During assessment of suicidal ideas or acts, which indicator best signals imminent risk?

• A. The seriousness of the intent
• B. How lethal is the plan
• C. Do they have the means to follow through
• D. Talking about death, giving away things, getting things in order

Answer: (D)

Understanding imminent risk hinges on recognizing concrete preparations that signal a person is about to act. When someone talks about death and also takes steps to finalize affairs—such as giving away prized possessions or making plans to put their life in order—these behaviors show they are actively moving toward completing the act. Such preparatory actions demonstrate a sense of certainty and commitment to the plan, which is the strongest indicator that an attempt could be imminent.

Serious intent and the lethality of a plan are important risk factors, but they don’t by themselves confirm immediacy. A person might express intent or have a highly lethal plan without acting soon, or might have means but not yet be organizing actions. Similarly, having means to follow through is concerning, yet the presence of explicit preparations offers more direct evidence of imminent risk.

So, when you observe behaviors like talking about death in conjunction with giving away possessions or getting affairs in order, that combination signals a high likelihood that an attempt could occur in the near term, and it warrants immediate safety interventions and escalation.