Title: Asking about possible suicide when someone has a mental illness
Course: Non-Communicable Diseases, Emergency Care and Mental Health Part 2 - Ethiopia (Full)

Asking about possible suicide when someone has a mental illness

As stated earlier, suicide and self-harm are significant risks in people with SMIs. In order to investigate the risk in an individual patient, you should gently ask about their view of the future, their sense of self-worth and, when your relationship of trust is well established, whether they experience upsetting or persistent thoughts about death, including possible suicide. Examples of questions you can use to help investigate these difficult issues are provided in Box 10.5.

Box 10.5 Questions to help assess the risk of suicide in someone with a mental illness

- How do you see the future?
- Do you think things will get better for you?
- Are there times when you feel you have had enough of life itself?
- Are there times when you wish you were dead, or when you feel it would be better if you had died?
- I know this may be a difficult question, but have you even considered ending your own life?
- If you have thought of suicide, have you thought how you might do it?

If the person answers yes to any of the last three questions, you must refer them to a higher health facility for further assessment.

In this study session you have learned some important principles of mental health assessments, especially about the risks associated with mental illness. In the next study session we continue the theme of mental health assessment more generally.