Two “Tricks of the Trade” for Assessing Suicidal Intent

Mar 07, 2017

“But I am talking about the general psychological health of the species, man.
He needs the existence of mysteries. Not their solution.”

from “The Magus”
by John Fowles

Two “Tricks of the Trade” for Assessing Suicidal Intent

TISA Description of the Problem: It is always challenging to uncover a client’s real intent with regard to attempting suicide. Sometimes the clients themselves may feel uncertain of their intent. The following sophisticated tips by Daniel Mayman may offer some help in this regard.

Tip: I find that the following questions often help both the client and myself to better gauge the client’s immediate suicide risk. Clients seem to find both questions to be thought provoking, and they often lead to an increase in open discussion:

1) “I know that it’s not reasonable to ask you to promise never to commit suicide, but for how long a time could you promise me you will absolutely not kill yourself?” (Note that this question often leads into a productive exploration of treatment planning).

2) “What’s the percent chance you’ll be alive in two weeks time?”

TISA Follow-up: There is a frankness and openness to both of these questions, that I think many clients will find refreshing. They invite a collaborative approach to both the assessment of risk and treatment planning.

Tip provided by:

Daniel Mayman, M.D.
Psychiatry Resident, third year