Lethality of suicidal intent can be assessed based on the following: Degree of forethought evidenced (eg, by writing a suicide note) Steps taken to prevent discovery Method used (eg, firearms are more lethal than pills) Degree of self-injury sustained Circumstances or immediate precipitating factors surrounding the attempt Mental state at the time of the episode (acute agitation is especially concerning) Recent discharge from inpatient care Recent discontinuation of psychoactive medications Medications may be indicated for any underlying disorder (eg, depression, bipolar disorder, conduct disorder, psychosis) but cannot prevent suicide.