The Suicide Threshold and Suicide Likelihood Framework

A Proposed Longitudinal System for Population-Level Suicide Prevention

Abstract

Suicide remains one of the world's major public-health challenges. The World Health Organization estimates that more than 700,000 people die by suicide each year. Suicide is multifactorial, emerging through interactions among psychological, biological, social, economic, and environmental conditions. (who.int)

Most suicide-prevention systems concentrate on identifying people after significant distress has already become visible. This paper proposes a complementary approach: a population-wide system designed to identify changes in vulnerability before they develop into acute crisis.

The framework introduces two proposed constructs: Suicide Threshold and Suicide Likelihood.

Suicide Threshold represents an individual's relative protective and resilience capacity in the face of severe adversity. Suicide Likelihood represents the individual's current accumulation of circumstances, conditions, and psychological states associated with increased vulnerability to suicidal crisis.

The fundamental proposition is that these dimensions interact. Two individuals may experience similar adversity while possessing very different levels of protective capacity. Conversely, an individual with substantial resilience may become increasingly vulnerable when multiple adverse conditions accumulate simultaneously.

The proposed system would therefore provide a standardized assessment designed by the government but completed individually and privately by the citizen. The assessment would be offered approximately every three months, while retaining an explicit option not to participate. The government would establish the scientific standards, maintain the infrastructure, and use appropriately anonymized and aggregated results to understand population-level changes. It would not ordinarily administer the assessment to individuals itself.

The system would measure not only current vulnerability but also longitudinal change. An individual whose Suicide Likelihood is increasing while their Suicide Threshold is declining could be identified as entering a period of increasing vulnerability, allowing support to be offered before an acute crisis develops.

The proposal is not presented as an established clinical instrument or as a proven method of preventing suicide. It is a research and policy framework whose effectiveness must be demonstrated empirically. Its central hypothesis is that systematic, recurring self-assessment combined with timely human support could move suicide prevention upstream: from responding to crisis toward preventing the conditions that allow crisis to emerge.

1. Introduction

Suicide is rarely the product of one isolated event.

Financial distress, relationship breakdown, serious illness, chronic pain, addiction, social isolation, bereavement, violence, humiliation, academic or occupational pressure, hopelessness, and other adverse conditions can interact to increase vulnerability. At the same time, protective factors such as social connectedness, coping ability, reasons for living, problem-solving ability, and access to support can reduce vulnerability. WHO therefore describes suicide as a multifaceted phenomenon requiring action across health, social, economic, community, and other domains. (who.int)

This creates a fundamental difficulty for prevention.

The same event does not produce the same psychological consequence in every person.

The loss of employment may be a manageable setback for one person and a devastating event for another. A relationship ending may produce temporary grief in one individual and profound destabilization in another. A serious illness may be manageable for a person with strong social support, purpose, financial security, and access to treatment while becoming overwhelming for someone who is isolated and already under severe psychological or economic pressure.

Thus, suicide prevention should consider two questions simultaneously:

What pressures are currently acting upon the individual?

and

What capacity does the individual currently possess to withstand and recover from those pressures?

The Suicide Threshold and Suicide Likelihood framework is constructed around this distinction.

The idea of an individual threshold also has some precedent in suicide research. Research concerning thresholds of unacceptable loss suggests that some individuals who have experienced suicidal behaviour report an internal tolerance limit beyond which life circumstances become subjectively intolerable. In one preliminary study, 70.8% of participants with a history of suicide attempts reported having developed such a threshold, while 63.9% reported that relatively small losses could trigger feelings that life was no longer worth living. The researchers explicitly described the findings as preliminary and called for further study. (pubmed.ncbi.nlm.nih.gov)

The present framework extends this general idea by treating the threshold not as a fixed boundary but as a potentially dynamic characteristic influenced by protective capacities and social conditions.

2. Suicide Threshold

2.1 Definition

Suicide Threshold is proposed as a multidimensional measure of an individual's relative capacity to tolerate, process, and recover from severe adversity without progressing toward suicidal crisis.

The threshold should not be understood as a literal biological line.

Nor should it be interpreted as a permanent personality trait.

It may change throughout a person's life.

An individual's capacity can increase through strengthened coping skills, meaningful relationships, physical health, purpose, successful experiences of overcoming adversity, and other protective factors. Conversely, prolonged stress, isolation, trauma, illness, addiction, exhaustion, or repeated losses may reduce protective capacity.

