National Suicide Prevention Lifeline (NSPL) Suicide Risk Assessment Standards
Core Principles and Subcomponents of Suicide Assessments
Adapted from original source (2006)
SUICIDAL DESIRE
SUICIDAL CAPABILITY
SUICIDAL INTENT
BUFFERS/CONNECTEDNESS
Suicideal ideation  Hurting self
and/or others
Psychological Pain
 Hopelessness
 Helplessness
 Perceives self as
a burden on
others
Feeling trapped
History of suicide attempts
Attempt in progress
Immediate supports
Exposure to someone
else's death by suicide
Plan to hurt self/other
Method known
Social upports
History of/current violent
to others
Available means of hurting
self/other
Currently intoxicated
Substance abuse
Acute symptoms of mental
illness - e.g.
 Recent dramatic
mood change
 Out of touch with
reality
Extreme agitation / rage e.g.
 Increased anxiety
 Decreased sleep
 Recent acts
and/or threats of
aggression
Preparatory behaviors
Planning for the future
Expressed intent to die
Ambivalence for living
Core values/beliefs
Sense of purpose
Suicidal Desire
In studies by Beck, Joiner, Rudd, and colleagues (e.g., Beck et al., 1997; Joiner et al., 1997, 2003), suicidal
desire has been shown to be made up of the following components: No reasons for living; wish to die;
wish not to carry on; passive attempt (e.g., not caring if death occurred); and desire for suicide attempt .
Influenced by several other strands of research (e.g., Rudd et al., 2006; Joiner [2005] on
burdensomeness; Williams [2006] on feeling trapped), the CTS emphasized psychological conditions
that, while not the same as suicidal desire, are strong contributors to it - namely, feeling trapped, like
there is no alternative course of action or escape, and psychological pain (i.e., hopelessness,
helplessness, and perceiving oneself as a burden on others).
Suicidal Capability
A sense of fearlessness to make an attempt; a sense of competence to make an attempt; availability of
means to and opportunity for attempt; specificity of plan for attempt; and preparations for attempt.
Included in this are these factors: history of prior and/or multiple attempts; history of violence to
others; exposure to someone else's death by suicide; availability of means; current intoxication or
tendency toward frequent intoxication; acute symptoms of mental illness; recent dramatic mood
change; out of touch with reality; extreme rage; increased agitation; decreased sleep.
Suicidal Intent
Factors indicating suicidal intent include: plan or attempt in progress; imminent plan to hurt self/or
another; preparatory behaviors; expressed ientent to die (little ambivalence)
Desire by itself is best vieweed as a sypmtom of a mod disorder, and does not entail significant risk by
iteslf. Capability and inetn are more pernicious, and here again, the safety afforded by bbuffers is partly
determinative. if safety is hghhigh, capability annd/or intent do not convey the higher risk cateogries, but
may convey moderate reisk and require regular monitoring. If safety is low, capability and/or ientnt is a
more serious concern, and requires active intervnetion, though problbabyly not oth level o frigor ior
immaacy coccasionsed ty the conmbinations of desre capability, and entent, as noted in the prior
graphics.
When desire is paired with either intent or capability, (but not both), risk is lower but still considerable, and the
determination of whether risk is particularly high rests with the safety afforded by buffers -- if safety is high, risk is
more moderate (though still elevated and in need of regular monitoring); if safety is low, risk is approximately as
high as when desire, capability, and intent are all present.
When suicidal desire, suicidal capability, and suicidal intent are all present, risk is high, and this is essentially true
regardless of the presence of buffers.