Promoting Hope, Preventing Suicide

Research and advice on preventing teen and adult suicide.

by Elana Premack Sandler, L.C.S.W., M.P.H.

Elana Premack Sandler, LCSW, MPH, is a public health social worker specializing in violence and injury prevention and adolescent health promotion. See full bio

October 14, 2009, Anxiety

What are the suicide warning signs to remember?

Using a mnemonic to remember suicide warning signs

Several years ago, the American Association of Suicidology developed a mnemonic to aid in remembering the warning signs for suicide. It's quite a list, so a quick way of recalling the most important warning signs can be very beneficial. The mnemonic developed, IS PATH WARM? appears below, along with further detail about each warning sign.

I Ideation
S Substance Abuse

P Purposelessness
A Anxiety
T Trapped
H Hopelessness

W Withdrawal
A Anger
R Recklessness
M Mood changes

The warning signs of acute risk are related to suicide ideation and require immediate action:
-Threatening to hurt or kill himself or herself, or talking of wanting to hurt or kill himself or herself; and/or,
-Looking for ways to kill himself or herself by seeking access to means; and/or,
-Talking or writing about death, dying, or suicide, when these actions are out of the ordinary.

Additional Warning Signs
Increased substance use
No reason for living; no sense of purpose in life
Anxiety, agitation, unable to sleep or sleeping all the time
Feeling trapped - like there's no way out
Hopelessness
Withdrawal from friends, family, and society
Rage, uncontrolled anger, seeking revenge
Acting reckless or engaging in risky activities, seemingly without thinking
Dramatic mood changes

Some details to keep in mind: this list is not a ranking of warning signs based on prevalence, nor is it a list of risk factors, which are related to the potential, rather than imminent, risk of suicide. There has been some recent debate in the suicidology and suicide prevention communities regarding the usefulness of this mnemonic to remember the warning signs. What do you think? What devices have you used to remember other signs or symptoms?