Technical Counseling
Suicide and Safety
Talking about suicide doesn’t cause it — silence does.
Most people in the United States experience suicidal thoughts at least once in their lives. These thoughts aren’t proof of weakness or failure; they’re signs of deep pain and disconnection. My goal is to make it safe to talk about those thoughts openly and without judgment.
In therapy, we use a shared language I developed called the Suicidality Scale, which helps clients describe their level of risk clearly and safely. The scale runs from 6 to 0, with 6 representing a completed suicide and 0 representing no suicidal thoughts. It allows us to speak honestly about where you are without fear of being misunderstood or punished.
Suicidality Scale (6–0):
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6 – Dead by suicide. I avoid the phrase “completed suicide” because it implies success.
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5 – Immediately after a suicide attempt. People often fall into two groups here: those relieved to have survived and those angry they did. I have not worked directly with anyone at this level.
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4 – Active suicidal thoughts with a detailed plan or visualization and linked to a specific trigger or short timeframe. At this level, I must act to ensure safety, possibly requiring hospitalization.
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3 – Suicidal thoughts with a plan or visualization but without an immediate timeframe or likely trigger. This level still may require hospitalization, especially if combined with high-risk factors like substance use, bipolar disorder, or psychosis.
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2 – Suicidal ideation without a plan or visualization. There’s no immediate danger, but we talk openly to prevent escalation.
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1 – Passive suicidality or morbid rumination. Thoughts like “I don’t care if I get hit by a bus.” These thoughts deserve attention before they deepen.
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0 – No suicidal thoughts.
There’s also a not life-threatening cognitive form where suicide appears as a habitual mental “escape hatch.” It’s not life-threatening, but it’s important to address so that the mind learns new ways to handle stress.
I’ve never had to hospitalize anyone against their will — but I will do so if necessary to protect life.
My commitment is compassion first, safety always.