Patient Guide 
Key Information for Your Stay
Suicide Prevention

Suicide Prevention

Do you know someone who might be thinking about killing themselves? Ask this person these questions to determine their risk and help save a life.

Start With Questions 1 and 2

Past Month

Start With Questions 1 and 2

In the past month:

1) Have you wished you were dead or wished you could go to sleep and not wake up?

2) Have you actually had any thoughts about killing yourself?

Yes or No

Yes or No

If YES to 2, answer questions 3, 4, 5 and 6.

If NO to 2, go directly to question 6.

If YES to 2, answer questions 3, 4, 5 & 6.
If NO to 2, go directly to question 6.

In the past month:

3) Have you thought about how you might do this?

4) Have you had any intention of acting on these thoughts of killing yourself, as opposed to you  have the thoughts but you definitely would not act on them?

5) Have you started to work out or worked out the details of how to kill yourself? Do you intend to carry out this plan?

Yes or No

Yes or No (Yes is High Risk)

Yes or No (Yes is High Risk)

Always Ask Question 6

Lifetime

Past 3 Months

6) Have you done anything, started to do anything, or prepared to do anything to end your life? Examples: Collected pills, obtained a gun, gave away valuables, wrote a will or suicide note, held a gun but changed your mind, cut yourself, tried to hang yourself, etc.

Yes or No

Yes or No
(Yes is High Risk)

Start With Questions 1 and 2

In the past month:

1) Have you wished you were dead or wished you could go to sleep and not wake up? Yes or No

2) Have you actually had any thoughts about killing yourself? Yes or No

If YES to 2, answer questions 3, 4, 5 and 6.

If NO to 2, go directly to question 6.

In the past month:

3) Have you thought about how you might do this? Yes or No

4) Have you had any intention of acting on these thoughts of killing yourself, as opposed to you have the thoughts but you definitely would not act on them? Yes or No
If yes, then the person is High Risk.

5) Have you started to work out or worked out the details of how to kill yourself? Do you intend to carry out this plan? Yes or No
If yes, then the person is High Risk.

Always Ask Question 6

In your lifetime OR in the past three months:


6) Have you done anything, started to do anything, or prepared to do anything to end your life? Examples: Collected pills, obtained a gun, gave away valuables, wrote a will or suicide note, held a gun but changed your mind, cut yourself, tried to hang yourself, etc. Yes or No
If yes to the past three months, then the person is High Risk.

Any yes indicates the need for further care. However, if the answer to 4, 5 or 6 is yes, immediately escort the person to emergency personnel for care, call 1-800-273-8255, text 741741 or call 911. Don’t leave the person alone. Stay with them until they are in the care of professional help.

If you are worried about a loved one, call the National Suicide Prevention Lifeline at 1-800-273-8255 or visit suicidepreventionlifeline.org.

Used with permission from The Columbia Lighthouse Project

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