Navigating the Waters: Essential Questions for Assessing Suicide Risk in Clients

Suicide remains a pressing public health issue in the United States, affecting people across all age groups and backgrounds. It ranks as the second most common cause of death for individuals aged 10 to 24, a trend that has been rising since 2021. Additionally, accidental injuries—including poisonings and falls—are also on the rise, raising significant safety concerns. To delve further into this topic, continue reading for 75 questions related to suicide risk assessment that can be posed to clients during therapy sessions.

Statistics reveal some differences in suicide rates across various demographics. For instance, the rate of suicide is four times higher in men compared to women, and the highest rates are noted among adults aged 85 and above. American Indian and Alaska Native populations experience the highest suicide rates in the U.S., while rates are lowest among Asian individuals.

The Centers for Disease Control and Prevention (CDC) has reported that around 10.6 million adults, or approximately 4.3% of the adult population, in the United States experience suicidal thoughts. The prevalence of these thoughts differs regionally. For some people, suicidal ideation refers to thoughts of death or a desire to die, and about 1.3% develop actual plans for suicide.

According to the CDC, adults aged 18 to 39, those without a college education, individuals living in poverty, and people who are widowed, separated, or divorced are more likely to experience suicidal thoughts, plans, and attempts. Understanding the risk factors associated with suicide is crucial for mental health professionals. It’s essential to assess the severity of symptoms and evaluate risks effectively. You may need to utilize suicide risk assessment questions during therapy, whether with new clients or those you are already familiar with. This enables you to determine if a client requires immediate support for their mental health.

Explore all available Suicide Prevention Worksheets.

Preparing for Your Initial Therapy Session with a Client

Before meeting a new client, it’s advisable to thoroughly review any paperwork you have received. While this will vary depending on your clinical setting, you may have access to referral forms, self-assessments, or completed biopsychosocial evaluations. Regardless of your typical client demographic, it’s crucial to ensure you are equipped to identify self-harm and suicidal concerns properly.

To facilitate this, consider using worksheets or templates. TherapyByPro is a reliable resource for mental health professionals, offering a variety of customizable worksheets, including those for assessing self-harm and suicidal risk. Having these materials readily available can make assessments more effective. Examples of worksheets suitable for therapy include:

We also encourage you to check in with yourself prior to your session with a new client. Although reviewing paperwork can be beneficial, it can’t fully prepare you for how your clients may feel during your session. By being mindful of our own thoughts and feelings, we can utilize our coping strategies to ensure we provide supportive and empathetic care.

What Questions Should I Ask About Suicide Risk During Sessions?

If you believe it would be useful to explore suicidal ideation with your client, we suggest adapting your questions to suit their needs. Using direct language can help you accurately assess the risk and determine the best path forward. Below are some sample questions regarding suicide that you may find helpful during your sessions:

1. How have you been feeling emotionally in recent weeks?
2. Have you noticed any changes in your mood lately?
3. Could you describe your recent sleep patterns?
4. Have you experienced feelings of helplessness or hopelessness lately?
5. What activities or hobbies have you enjoyed recently?
6. Have you encountered any significant life changes, stresses, or losses recently?
7. Do you feel like a burden to others?
8. On a scale from 1 to 10, with 10 being optimal and 1 being the worst, how do you rate your mental health?
9. Have you ever thought about going to sleep and not caring if you wake up?
10. Have you ever felt that those around you would be better off without you?
11. Have you ever felt like life isn’t worth living?
12. Have you ever felt indifferent about being alive?
13. How often do you think about death?
14. Have you ever imagined what it would be like if you were dead?
15. Are your thoughts about death persistent or do they come and go?
16. Have you contemplated hurting or killing yourself?
17. Could you describe your most recent suicidal thought?
18. How frequently do you experience suicidal thoughts?
19. Have you discussed these thoughts with anyone in your life?
20. Have you felt frightened or alarmed by your suicidal thoughts?
21. Are there particular triggers that lead to your suicidal thoughts?
22. What do you think might happen if you acted on these thoughts?
23. Do you feel in control of these thoughts?
24. Have you ever intentionally harmed yourself?
25. Can you describe the types of self-harm behaviors you have engaged in?
26. When did you first start self-harming?
27. How often do you engage in self-harming behaviors?
28. Can you share your emotional state before, during, and after self-harming?
29. Are there specific triggers, such as feelings or thoughts, that lead to your self-harming behaviors?
30. Do you sometimes feel out of control while engaging in these behaviors?