| Wish to live | Moderate/Strong Weak None |
| Wish to die | None Weak Moderate/Strong |
| Reasons for living / dying | For living outweigh for dying About equal For dying outweigh for living |
| Desire to make active suicide attempt | None Weak Moderate/Strong |
| Passive suicidal desire | Wound take precautions to save life Would leave life/death to chance Would avoid steps necessary to save or maintain life |
| Duration of suicide ideation / wish | Brief fleeting periods Longer periods Continuous (chronic) or almost continuous |
| Frequency of suicide ideation | Rare/Occasional Intermittent Persistent/Continuous |
| Attitude toward ideation/wish | Rejecting Ambivalent/Indifferent Accepting |
| Control over suicidal action / acting - out wish | Has sense of control Unsure of control Has no sense of control |
| Deterrents to active attempt | Would not attempt because of a deterrent Some concern about deterrents Minimal or no concern about deterrents |
| Reason for contemplated attempt | To manipulate the environment; get attention or revenge Combination of desire to manipulate and to escape Escape/Surcease/Solve problems |
| Method Specificity or planning of contemplated attempt | Not considered Considered but details not worked out Details worked out and well - formulated |
| Method Availability or opportunity for contemplated attempt | Method not available or no opportunity Method would take time or effort; Opportunity not readily available Future opportunity or availability of method anticipated |
| Sense of capability to carry out attempt | No courage, too weak or afraid, incompetent Unsure of courage or competence Sure of competence or courage |
| Expectancy / anticipation of actual attempt | No Uncertain/Not sure Yes |
| Actual preparation for contemplated attempt | None Partial Complete |
| Suicide note | None Started but not completed, or only thought about Completed |
| Final acts in anticipation of death | None Thought about or made some arrangements Made definite plans or completed arrangements |
| Deception or concealment of contemplated suicide | Revealed ideas openly Held back on revealing Attempted to deceive, conceal or lie |
Suicide incidence is relatively low in the United States, but is prevalent enough to make it the 11 th leading cause of death in 2000. Adolescents and the elderly are at highest risk. Males are more successful than females at suicide, with females making more frequent, but less successful attempts. Two-thirds of successful suicide attempts occur on the first attempt.
It is unclear whether screening for suicidal ideation results in any benefit on a routine basis; however, various scales, including the Scale for Suicide Ideation (SSI) are commonly utilized for screening in appropriate cases. The SSI appears to be a valid measure of suicidal ideation in both adolescents and adults.
The SSI is clinician administered in a structured patient interview. There are 19 questions meant to evaluate 3 dimensions of suicidal ideation:
Scoring for each item is from 0-2 points with a higher total score indicating a higher level of suicidal ideation (range of scores 0-38).
In adults, a score of >=6 points is often used as a cutoff to indicate clinically significant suicidal ideation. Holi, et al., found that a cutoff for 3-4 points for adolescents "may be useful."
The Questionnaire:
References: