Screening for Suicidality v2€¦ · 26.03.2018 · QUESTIONS MATTER Rapport (eye contact, warm-up, explanations) Provide a rationale for asking Direct and understandable Start low
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Screening for Suicidality Fearlessly Asking Fearsome Questions
Joseph H. Obegi PsyD
MORBID THOUGHTS “I wish I could disappear.”
WISHES TO DIE "I wish I was dead.”
INTERNAL DEBATE “Maybe I should kill myself.”
PLANNING “How and where should I kill myself?”
DECISION “I should kill myself.”
ACTION Communications, preparations, attempt
INTE
NT
TO
DIE
SUICIDAL THINKING
Ideation and Intent
Suicidal ideation comes in a variety of forms. Sometimes it loosely follows a step-wise progression. But suicidal people often skip “steps”, reverse steps, do several at the same time (very common), vary the time between steps (impulsiveness).
The first thoughts related to the current attempt often—but not always—happen about two weeks before the attempt (Millner et al 2016). Of particular concern is that the last few steps seem to frequently happen in 6 hours or less (MIllner et al 2016).
Adapted from Millner et al. (2016) and Harris et al. (2015) 2
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