Suicidal Ideation as an Articulation of Intent: A Focus for Suicide Prevention?

Suicidal ideation is the most common of all suicidal behavior, but only a minority of ideators ever engages in overt self-harm. If ideation is to prove useful in the assessment of suicide intent and risk, factors creating continuity between suicidal ideation and action need to be carefully examined. The relationship between ideation and intent may resolve this dilemma, as intent is assessed by examining thoughts of self-harm in the distressed person, yet there is debate as to whether ideation must involve intent. Applying ideation as a risk factor is complicated by the failure to agree upon its definition within the nomenclature of suicidology (Leenaars et al., 1997; Shneidman, 1995). Suicide ideators are an important group because most suicides and parasuicides have engaged in suicidal thoughts prior to their acts (Shneidman, 1996). Identification of those ideators most likely to attempt or commit suicide is therefore a clinical priority (Bagley, 1975).