Suicide risk and inability to stay safe

Suicide risk may be stated directly or hinted at through phrases about hopelessness, goodbye messages, giving possessions away, disappearing, overdose, self-harm or being unable to stay safe. These contacts should not be recorded as vague appointment requests.

Some people speak calmly when they are at high risk. Others may sound distressed, angry, intoxicated, ashamed or unwilling to answer questions. Reception staff should listen for warning words, keep the person engaged where possible, and activate the local urgent route.

Listen or look for

• Direct suicidal wording: "I want to die", "I am going to kill myself", "I cannot stay safe" or similar.
• Plan or intent: reference to tablets, weapons, ligatures, locations, timing, letters or goodbye messages.
• Recent or current self-harm: cutting, overdose, injury, poisoning or preparation to harm themselves.
• Being unreachable after concerning messages: especially where a third party reports goodbye messages or disappearance.
• Escalating distress: panic, agitation, despair, intoxication, refusal of help or sudden calm after serious threats.

Do not make it vague

"Has tablets in front of them and does not want to be alive tonight" is clearer and safer than "low mood". "Sent goodbye messages and cannot be reached" is clearer than "mental health concern". Exact wording helps the next person understand the urgency.

If the person is on the phone, local protocols may require staff to keep them talking while help is arranged. For online or third-party contacts, record who will check location and call-back details, and which crisis or safeguarding routes will be used.

Third-party contacts

Suicide-risk wording should remain visible in the record and should trigger urgent ownership, even when the person has not used clinical language.