75 Suicide Risk Assessment Questions to Ask Clients in Therapy Sessions

Suicide is a significant health concern within the United States among individuals of various ages and demographics. It is the second leading cause of death for those between the ages of 10 to 24 years old, which showed an increasing trend in 2021. Accidental injuries, such as poisonings and falls, have also increased, gaining their attention as a safety concern. Keep reading to learn 75 suicide risk assessment questions you can ask your clients in therapy sessions.

There are some variations in the statistics regarding suicide among those with varying demographics. As an example, the suicide rate among men was four times higher than that of women, and adults over the age of 85 showed the highest rates compared to other age groups. American Indian and Alaska Natives had the highest rates of suicide in the U.S., while the lowest rate was observed among Asians.

The Centers for Disease Control and Prevention (CDC) indicated that approximately 10.6 million adults in the United States. This is approximately 4.3% of the adult population. The prevalence of suicidal ideation can vary in different areas of the country. For some, suicidal ideation includes thoughts of death or wanting to die, while about 1.3% find that their thoughts begin to focus on developing a suicide plan.

The CDC indicated that the prevalence of suicidal thoughts, planning, and attempts was higher among adults between the ages of 18 and 39, those who are non-college graduates, those living in poverty, and individuals who are widowed, separated, divorced, or married. Having an understanding of risk factors for suicide is essential for mental health professionals. It is also important to have the ability to understand the severity of symptoms and assess risks. You may find yourself using suicide risk assessment questions in inpatient or outpatient therapy settings with clients who are new to you, or those you have been working with. You may use questions and determine that they are not at risk of harming themselves, or you may help them get the support they need for overall mental wellness. 

View all Suicide Prevention Worksheets

Getting Ready for Your First Therapy Session with a New Client

When you’re preparing to meet with a new client, we recommend taking time to review the paperwork you have received so far. While this can vary among different clinical settings, you may have referral paperwork, self-report forms, screeners, or even a completed biopsychosocial assessment. Regardless of the setting and population that you typically work with, it is important to ensure that you’re able to properly assess for self-harm and suicidal concerns.

One way that you can approach this topic is to use worksheets or templates. TherapyByPro is a trusted resource among mental health professionals that offers a range of customizable worksheets, including those for self-harm and suicidal concerns. You may find that having worksheets on hand allows you to be prepared for assessments when needed. Examples of worksheets that can be used in therapy sessions include:

• Suicide Prevention Worksheet Bundle
• Mental Health Risk Assessment
• Suicide Risk Assessment Form
• Suicide Triggers and Coping Skills Worksheet
• Suicide Safety Plan Template   

We encourage you to take time to check in on yourself before meeting with a new client. While we can review paperwork beforehand, there is no way for us to truly predict how clients will feel when they come into your session. With an awareness of our own thoughts and internal experiences, we can take time to use our coping skills to ensure that we are ready to sit with clients in a supportive and empathetic manner.

What Suicide Risk Assessment Questions Should I Ask In Sessions?

If you find yourself thinking that it would be helpful to use suicidal ideation questions in session, we encourage you to tailor your questions to your client. Being direct in the language that you use can help you properly assess risk and other factors that help determine how to move forward with your session. Continue reading for suggestions of questions about suicide that you can incorporate into your sessions:

