Editing Mental Health and Psychosocial Nursing (section)

=== Assessment ===
Ask directly and specifically. Asking about suicide does not plant the idea. Progress from ideation to plan to means to intent to preparatory behavior:
# "Have you had thoughts of killing yourself?"
# "Do you have a plan?"
# "Do you have access to what you would need?"
# "What has stopped you so far?"
# "Have you done anything to prepare, such as giving things away, writing a note, or changing a will?"

'''A specific plan with available and lethal means and a set time is the highest-risk profile and requires immediate one-to-one observation.''' Screening tools include the Columbia-Suicide Severity Rating Scale and the ASQ; they support but do not replace clinical judgment.

Warning signs of imminent risk include a '''sudden unexplained calm or improvement in mood''' in a previously despondent client, which may signal that the decision has been made; giving away prized possessions; saying goodbye; and finalizing affairs.