C-SSRS Assessment

Patient Information

• Patient Name: Marcus Vance
• Date of Birth (DOB): 14/08/1989

Suicidal Ideation

1. Wish to be Dead

• Have you thought about being dead or what being dead would be like? Yes, reports intermittent thoughts that death would bring relief from chronic insomnia and financial stress.
• Have you wished you were dead or wished you could go to sleep and never wake up? Yes, states he frequently wishes he would not wake up in the morning.
• Do you wish you were no longer alive? No
• Since last visit: Yes [X] No [ ]

2. Non-Specific Active Suicidal Thoughts

• Have you thought about doing something to make yourself no longer alive? Yes, fleeting thoughts of ending his life over the past week.
• Have you had thoughts about killing yourself? Yes, brief thoughts of suicide when alone at night.
• Since last visit: Yes [X] No [ ]

3. Active Suicidal Ideation with Methods (Not Plan) Without Intent to Act

• Have you thought about how you would do that or make yourself no longer alive? Yes, considered overdosing on his prescribed quetiapine (Seroquel®) 50 mg tablets.
• Since last visit: Yes [X] No [ ]

4. Active Suicidal Ideation with Some Intent to Act Without Specific Plan

• When you thought about making yourself no longer alive, did you think you might actually do it? No
• Since last visit: Yes [ ] No [X]

5. Active Suicidal Ideation with Specific Plan and Intent

• Have you decided how or when you would make yourself no longer alive? No
• Have you planned how you would do it? No
• When making this plan, was any part of you considering actually carrying it out? No
• Since last visit: Yes [ ] No [X]

Intensity of Ideation

• Most Severe Ideation: 3 - Active Suicidal Ideation with Any Methods (Not Plan) without Intent to Act
• Description: Thoughts of overdosing on prescribed quetiapine without specific plan or intent to act, citing his sister as a strong protective factor.
• Frequency: 2 = A few times (Patient states these thoughts occurred 2 to 3 times over the past week, lasting a few minutes each time).

Suicidal Behavior

Actual Attempt

• Did you do anything to try to kill yourself or make yourself no longer alive? No
• Did you deliberately hurt yourself? Yes, superficial cutting on the left volar forearm with a razor blade 4 days ago.
  • Did you hurt yourself as a way to end your life? No
  • Did you want to die, even a little, when you deliberately hurt yourself? No
  • Were you trying to make yourself no longer alive when you deliberately hurt yourself? No
  • Did you think it was possible that you could have died from deliberately hurting yourself? No
• Was this entirely for reasons other than ending your life, such as feeling better or getting a reaction? Yes, states he cut himself purely to relieve acute emotional numbness and anxiety.

Self-Injurious Behavior (Non-Suicidal)

• Has the patient engaged in non-suicidal self-injurious behavior? Yes, made 3 superficial lacerations on the left forearm to alleviate emotional numbness.
• Since last visit: Yes [X] No [ ]

Self-Injurious Behavior (Intent Unknown)

• Has the patient engaged in self-injurious behavior for which intent is unclear? No

• Since last visit: Yes [ ] No [X]

• Total Number of Suicide Attempts: 1 (Historical attempt in 2019; 0 since last visit)

Interrupted Attempt

• Has there been a time when you began doing something to end your life, but someone or something stopped you before you acted? No
• Since last visit: Yes [ ] No [X]
• Total Number of Interrupted Attempts: 0

Aborted or Self-Interrupted Attempt

• Has there been a time when you began doing something to end your life but stopped yourself before acting? Yes, 6 months ago walked to a bridge with intent to jump, but turned back on his own after thinking of his family.
• Since last visit: Yes [ ] No [X]
• Total Number of Aborted Attempts: 1

Preparatory Acts or Behavior

• Have you done anything to prepare to end your life, such as giving away possessions, writing a goodbye note, or obtaining means? No
• Since last visit: Yes [ ] No [X]
• Total Number of Preparatory Acts: 0

Suicide Outcome and Lethality

• Death by Suicide Since Last Visit: No
• Most Lethal Attempt Date: 12/11/2019
• Actual Lethality/Medical Damage: 2 (Moderate physical damage; medical attention needed following historical paracetamol (acetaminophen, Tylenol®) overdose)
• Potential Lethality (if no actual damage): Not applicable (Actual medical damage occurred)