The threshold may also vary according to the kind of adversity involved.

Someone may be highly resilient in financial crises but exceptionally vulnerable to interpersonal rejection. Another person may function well under social stress while struggling significantly with physical illness or chronic pain.

A scientifically useful Suicide Threshold assessment must therefore measure underlying protective capacities rather than rely on superficial demographic characteristics.

3. Potential Determinants of Suicide Threshold

The original formulation identifies athletic engagement, emotional independence, emotional intelligence, and previous resilience to adversity as potential components of Threshold.

These ideas can be developed into measurable underlying domains.

Potential components include:

emotional regulation

psychological flexibility

problem-solving ability

perceived self-efficacy

tolerance of uncertainty and frustration

ability to recover following adversity

future orientation

sense of purpose

reasons for living

social connectedness

ability to seek help

perceived personal agency

stable routines

physical activity

meaningful social roles

financial and practical independence

previous successful adaptation to adversity

The objective is not to determine who is "strong" and who is "weak."

A lower Threshold should not be treated as a character defect.

A person may simply have a greater psychological sensitivity to particular circumstances.

4. Athletic Engagement and Resilience

The proposition that sustained athletic experience can contribute to a higher Suicide Threshold deserves investigation.

The original paper cites research involving 8,599 young athletes in which higher competitive participation was associated with lower rates of suicidality.

This does not establish that athletic participation itself causes a higher Suicide Threshold.

The potentially important variables may instead be the capacities developed through particular forms of athletic experience:

disciplined goal pursuit

repeated exposure to failure and recovery

delayed gratification

physical activity

structured routines

mastery and competence

social belonging

stress management

learning to function under pressure

The eventual instrument should therefore attempt to measure these underlying capacities rather than simply assign points to someone because they played sport.

5. Emotional Independence and Emotional Intelligence

The original framework also proposes emotional independence and emotional intelligence as possible contributors to Threshold.

These concepts require careful definition.

Healthy human relationships are not a weakness.

Social dependence, when understood as ordinary human interdependence, is not inherently dangerous. Indeed, social connection is an important protective factor.

The relevant construct is better understood as psychological autonomy: the ability to maintain one's sense of identity, worth, and functioning without making emotional survival entirely dependent upon a single person.

Emotional intelligence may similarly involve multiple capacities:

recognizing one's emotional state

understanding why distress is occurring

regulating intense emotions

considering alternative interpretations

distinguishing temporary emotional states from permanent conclusions

delaying irreversible decisions during periods of acute distress

seeking assistance when required

These capacities may contribute to resilience and therefore deserve empirical investigation as potential Threshold variables.

6. Suicide Likelihood

6.1 Definition

Suicide Likelihood is proposed as a dynamic measure of an individual's current accumulation of circumstances, psychological states, and behavioural conditions associated with increased vulnerability to suicidal crisis.

This differs fundamentally from Threshold.

Threshold describes protective capacity.

Likelihood describes the pressure and vulnerability currently acting upon the individual.

Likelihood should therefore be expected to change substantially over time.

An individual may move from:

financial stability to severe financial stress

relationship security to separation

good physical health to chronic illness

social connection to isolation

controlled substance use to addiction

emotional stability to prolonged hopelessness

within a matter of months.

This makes Likelihood particularly suitable for longitudinal measurement.

7. Potential Contributors to Suicide Likelihood

The original paper identifies four major contributors: financial strain, relationship struggles, health problems, and addiction.

The broader framework may assess:

financial insecurity

unemployment

severe academic or occupational pressure

relationship conflict or loss

bereavement

social isolation

chronic illness

chronic pain

disability

substance-use disorders

severe behavioural addictions

violence or abuse

housing insecurity

legal or social crises

sleep disruption

depression and other significant psychological symptoms

hopelessness

previous self-harm

previous suicide attempts

current suicidal thoughts

These should be treated as risk indicators, not deterministic predictors.

A person experiencing financial hardship is not necessarily suicidal.

A person with depression is not necessarily suicidal.

A person with an addiction is not necessarily suicidal.

The framework concerns accumulated vulnerability and changes in vulnerability, not destiny.

8. The Relationship Between Threshold and Likelihood

The central theoretical proposition is that vulnerability emerges from the interaction between the two constructs.

Conceptually:

Suicide Threshold = protective capacity

Suicide Likelihood = current accumulated vulnerability

A simplified conceptual representation is:

Vulnerability = f(Likelihood, Threshold, Acute Events, Protective Support)

The actual mathematical relationship would need to be established empirically.

