That is, if someone actively wishes his or her own death, then physician evaluation is absolutely essential. By the time someone admits to having a thought or plan to end one's life, the person may have already initiated the plan. It is not uncommon in the Emergency Department to evaluate a person for suicidal ideation who has already taken an overdose, but has told no one. Guessing about a person's true intentions where suicidal ideation is involved is dangerous and wrong. This occurs when a person harms himself or herself in such a way as to bring sympathy but not death.
Many people make gestures that are unintentionally lethal.
For instance, someone may take an overdose of Tylenol in order to gain sympathy, not understanding that an overdose of Tylenol can be fatal. It is not your job as a concerned friend or family member to evaluate the intent of the person with suicidal ideation. Your job is to get them to the hospital as soon as possible. This is a formalized series of questions and commands designed to point toward any psychiatric or neurologic problems that might be affecting the person. For instance, the physician will ask questions designed to screen for the presence of depression and for schizophrenia.