Suicidality and Targeted Violence in University Threat Assessment: Behavioral Risk Patterns and Clinical Implications

College campuses are increasingly relying on threat assessment (TA) teams to identify and intervene with students exhibiting behaviors of concern (e.g. stalking, harassment, and targeted violence). Many of these students also present with suicidal ideation embedded within broader mental health concerns, yet the intersection of suicidality and targeted violence risk remains underexplored in college mental health literature. This study analyzes 494 cases managed by a university TA team to better understand how suicidality influences clinical risk indicators and behavioral escalation. Individuals presenting with suicidal ideation were more likely to have diagnosed mental illness, particularly symptoms of psychosis and emotional dysregulation, and often voiced grievances rooted in perceived victimization. Their communication patterns were more frequent, multimodal, and threatening, with several including specific plans to harm themselves or others. Although these individuals were not more likely to perpetrate violence, their cases reflected greater psychological complexity and more intense clinical presentations. These findings support the importance of integrating campus mental health professionals into behavioral intervention teams, and the need for Structured Professional Judgment (SPJ) models that account for co-occurring risks to self and others. Implications for assessment, clinical management, and suicide prevention efforts in college settings are discussed.