What level of suicide lethality is described by more than one predictor or a single intense predictor, with intent and plan but no access to means?

• A. Low
• B. Low-moderate
• C. Moderate
• D. High

Answer: (A)

Supreme risk is determined by how likely someone is to act on their thoughts in the near term, which depends on a mix of predictors, intent, plan, and access to means. In this scenario, there is clear intent and a plan, which signals serious concern, but the absence of access to means reduces the immediacy and feasibility of carrying out the act. Many risk assessment frameworks place higher lethality only when there is both the capacity to act (means) and intent with a plan; without means, the level is categorized as low because the individual cannot readily translate the plan into action. This doesn’t erase risk—safety planning and ongoing support are still essential—but the immediate lethality rating remains low due to the lack of means. If access to means were present or if the person had multiple strong predictors with imminent capability, the level would rise accordingly.