Nevertheless, the conceptual model is useful:

Lower LikelihoodHigher Likelihood
Higher Threshold	Relative stability	Significant pressure but substantial protective capacity
Lower Threshold	Latent vulnerability	High concern

The highest-concern trajectory may therefore not simply be "high Likelihood."

It may be:

Likelihood rising + Threshold falling.

This combination indicates that the pressures acting upon an individual are increasing at the same time that their ability to withstand those pressures may be deteriorating.

9. Why Longitudinal Measurement Matters

A single assessment provides a snapshot.

A sequence of assessments provides a trajectory.

Consider a hypothetical individual:

Quarter 1

Threshold: 74
Likelihood: 18

Quarter 2

Threshold: 67
Likelihood: 27

Quarter 3

Threshold: 55
Likelihood: 43

The significance lies not merely in the third result.

The person has undergone a simultaneous decline in protective capacity and increase in vulnerability.

This could be more informative than a single absolute score.

The system should therefore evaluate:

current level

change from previous assessment

long-term trend

rate of deterioration

accumulation of simultaneous stressors

recovery following intervention

emergence of acute warning indicators

The framework consequently becomes a longitudinal monitoring system, rather than simply a screening questionnaire.

10. The Three-Month Assessment

The proposed standard is that every person should be given the opportunity to complete the assessment approximately once every three months.

The important distinction is this:

The government designs and maintains the test. The individual takes the test.

The government should determine the scientific standards, validate the methodology, maintain the technological infrastructure, and ensure that the test is available to the entire population.

It should not ordinarily conduct an invisible psychological examination of citizens.

The individual should actively open the assessment, answer the questions, review the result, and determine whether to authorize additional support.

Participation should therefore include an explicit option not to take the assessment.

The reason for retaining this option is both ethical and practical.

A population-level prevention system must cultivate trust. People are more likely to answer honestly when they understand what information is being collected, why it is being collected, who can access it, and what happens after they complete the assessment.

The precise legal and policy status of participation should be determined through evidence, public consultation, and democratic process rather than assumed in advance.

11. What the Government Actually Controls

The government would have five principal responsibilities.

Standardization

It would establish the national assessment methodology.

Validation

It would ensure that the assessment is subjected to continuing scientific evaluation.

Infrastructure

It would provide the secure platform through which citizens can take the assessment.

Intervention

It would fund and coordinate services for people who require assistance, particularly those without adequate private support.

Population intelligence

It would analyze appropriately anonymized aggregate data to determine whether the country's overall conditions are improving or deteriorating.

The citizen, however, remains the person who actually takes the assessment.

This distinction is fundamental.

Government designs the instrument. The citizen performs the assessment.

12. The Assessment Must Lead to Action

The test must never become merely an information-gathering exercise.

Each outcome should correspond to an appropriate response.

Stable

The individual's protective capacity is adequate and current vulnerability is relatively low.

The system provides preventive recommendations and continues ordinary longitudinal assessment.

Vulnerable

The individual's Threshold has declined, Likelihood has increased, or important stressors are accumulating.

The system provides personalized recommendations and facilitates access to appropriate support.

High Concern

The individual shows substantial vulnerability, significant deterioration, or concerning suicide-related indicators.

The system encourages or facilitates timely professional and social intervention.

Acute Crisis

The individual reports imminent suicidal intent, serious current danger, recent serious self-harm, or another acute indicator.

The ordinary three-month cycle is immediately suspended.

The individual enters an urgent human-led crisis pathway.

No algorithmic score should override the reality of an acute crisis.

13. The Individual's Support Network

The system should also allow citizens to identify trusted people who may help them during periods of deterioration.

These could include:

family members

friends

partners

teachers

colleagues

coaches

community members

healthcare professionals

The person could determine in advance who may receive information and under what circumstances.

This creates a crucial transition:

assessment → recognition → connection → intervention

The objective is not to inform everyone that a person has been assigned a high numerical score.

It is to make it easier for another human being to notice:

"Something is wrong. I should be there."

The original proposal similarly envisioned a support-network mechanism involving family, friends, community members, and professionals.

14. Government Should Not Become a Surveillance System

A national suicide-prevention infrastructure could generate extraordinarily sensitive data.

That creates a serious danger.

A person's suicide-related assessment should never become a mechanism for:

employment discrimination

insurance discrimination

credit decisions

political profiling

criminal profiling

unnecessary policing

social stigmatization

The safest structure would separate individual identity from population-level analytical data wherever possible.

