Acute Warning Signs of Suicidality

• Verbal
  • Preoccupation with themes of death or suicide
  • Expressions of unworthiness or failure
  • Lack of interest or hope for the future
  • Statements of suicidal plan or intent to carry it out
• Behavioral
  • Giving away cherished possessions or making a will
  • Canceling future plans as if there will be no future for the person
  • Stockpiling pills or acquiring a weapon
  • Sending cryptic emails that suggest wish to harm self, feelings of hopelessness

Sometimes out of a cry for help or ambivalence about acting on suicidal thoughts, indirect statements will be made:

• Hopelessness
  • “I’m not sure any of this is worth it anymore.”
• Wishes for Escape
  • “I’d like this all to go away.”
• Death Allusions
  • “I wish I could sleep and never wake up.”
• Burdening Others
  • “It would be better for everyone if I were gone.”
• Not  Belonging
  • “No one would miss me anyway.”

Acute Risk Factors
Risk for self harm increases when the above warning signs and risk factors below are both present.

• Expression of specific plans with active intent to harm self
• Prior suicide attempts
• Recent discharge from a psychiatric hospitalization
• Chronic feelings of hopelessness and suicidal thinking

Protective Factors

•  Effective clinical care for mental, physical, and substance abuse disorders
•  Easy access to a variety of clinical interventions and support for help seeking
•  Family and community support
•  Support from ongoing medical and mental health care relationships
•  Skills in problem solving, conflict resolution, and nonviolent handling of disputes
•  Cultural and religious beliefs that discourage suicide and support self-preservation instincts