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DIM - Suicide appears to occur when a mental Disorder is present, Intent develops, and Means become available When Should Suicide Assessment be Conducted?  First assessment on any patient with a mental illness or substance abuse diagnosis.  When a patient experiences sadness, low mood, recent loss or hopelessness, and at each subsequent session as long as the patient remains at risk.  Any time a patient has any other identified potential risk factors.  Dimensions of Assessing Suicide? - Elicitation of suicidal ideation - Identification of risk factors for suicide. - Weighing of risk factors. Overview of Ideation Assessment.  Be sensitive to the different cultural views regarding suicide  At minimum, ask directly for presence and nature of suicidal thoughts, including frequency, intensity, circumstances, & characteristics.  Determine if there is current intent or a plan.  Ask for plan details, including rehearsals.  Assess availability and lethality of means.  Determine if there's a history of thoughts, wishes, impulses or attempts.  Assess attitude, beliefs and values about suicide.  Determine if anything is different this time that will raise or lower risk.