1. Wish to be Dead
Subject endorses thoughts about a wish to be dead or not alive anymore, or wish to fall asleep and not wake up.
2. Non-Specific Active Suicidal Thoughts
General non-specific thoughts of wanting to end one's life/commit suicide (e.g. "I've thought about killing myself") without thoughts of ways to kill oneself/associated methods, intent, or plan during the assessment period.
3. Active Suicidal Ideation with Any Methods (Not Plan) Without Intent to Act
Subject endorses thoughts of suicide and has thought of at least one method during the assessment period. This is different than a specific plan with time, place, or method details worked out (e.g. thought of method to kill self, but not a specific plan). Includes person who would say, "I thought about taking an overdose, but I never made a specific plan as to when, where, or how I would actually do it...and I would never go through with it."
4. Active Suicidal Ideation with Some Intent to Act, Without Specific Plan
Active suicidal thoughts of killing oneself and subject reports having some intent to act on such thoughts, as opposed to "I have the thoughts, but I definitely will not do anything about them."
5. Active Suicidal Ideation with Specific Plan and Intent
Thoughts of killing onself with details of plan fully or partially worked out and subject has some intent to carry it out.
A potentially self-injurious act committed with at least some wish to die, as a result of act. Behavior was in part thought of as method to kill oneself. Intent does not have to be 100%. If there is any intent/desire to die associated with the act, then it can be considered an actual suicide attempt. There does not have to be any injury or harm, just the potential for injury or harm. If person pulls trigger while gun is in mouth, but gun is broken, so no injury results, this is considered an attempt.
Inferring Intent: Even if an individual denies intent/wish to die, it may be inferred clinically from the behavior or circumstanced. For example, a highly lethal act that is clearly not an accident so not other intent but suicide can be inferred (e.g. gunshot to head, jumping from window of a high floor/story). Also, if someone denies intent to die, but they thought that what they did could be lethal, intent may be inferred.
Overdose: Person has pills in hand, but is stopped from ingensting. Once they ingest any pills, this becomes an attempt rather than an interrupted attempt.
Shooting: Person has a gun pointed at self, gun is taken away by someone else, or is somehow prevented from pulling trigger. Once they pull the trigger, even if the gun fails to fire, it is an attempt.
Jumping: Person is poised to jump, is grabbed and taken down from ledge.
Hanging: Person has noose around neck, but has not yet started to hang - is stopped from doing so.
Actual Lethality/Medical Damage:
0 - No physicial damage or very minor physical damage (e.g. surface scratches).
1 - Minor physical damage (e.g. lethargic speech; first-degree burns; mild bleeding; sprains).
2 - Moderate physical damage; medical attention needed (e.g. conscious but sleepy, somewhat responsive; second-degree burns; bleeding of major vessel).
3 - Moderately severe physical damage; medical hispitalization and likely intensive care required (e.g. comatose with reflectes intact; third-degree burnms less than 20% body; extensive blood loss, but can recover; major fractures).
4 - Severe physical damage; medical hospitalization with intesive care required (e.g. comatose without reflexes; third-degree burns over 20% of body; extensive blood loss with usntable vital signs; major damage to a vital area).
5 - Death.
0 - Behavior not likely to result in injury.
1 - Behavior likely to result in injury, but not likely cause death.
2 - Behavior likely to result in death, despite available medical care.