Nursing Diagnosis for Suicidal Ideation | Symptoms & Plans

Identifying and managing suicidal ideation is a critical skill for any nurse, especially those preparing for the NCLEX-RN. With the increasing prevalence of mental health concerns, including depression and suicide risk, nurses must understand how to assess, diagnose, and intervene effectively. This guide covers the nursing diagnosis for suicidal ideation, including associated NANDA-approved labels, clinical cues, interventions, and care planning strategies.

What is Suicidal Ideation?

Suicidal ideation refers to thoughts or considerations of self-harm or ending one’s life. These thoughts can range from passive wishes to die to active planning of suicide. As a nurse, recognizing these warning signs early and implementing appropriate interventions is crucial to prevent suicide attempts.

Suicidal ideation often occurs in the context of:

• Major depressive disorder

• Bipolar disorder

• Schizophrenia

• Post-traumatic stress disorder (PTSD)

• Substance use disorders

• Situational crises (e.g., loss, trauma, or chronic illness)

Common NANDA Nursing Diagnosis for Suicidal Ideation

When documenting a care plan, use NANDA-approved nursing diagnoses to ensure clarity and consistency. For patients experiencing suicidal thoughts, the most common and appropriate diagnoses include:

1. Risk for Suicide

Definition: At risk for self-inflicted, life-threatening injury.

Related to:

• Depression

• Feelings of hopelessness or worthlessness

• History of suicide attempts

• Substance abuse

• Lack of social support

• Psychosis or hallucinations

As evidenced by (clinical cues):

• Expressed desire to die

• Verbalizing thoughts of self-harm

• Giving away personal belongings

• Sudden mood improvements (may indicate a final decision)

• Withdrawal from others

This is the primary nursing diagnosis for suicidal ideation.

2. Hopelessness

Often used as a secondary nursing diagnosis for depression with suicidal ideation, this reflects the patient’s view that nothing will improve, making life feel meaningless.

Related to:

• Chronic illness

• Loss or grief

• Social isolation

• Ineffective coping mechanisms

3. Ineffective Coping

This diagnosis applies when patients exhibit an inability to manage internal or external stressors, leading to suicidal behaviors.

Useful in care plans involving:

• Substance abuse

• PTSD

• Adolescents facing academic/family pressure

4. Powerlessness

This NANDA diagnosis may be appropriate when patients feel unable to influence events or control aspects of their lives, leading to despair.

Nursing Diagnosis Statement

Risk for suicide related to feelings of hopelessness and depression, as evidenced by verbal expressions of suicidal thoughts, withdrawal from social contact, and history of previous suicide attempts.

Risk Factors to Watch For

Nurses must be vigilant in identifying key suicide risk factors:

Nursing Assessment for Suicidal Ideation

A thorough nursing assessment is the foundation of effective care. Questions may include:

• “Have you had thoughts of harming yourself?”

• “Do you have a plan?”

• “Have you ever attempted suicide before?”

• “Do you feel hopeful about your future?”

Always assess for:

• Lethality of the plan (e.g., firearms, hanging, overdose)

• Means and access

• Timing and intent

• Support systems

• Co-occurring depression or psychosis

Nursing Interventions for Suicidal Ideation

When a patient expresses suicidal thoughts, immediate nursing actions are required. These should always be part of the nursing care plan and tailored to the patient’s risk level.

1. Ensure Patient Safety

• Remove harmful objects (e.g., belts, sharps, medications)

• Initiate suicide precautions (1:1 observation if needed)

• Assign patient to a safe, supervised environment

• Do not leave the patient alone during high-risk periods

2. Build a Trusting Nurse-Patient Relationship

• Use therapeutic communication: open-ended questions, active listening, nonjudgmental attitude

• Show empathy and genuine concern

• Allow the patient to express emotions freely

3. Administer Prescribed Medications

• Monitor the effects of antidepressants, especially SSRIs and mood stabilizers

• Watch closely for increased suicidal thoughts during early treatment phases

4. Collaborate with the Mental Health Team

• Notify the provider or psychiatric crisis team immediately

• Refer to psychologists, psychiatrists, or social workers

• Involve family if appropriate (with patient consent)

5. Create a Safety or Crisis Plan

• Develop an actionable plan the patient can follow when feeling overwhelmed

• Include emergency contact numbers and calming techniques

• Teach the patient to identify personal triggers

6. Education and Support

• Educate the patient and family about depression and suicidal ideation

• Encourage participation in therapy, group counseling, or support groups

• Teach coping skills (journaling, mindfulness, physical activity)

Nursing Care Plan for Suicidal Ideation

NCLEX Tips: Nursing Diagnosis for Suicidal Ideation

The NCLEX-RN often includes psychosocial scenario-based questions, particularly in the Mental Health Nursing section. Here’s how to handle them:

• Always prioritize safety: If a patient mentions suicide, assess for plan and intent.

• Use therapeutic communication: Don’t give false reassurance. Instead, say: “Can you tell me more about how you’re feeling?”

• Know the difference between nursing diagnosis for suicidal ideation and general mood disorders like nursing diagnosis for depression and suicidal ideation.

• Look for NANDA keywords in answer options like: risk for suicide, hopelessness, ineffective coping.

Final Thoughts

The nursing diagnosis for suicidal ideation is a crucial component of psychiatric nursing and is commonly tested on the NCLEX-RN exam. Understanding how to recognize, document, and respond to suicidal behaviors can not only help you pass the exam but save lives in clinical practice.

Stay grounded in NANDA guidelines, prioritize patient safety, and use therapeutic communication as your most powerful tool. As a future nurse, your role in suicide prevention is both vital and potentially life-saving.