In the standard suicide risk assessment sequence, which factor comes immediately after ideation?

• A. Plan
• B. Intent
• C. Means
• D. Immediacy of risk

Answer: (B)

The key idea is moving from thinking about self-harm to deciding to act. After someone reveals suicidal thoughts (ideation), the most important next thing to assess is whether they have intent—the decision or plan to act on those thoughts. Intent signals a real commitment to act and is the strongest predictor of imminent danger, so it guides how urgently you need to intervene. Planning and means are important refinements that determine how feasible and lethal an act would be, but they assume there is already intent to act. Immediacy of risk measures how soon an act might occur, which is also assessed after establishing intent. So, immediately after ideation, evaluating intent best indicates whether the person is at high imminent risk and requires urgent safety actions.