TW: topic of suicide
Contact the 988 Suicide and Crisis Lifeline if you are experiencing mental health-related distress or are worried about a loved one who may need crisis support.
- Call or text 988
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Connect with a trained crisis counselor. 988 is confidential, free, and available 24/7/365.
Visit the 988 Suicide and Crisis Lifeline for more information at 988lifeline.org
The United States surgeon general declared a youth mental health crisis in 2021, citing major increases in depressive symptoms and risk of suicide (OSG, 2021). Furthermore, in May 2023, the surgeon general issued an additional advisory addressing the increased impact of social media on these same issues (APA, 2023). In light of this escalating concern, it is helpful to understand a core facet of suicide risk: suicidal ideation.
Broad definition
Suicidal ideation (SI) is an umbrella term which is broadly understood as thoughts or ideas of one’s death, suicide, or ending ones life. SI is typically categorized into two types: active and passive.
Active SI
Active SI means that thoughts of suicide are specific, and feel desirable on some level to an individual. It often includes specific plans and details for acting on self-injurious behaviors where the individual’s desired outcome is death.
Example of how a professional would assess Active SI
Posner et al. (2010) Columbia Suicide Severity Rating Scale
- Have you thought about how you would do that or how you would make yourself not alive anymore? What did you think about?
Passive SI
Passive SI is defined as having “passing” or “indifferent” thoughts or ideas of wanting to end one’s life. These thoughts and considerations tend to be generalized in nature, and do not typically reference specific plans, details, or intent to act on the SI.
Example of how a professional would assess Passive SI (Harmer et al., 2023)
Miller et al. (1991) Modified Suicidal Ideation Scale
- “Would you deliberately ignore taking care of your health? Do you feel like trying to die by eating too much (too little), drinking too much (too little), or by not taking needed medications?”
How to recognize SI
The Columbia Protocol Community Card is available to the public and details specific questions for helping to determine a person’s risk level.
Formal assessing of SI should be done by a professional and can be assessed through a variety of measures, which include the Columbia Protocol and Columbia-Suicide Severity Rating Scale (C-SSRS), the Modified Suicidal Ideation Scale, and the Beck Scale for Suicidal Ideation (SSI).
Why does it matter?
Both active and passive SI are widely recognized as significant signs that an individual is struggling with suicidality. SI often fluctuates across clinical experiences, and varies in how long it lasts and content. For this reason, it’s important to keep track of pattern, intensity, and nature of SI and additionally important to reassess SI frequently with a professional (Harmer et al., 2023).
Resources:
American Psychological Association. (2023). Health Advisory on Social Media Use in Adolescence. Retrieved from https://www.apa.org/topics/social-media-internet/health-advisory-adolescent-social-media-use.pdf
Harmer, B., Lee, S., Duong, T. V. H., & Saadabadi, A. (2023). Suicidal Ideation. In StatPearls. StatPearls Publishing.
Office of the Surgeon General (OSG). (2021). Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory. U.S. Department of Health and Human Services. Retrieved from https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf
