempts

Has anyone in your family or someone you knew really well ever killed themselves?

What would keep you from trying again? What could you do if you began thinking about suicide?

Suicide "contracts"

1st choice: a clear, unequivocal statement, declarative :

I promise you I will not kill myself.

This can be followed up with emergency plans to follow if anything happens which appears to threaten the promise.

2nd choice: a conditional statement:

I promise you I will not kill myself without first talking to you about it.

I promise I will not kill myself during the next week.

I promise I will not kill myself between now and our next session.

If client cannot make a conditional statement, with convication and eye contact, emergency care plans may be necessary