Did you know that 70% of people who commit suicide tell someone about their
plans, or give warning signs? Take this questionnaire to find out if someone
you know needs help.
Download the Suicide Risk Questionnaire (PDF) - for Community Members
Download the Suicide Risk Questionnaire (PDF) - for Military and their Family Members
Part I: Suicide Risk Questionnaire
Have you heard someone say:
Have you observed:
Life isn't worth living
My family would be better off
without me
Next time I'll take enough pills to
do the job right
Take my (prized collection,
valuables) - I don't need this
stuff anymore
I won't be around to deal with
that
You'll be sorry when I'm gone
I won't be in your way much
longer
I just can't deal with
everything -- life's too hard
Nobody understands me -- nobody
feels the way I do
There's nothing I can do to
make it better
I'd be better off dead
I feel like there is no way out
Getting affairs in order
(paying off debts, changing a will)
Giving away articles of
either personal or monetary value
Signs of planning a suicide such
as obtaining a weapon or writing a suicide note
Part II: Depression Risk Questionnaire
Have you noticed the following signs of depression:
If depression seems possible, have you also noticed:
Depressed mood
Change in sleeping
patterns (too much/little, disturbances)
Change in weight or
appetite
Speaking and/or moving with
unusual speed or slowness
Loss of interest or
pleasure in usual activities
Withdrawal from family and
friends
Fatigue or loss of energy
Diminished ability to think
or concentrate,
slowed thinking or indecisiveness
Feelings of worthlessness,
self-reproach, or guilt
Thoughts of death, suicide, or
wishes to be dead
Extreme anxiety, agitation,
irritability or risky behavior
Racing thoughts, excessive
energy,
reduced need for sleep
Excessive drug and/or
alcohol use or abuse
Neglect of physical health
Feelings of hopelessness