Suicide Inventory

GOODMAN AND HEIDRICH
Psychological Assessment Center and Psychotherapy 270 26th Street #201 Santa Monica, CA 90402
*Donald Goodman, Ph.D Lic# Psy 22613 Phone: 818-917-4524 Fax: 800-878-7720 *Brenda Heidrich ,Ph.D Lic# Psy 29105 Phone: 310-748-8393

Personal Information

Hidden

Date(Required)

MM slash DD slash YYYY

Name(Required)

First Last

Phone(Required)

Email(Required)

Birth Date(Required)

MM slash DD slash YYYY

The suicide intent scale was developed by Aaron T. Beck and his colleagues at the University of Pennsylvania for use with patients who attempt suicide but survive. It is important to understand a patient's will to die in order to assess the severity of the suicide attempt. Some attempted suicides are carried out with little to no intention of cessation of life, while others clearly have no other goal . The suicide intent scale is an attempt to redefine the meaning of attempted suicide, placing them on a scale based on intent. Another factor that plays an important role, but is not listed on the scale below, includes the chosen method of attempted death. Hangings and firearms is clearly more effective tools of suicide, the damages much more difficult to reverse. Suicide by poisoning, on the other hand, is less likely to be successful. This, however, is not the case in less developed nations, where access to emergency treatment is less possible and there is greater access to more deadly poisons such as pesticides . These factors must be also taken into consideration.

Objective Circumstances Related to Suicide Attempt

Isolation(Required)

Somebody present

Somebody nearby, or in visual or vocal contact

No one nearby or in visual or vocal contact

Timing(Required)

Intervention is probable

Intervention is not likely

Intervention is highly unlikely

Precautions against discovery/intervention(Required)

No precautions

Passive precautions (as avoiding other but doing nothing to prevent their intervention; alone in room with unlocked door)

Active precautions (as locked door)

Acting to get help during/after attempt(Required)

Notified potential helper regarding attempt

Contacted but did not specifically notify potential helper regarding attempt

Did not contact or notify potential helper

Final acts in anticipation of death (will, gifts, insurance)(Required)

None

Thought about or made some arrangements

Made definite plans or completed arrangements

Active preparation for attempt(Required)

None

Minimal to moderate

Extensive

Suicide Note(Required)

Absence of note

Note written, but torn up; note thought about

Presence of note

Overt communication of intent before the attempt(Required)

None

Equivocal communication

Unequivocal communication

Self Report

Alleged purpose of attempt(Required)

To manipulate environment, get attention, get revenge

Components of above and below

To escape, surcease, solve problems

Expectations of fatality(Required)

Thought that death was unlikely

Thought that death was possible but not probable

Thought that death was probable or certain

Conception of method's lethality(Required)

Did less to self than s/he thought would be lethal

Wasn't sure if what s/he did would be lethal

Equaled or exceeded what s/he thought would be lethal

Seriousness of attempt(Required)

Did no seriously attempt to end life

Uncertain about seriousness to end life

Seriously attempted to end life

Attitude toward living/dying(Required)

Did not want to die

Components of above and below

Wanted to die

Conception of medical rescuability(Required)

Thought that death would be unlikely if s/he received medical attention

Was uncertain whether death could be averted by medical attention

Was certain of death even if s/he received medical attention

Degree of premeditation(Required)

None; impulsive

Suicide contemplated for three hours of less prior to attempt

Suicide contemplated for more than three hours prior to attempt

Other Aspects (Not included in total score)

Reaction to attempt(Required)

Sorry it was made; feels foolish; ashamed

Accepts both attempt and failure

Regrets failure of attempt

Visualization of death(Required)

Life after death, reunion with descendants

Never-ending sleep, darkness, end of things

No conceptions of or thoughts about death

Number of previous attempts(Required)

None

One or two

Three or more

Relationship between alcohol intake and attempt(Required)

Some alcohol intake prior to but not related to attempt; reportedly not enough to impair judgment, reality testing

Enough alcohol intake to impair judgment; reality testing and diminish responsibility

Intentional intake of alcohol in order to facilitate implementation of attempt

Relationship between drug intake and attempt(Required)

Some drug intake prior to but not related to attempt; reportedly not enough to impair judgment, reality testing

Enough drug intake to impair judgment; reality testing and diminish responsibility

Intentional intake of drug in order to facilitate implementation of attempt

Answer(Required)

15-19 Low Intent
20-28 Medium Intent
29+ High Intent

There is also a greater risk of repeated attempts the higher the intent rating.

CAPTCHA