One night…I went down alone to the beach with my thoughts full of death. I took off my clothes and began swimming out to sea. Did I really intend to drown myself? That certainly was in my mind and I left a note with my clothes, the quotation from Euripedes about the sea which washes away all human ills. I went to the trouble of verifying it, accents and all, from the school text…At my present age I cannot tell you how much real despair and act of will, how much play-acting, prompted the excursion.

Evelyn Waugh

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

  1. Isolation
    1. Somebody present
    2. Somebody nearby, or in visual or vocal contact
    3. No one nearby or in visual or vocal contact

  2. Timing
    1. Intervention is probable
    2. Intervention is not likely
    3. Intervention is highly unlikely

  3. Precautions against discovery/intervention
    1. No precautions
    2. Passive precautions (as avoiding other but doing nothing to prevent their intervention; alone in room with unlocked door)
    3. Active precautions (as locked door)

  4. Acting to get help during/after attempt
    1. Notified potential helper regarding attempt
    2. Contacted but did not specifically notify potential helper regarding attempt
    3. Did not contact or notify potential helper

  5. Final acts in anticipation of death (will, gifts, insurance)
    1. None
    2. Thought about or made some arrangements
    3. Made definite plans or completed arrangements

  6. Active preparation for attempt
    1. None
    2. Minimal to moderate
    3. Extensive

  7. Suicide Note
    1. Absence of note
    2. Note written, but torn up; note thought about
    3. Presence of note

  8. Overt communication of intent before the attempt
    1. None
    2. Equivocal communication
    3. Unequivocal communication


    Self Report

  9. Alleged purpose of attempt
    1. To manipulate environment, get attention, get revenge
    2. Components of above and below
    3. To escape, surcease, solve problems

  10. Expectations of fatality
    1. Thought that death was unlikely
    2. Thought that death was possible but not probable
    3. Thought that death was probable or certain

  11. Conception of method's lethality
    1. Did less to self than s/he thought would be lethal
    2. Wasn't sure if what s/he did would be lethal
    3. Equaled or exceeded what s/he thought would be lethal

  12. Seriousness of attempt
    1. Did no seriously attempt to end life
    2. Uncertain about seriousness to end life
    3. Seriously attempted to end life

  13. Attitude toward living/dying
    1. Did not want to die
    2. Components of above and below
    3. Wanted to die

  14. Conception of medical rescuability
    1. Thought that death would be unlikely if he received medical attention
    2. Was uncertain whether death could be averted by medical attention
    3. Was certain of death even if he received medical attention

  15. Degree of premeditation
    1. None; impulsive
    2. Suicide contemplated for three hours of less prior to attempt
    3. Suicide contemplated for more than three hours prior to attempt

    Other Aspects (Not included in total score)

  16. Reaction to attempt
    1. Sorry it was made; feels foolish; ashamed
    2. Accepts both attempt and failure
    3. Regrets failure of attempt

  17. Visualization of death
    1. Life after death, reunion with descendants
    2. Never-ending sleep, darkness, end of things
    3. No conceptions of or thoughts about death

  18. Number of previous attempts
    1. None
    2. One or two
    3. Three or more

  19. Relationship between alcohol intake and attempt
    1. Some alcohol intake prior to but not related to attempt; reportedly not enough to impair judgment, reality testing
    2. Enough alcohol intake to impair judgment; reality testing and diminish responsibility
    3. Intentional intake of alcohol in order to facilitate implementation of attempt

  20. Relationship between drug intake and attempt
    1. Some drug intake prior to but not related to attempt; reportedly not enough to impair judgment, reality testing
    2. Enough drug intake to impair judgment; reality testing and diminish responsibility
    3. Intentional intake of drug in order to facilitate implementation of attempt

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.

Source: Night Falls Fast by Kay Redfield Jamison

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