Suicide And Crisis Assessment Form Guidelines (Page 3 of 6) in pdf

Suicide And Crisis Assessment Form Guidelines Page 3

• How did they complete suicide?

Risk increases if family/network history of completed suicide exists and risk fur-

ther increases the more recent the family/network completed suicide.

Part B: Danger to Others

Homicidal Thoughts:

Yes

• Are you currently having any thoughts of hurting or killing anyone?

• What thoughts are you having? Tell me more (get speciﬁc details).

• Who are the thoughts about?

• How far are you away from that (those) persons(s)? How long would it

take you to ﬁnd them?

• Is there anyone there with you right now? (Assess the safety of that person)

• How much time are you spending thinking about hurting or killing that

(those) person(s), or someone? Are the thoughts ﬂeeting?

• Have you pictured yourself following through with your plan?

• Is the intensity of the thoughts increasing?

Current Violent Thought:

Yes

Plan

• Find out as many details as possible.

• Who does it involve?

• How soon do they plan to carry it out?

• What means (weapons, etc.) does it entail? Are the means to carry out the

plan in place?

• When do they intend to act on their thoughts/plan?

Also assess general thoughts of violence or anger. (e.g., Do such thoughts relate

to past abuse/trauma? How do they express anger and violence?)

Access to Plan:

Yes

. Is (are) the person(s) you are wishing to harm/kill within access (versus

feeling vengeful toward someone you have lost track of and are unable to

locate).

. Do you have weapons/means in place to carry out the plan? (How easily

can client access the means/weapons needed?)

appendix b

Suicide And Crisis Assessment Form Guidelines Page 3