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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