and gets out of bed for the day (i.e. cannot fall back asleep). Notes: Score unable to score = a absent = 0 wakes up on own but goes back to sleep = mild = 1 wakes earlier than usual and gets out of bed for the day = severe = 2 16-19: ideational disturbance Q’s 16. Suicide (feels life is not worth living, suicide attempt or wishes) Interviewing staff or other informant: Interviewing the care recipient or Observation: In the last week, has X/ she/ he said that life A. In the last week, have you had any thoughts that isn’t worth living or that she would rather be dead? (rate life worth living? isn’t 0 for a history of, but without current thoughts) B. In the last week, have you had any thoughts that If yes, has she/ he spoken of wanting to harm you would rather be dead? herself? If yes to either A or B have you had any thoughts of If yes, has she/ he spoken of how she would do wanting to harm or kill yourself? that? (rate 1 for passive thoughts - has no plan ) If yes, have you thought about how you would do Can you give me an example? (rate 2 for active that? suicidal wishes and/ or any recent attempts, Can you give me an example? gestures or plans) Staff: Interview Other: Observation Guideline: Rate 1 for passive thoughts (feels life worth living or would rather be dead but has no plan to isn’t end their life). Rate 2 for active suicidal wishes and/or any recent attempts, gestures or plans. A history of one or more suicide attempts without current passive or active thoughts is not scored. Notes: Score unable to score = a history of one or more suicide attempts without current passive or active thoughts = absent = 0 passive thoughts = mild = 1 active suicidal wishes and/ or any recent attempts, gestures or plans = severe = 2
and gets out of bed for the day (i.e. cannot fall back asleep). Notes: Score unable to score = a absent = 0 wakes up on own but goes back to sleep = mild = 1 wakes earlier than usual and gets out of bed for the day = severe = 2 Q’s 16-19: ideational disturbance 16. Suicide (feels life is not worth living, suicide attempt or wishes) Interviewing staff or other informant: In the last week, has X/ she/ he said that life isn’t worth living or that she would rather be dead? (rate 0 for a history of, but without current thoughts) If yes, has she/ he spoken of wanting to harm herself? If yes, has she/ he spoken of how she would do that? (rate 1 for passive thoughts - has no plan ) Can you give me an example? (rate 2 for active suicidal wishes and/ or any recent attempts, gestures or plans) Interviewing the care recipient or Observation: A. In the last week, have you had any thoughts that life isn’t worth living? B. In the last week, have you had any thoughts that you would rather be dead? If yes to either A or B have you had any thoughts of wanting to harm or kill yourself? If yes, have you thought about how you would do that? Can you give me an example? Staff: Interview Other: Observation Guideline: Rate 1 for passive thoughts (feels life isn’t worth living or would rather be dead but has no plan to end their life). Rate 2 for active suicidal wishes and/or any recent attempts, gestures or plans. A history of one or more suicide attempts without current passive or active thoughts is not scored. Notes: Score unable to score = a history of one or more suicide attempts without current passive or active thoughts = absent = 0 passive thoughts = mild = 1 active suicidal wishes and/ or any recent attempts, gestures or plans = severe = 2
acfi_assessment_pack_2017.docx