• Severe depression
  
• Feelings of helplessness or hopelessness
  
• Substance abuse or mental health disorders
  
• Compulsive gambling
  
• Delusions of auditory hallucinations commanding self-harm
  
• Chronic debilitating or severe illness
  
• Severe pain
  
• Severe unrelenting anxiety
  
• Loss of self-esteem
  
• Severe over reaction to stress
  
• Lack of impulse control or poor judgment
  
• Feelings of rage, hostility, or revenge
  
• Repression of angry feelings
  
• Severe internal conflicts, such as overwhelming guilt or ambivalence

Stressors

• History of abuse
  
• Dysfunctional family
  
• Relationship difficulties
  
• Legal problems or criminal involvement
  
• Severe financial problems
  
• Experience of a serious loss or multiple losses
  
• Extreme social isolation from lack of social support
  
• Spiritual distress
  
• Feeling that there is no future
  
• Cult membership
  
• Family history of suicide
  
• Previous suicide attempts or threat

Suicidal Plan:

• Suicidal thoughts or ideation
  
• Getting personal business in order or giving away possessions
  
• Having a high lethality suicide plan (definite plan, time, place and means) to die
  quickly.
  
• Unwillingness to sign a no-suicide contract (contract signed by the client that contains a statement such as, “I will not kill myself in any way shape or form for any reason”).