1. Can you tell me about your mood in recent weeks?
2. Have you noticed any shifts in your mood?
3. Can you tell me about your sleeping patterns recently?
4. Have you experienced helplessness or hopelessness recently?
5. What enjoyable activities or hobbies have you been doing recently?
6. Have you experienced any major life changes, stressors, or losses recently?
7. Would you say that you feel like a burden to others?
8. On a scale of 1 to 10, with 10 being the best and 1 being the most difficult, how would you rate your mental health?
9. Have you found yourself thinking about going to sleep and not caring if you wake up?
10. Have there been times when you feel those around you would be better off without you here?
11. Has there been a time when you felt as though life was not worth living?
12. Have you found yourself feeling indifferent about being alive?
13. How often would you say that you think about your death?
14. Can you think of a time when you fantasized about what it would be like if you were dead?
15. Do your thoughts about death or dying come and go, or are they persistent?
16. Have you been thinking about hurting or killing yourself?
17. Can you tell me about the last suicidal thought you experienced?
18. How often would you say you experience suicidal thoughts?
19. Have you shared your experience with these thoughts with anyone in your life?
20. Have you felt alarmed or scared about your suicidal thoughts?
21. Are there triggers that you have noticed contribute to the onset of your suicidal thoughts?
22.   What do you think would happen if you acted on these thoughts?
23. Do you feel as though you have control over these thoughts?
24. Has there been a time when you hurt yourself on purpose?
25. Can you tell me about the types of self-harming behaviors you’ve engaged in?
26. When did you first begin self-harming?
27. How often would you say that you engage in these behaviors?
28. Can you tell me about your emotional experiences and thoughts before, during, and after self-harming behaviors?
29. Are there specific triggers, like emotions or thoughts, for your self-harming behaviors?
30. Have you found yourself feeling out of control when you’re engaging in these behaviors?
31. Has there been a time when you didn’t care if your self-harming behaviors caused death?
32. How do you feel about your self-harming behaviors? Is this something you try to hide or are ashamed of?
33. Can you tell me about the last time you engaged in self-harming behaviors?
34. Do you want to die, or do you want the pain you’re experiencing to stop?
35. Have you decided to end your life?
36. Do you think that you would act on this decision?
37. Has there been a time in the past when you attempted to end your life?
38. When was this?
39. Using a scale of 1 to 10, with 1 being not strong and 10 being extremely strong, how strong would you say that your desire to die is at this moment?
40. Do you have any plans to hurt yourself today?
41. Have you written a note or message to family or friends saying goodbye?
42. Does the thought of dying bring you peace or cause distress?
43. Have you made arrangements for after your death?
44. Do you have a specific plan to end your life?
45. Can you tell me about this plan?
46. Do you have access to the means of this plan?
47. Have you thought about when or where you would carry out your plan?
48. Has there been a time when you’ve researched suicide methods?
49. When did you develop your plan?
50. Has your plan changed over time? Why do you think this is?
51. Have you attempted suicide in the past? Can you share with me how many times?
52. Can you tell me the methods you had in your past suicide attempts?
53. Did you receive mental health or physical treatment after your previous attempts?
54. Can you tell me about the events leading up to this attempt?
55. Has your previous suicide attempt changed the way that you think about suicide now?
56. Can you tell me about the reasons you have for living?
57. What gives you hope in life?
58. What brings meaning to your life?
59. Can you tell me about plans you have for your future?
60. Can you think of people in your life who would be hurt if you died?
61. Would you say that your religion or spiritual beliefs discourage suicide?
62. What has kept you from acting on your suicidal thoughts?
63. Can you tell me about what makes you feel safe?
64. Are there any coping skills that help you cope with triggers and other stressors you experience?
65. Who do you turn to for support in your life?
66. Can you tell me about who brings peace to your life?
67. Do you know of a family history of mental health concerns or suicide?
68. Has anyone close to you died by suicide?
69. Can you tell me who you live with?
70. How would you describe your social support?
71. Have you been abused or neglected at home?
72. Can you tell me about the significant stressors or challenges at home, work, or school?
73. Can you tell me about your use of drugs and alcohol recently?
74. Have you found yourself using substances to cope with emotional pain or discomfort?
75. Do you act more impulsively when you’re using drugs or alcohol?

Final Thoughts On Asking the Right Questions in Sessions for Suicidal Clients

Thank you for taking the time to read about suicide risk assessment questions that can be incorporated into your clinical work. Early identification of suicidal thoughts and other risk factors can help you get your client the support they need before their symptoms turn into a crisis. Additionally, the use of through questions can help you develop a personalized treatment plan that addresses their triggers, underlying causes for symptoms, and environmental factors contributing to their suicidal ideation.

Additionally, proper assessment and interventions are an important component of ethical practice. If you find yourself concerned about a client or unsure how to proceed in treatment, we encourage you to seek supervision or consultation from a colleague. This can help you determine how you can best support your client. To learn more about assessing suicidal ideation and appropriate treatment options, we encourage you to explore available continuing education and training opportunities within your professional niche.

TherapyByPro is an online mental health directory that connects mental health pros with clients in need. If you’re a mental health professional, you can Join our community and add your practice listing here. We have assessments, practice forms, and worksheet templates mental health professionals can use to streamline their practice. View all of our mental health worksheets here.

View all Suicide Prevention Worksheets

Resources:

• Harmer B, Lee S, Rizvi A, et al. Suicidal Ideation. [Updated 2024 Apr 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK565877/
• Suicidal thoughts and behaviors among adults aged ≥18 years – United States, 2015–2019. Centers for Disease Control and Prevention. (2022b, January 6). https://www.cdc.gov/mmwr/volumes/71/ss/ss7101a1.htm   

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