Rethinking Suicide Risk With a New Generation of Suicide Theories

Background Suicide is a global concern to nurses and other health-care providers. However, deaths by suicide are only part of the spectrum of suicide, as suicidal thinking and behaviors may precede a suicide attempt. Theoretical models are used infrequently in research to explain how the individual progresses from suicidal ideation to a suicide attempt. Thus, there is a critical need to advance the study of suicide with useful theoretical models to describe and explain processes whereby suicidal thoughts transition to attempts and to suicide. Purpose This article provides a conceptual discussion and scoping review comparing historical and contemporary ideation-to-action theories of suicide. Method Systematic reviews and meta-analyses from three databases (CINAHL, JSTOR, and PsychINFO) were reviewed to find literature describing suicide theories. Results Historically, theory applications have limited capacity to differentiate between those individuals with suicidal ideations and those who attempt suicide. Newer theories, grounded in the ideation-to-action framework, propose distinct processes explaining what moves an individual from suicidal ideations toward suicidal behaviors. Implications for Practice The ideation-to-action theories can guide health-care providers' assessment of at-risk individuals beyond merely asking about suicidal thinking. Conclusion The new generation of suicide theories suggest that suicidal ideations are only one component of risk. The common factor in ideation-to-action theories that distinguishes ideators from attempters is the acquired capability for suicide.