How to assess the risk of suicide

When the primary health care staff suspect that suicidal behaviour is a possibility, the following factors need to be assessed:

· current mental state and thoughts about death and suicide;
· current suicide plan - how prepared the person is, and how soon the act is to be done;
· the person's support system (family, friends, etc.).

The best way to find out whether individuals have suicidal thoughts is to ask them. Contrary to popular belief, talking about suicide does not plant the idea in people's heads. In fact, they are very grateful and relieved to be able to talk openly about the issues and questions they are struggling with.

How to ask?

It is not easy to ask a person about his or her suicidal ideas. It is helpful to lead into the topic gradually. Some useful questions are:

· Do you feel sad?
· Do you feel that no one cares about you?
· Do you feel that life is not worth living?
· Do you feel like committing suicide?

When to ask?

· When the person has the feeling of being understood;
· When the person is comfortable talking about his or her feelings;
· When the person is talking about negative feelings of loneliness, helplessness, etc.

What to ask?

1. To find out whether the person has a definite plan to commit suicide:

· Have you made any plans to end your life?
· Do you have an idea of how you are going to do it?

2. To find out whether the person has the means (method):

· Do you have pills, a gun, insecticide, or other means?
· Is the means readily available to you?

3. To find out whether the person has fixed a time frame:

· Have you decided when you plan to end your life?
· When are you planning to do it?

All these questions must be asked with care, concern and compassion