PS12.1 | Psychiatric Emergencies — Glossary

A validated structured instrument that grades suicidal ideation from passive death wishes to active ideation with plan and intent; used to characterise severity and track change over time.

A cognitive state characterised by negative expectancies about the future; within major depressive disorder, hopelessness is the strongest cognitive predictor of suicidal behaviour and must be specifically assessed.

The availability to the patient of the specific means identified in a suicidal plan (e.g., medications, firearms, pesticides); a modifiable risk factor directly addressed by means restriction.

An evidence-based preventive intervention that reduces access to lethal means for at-risk individuals by involving the family in securing or removing medications, weapons, or other agents.

Indian legislation that replaced the Mental Health Act 1987; Section 115 states that a person who attempts suicide is presumed to have severe stress and shall not be punished under any law in force.

An outmoded clinical practice in which a patient agrees not to attempt suicide; has no evidence base and is not recommended; replaced by evidence-based safety planning.

A wish to be dead or for death to occur without an active intention or plan to self-harm; at the lower end of the suicidal ideation spectrum but clinically significant and requiring structured assessment.

A previous episode of deliberate self-harm with intent to die; the single strongest predictor of future completed suicide, elevating risk approximately tenfold.

Variables that buffer against suicidal behaviour, including reasons for living, social support, religious beliefs, future orientation, engagement with treatment, and absence of means access.

A clinical process of categorising a patient's immediate suicide risk as low, moderate, or high based on integrated assessment of ideation, intent, plan, means, history, and protective factors; a guide, not a prediction.

A clinical mnemonic for suicide risk factors: Sex, Age, Depression, Previous attempt, Ethanol/substance use, Rational thinking loss, Social support lacking, Organised plan, No spouse/partner, Sickness.

A collaborative, evidence-based crisis intervention (Stanley-Brown Safety Planning Intervention) in which the clinician and patient construct a written personalised plan listing warning signs, coping strategies, support contacts, and means restriction steps.

Thoughts about killing oneself, ranging from passive death wishes ('I wish I were dead') to active, specific plans; exists on a spectrum and must be characterised by frequency, intensity, and persistence.

The patient's subjective expectation or resolution to act on suicidal thoughts; the degree to which the patient intends to carry out an attempt, elicited by direct questioning.

A specific formulation of how, when, and where a suicide attempt will be carried out; specificity and lethality of the plan are key risk-amplifying features.