Suicide Inventory

Heidrich Psychological Evaluations Center and Psychotherapy
270 26th St. Suite 201. Santa Monica, CA. 90405
5743 Corsa Ave. Ste 125. Westlake Village, CA. 91360
Brenda Heidrich | Ph.D Lic# Psy 29105 | Phone: 310-748-8393

Please make sure you answer all required fields to submit this form.
If you do not answer all required fields then the form will not be sent.

Personal Information

This field is hidden when viewing the form
MM slash DD slash YYYY
Name(Required)
MM slash DD slash YYYY

Suicide Inventory

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)
Timing(Required)
Precautions against discovery/intervention(Required)
Acting to get help during/after attempt(Required)
Final acts in anticipation of death (will, gifts, insurance)(Required)
Active preparation for attempt(Required)
Suicide Note(Required)
Overt communication of intent before the attempt(Required)
Self Report
Alleged purpose of attempt(Required)
Expectations of fatality(Required)
Conception of method's lethality(Required)
Seriousness of attempt(Required)
Attitude toward living/dying(Required)
Conception of medical rescuability(Required)
Degree of premeditation(Required)
Other Aspects (Not included in total score)
Reaction to attempt(Required)
Visualization of death(Required)
Number of previous attempts(Required)
Relationship between alcohol intake and attempt(Required)
Relationship between drug intake and attempt(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.
If you do not see the confirmation page after Submitting this form, you must fix any error(s) on this page otherwise the form will not be sent.