The government primarily needs to know:

How is society doing?

It does not necessarily need to know:

Which named individual has a low Threshold score?

Those are fundamentally different questions.

15. Measuring the Government's Own Performance

This is one of the most important consequences of the framework.

The assessment system would not only measure individuals.

Over time, aggregated results could measure society itself.

Suppose, across several years, a country observes:

rising financial Likelihood

declining social connectedness

increasing addiction-related vulnerability

declining average Threshold

The government could not reasonably claim that suicide prevention is succeeding merely because more helplines were created.

The population data would provide another question:

Are people's lives actually becoming more resilient?

Likewise, if reforms produce:

lower financial vulnerability

stronger social connectedness

better psychological coping

greater perceived security

higher protective capacity

then the population-level indicators could provide evidence that policy is improving the underlying conditions associated with suicide vulnerability.

The system therefore creates a feedback loop between citizens and government:

Citizens report their lived condition.

Government observes aggregated change.

Government changes policy.

Citizens reassess their condition.

The population data show whether policy appears to be working.

This turns suicide prevention into an accountability mechanism, not merely a welfare programme.

16. From Individual Risk Assessment to Public Policy

Consider a hypothetical national result.

Suppose suicide Likelihood increases primarily because of financial distress among young adults.

A government response should not simply send those individuals counselling brochures.

The data could lead to broader interventions involving:

employment policy

financial assistance

debt restructuring

housing support

educational reform

addiction treatment

healthcare access

Similarly, a large deterioration in relationship or social-connectedness indicators could motivate investment in community infrastructure and social support.

The point is that suicide prevention should address the causes generating vulnerability.

This is consistent with the public-health understanding that suicide has social, economic, psychological, and environmental determinants.

17. The Framework Creates Two Directions of Prevention

Traditional prevention often focuses primarily on reducing risk.

The proposed framework adds a second direction:

increase the Threshold.

This means society can work simultaneously to:

reduce Likelihood

and

increase protective capacity.

Reducing Likelihood could involve:

reducing financial insecurity

treating addiction

managing illness and chronic pain

reducing violence

addressing severe social isolation

improving access to mental healthcare

Increasing Threshold could involve:

strengthening coping skills

improving emotional regulation

developing problem-solving ability

increasing social connection

creating meaningful roles

improving physical health

strengthening purpose and future orientation

This makes suicide prevention a project of building resilience as well as removing danger.

18. The Most Important Scientific Limitation

The framework should not claim that athletic experience, emotional intelligence, independence, financial hardship, relationship difficulties, illness, or addiction automatically determine a person's suicide risk.

These variables are candidates for a multidimensional model.

They must be tested.

The proposed terms Suicide Threshold and Suicide Likelihood should therefore initially be treated as research constructs.

The first task is to determine whether they can be measured reliably.

The second is to determine whether they explain meaningful differences in suicidal ideation, self-harm, crisis utilization, and suicide outcomes.

The third is to determine whether acting upon the information improves outcomes.

Only then can the framework become a validated public-health instrument.

19. Scientific Validation

The development programme should proceed through empirical stages.

First, candidate dimensions and questions should be developed.

Second, psychometric research should examine reliability, validity, factor structure, and measurement invariance across populations.

Third, longitudinal cohorts should determine whether Threshold and Likelihood change in predictable ways.

Fourth, researchers should examine whether changes in the measures are associated with later suicidal behaviour and other meaningful outcomes.

Fifth, predictive performance should be compared with established suicide-risk assessment approaches.

Sixth, implementation studies should determine whether using the framework actually increases appropriate help-seeking and reduces harmful outcomes.

Finally, large-scale controlled evaluations should examine whether the intervention reduces suicide attempts and suicide mortality.

The test should therefore be treated as an evolving scientific instrument rather than as a finished algorithm.

20. The Difference Between Prediction and Prevention

There is a critical philosophical distinction at the centre of the proposal.

The objective is not:

"Predict exactly who will die by suicide."

That is an unrealistic standard.

The objective is:

"Recognize when a person's vulnerability is increasing while there is still time to change the trajectory."

That is a fundamentally different problem.

A prediction system asks:

Who will die?

A prevention system asks:

Who is deteriorating, why are they deteriorating, and what can we change?

The second question may ultimately be more useful to society.

21. A National Feedback Loop

The mature system could operate as follows:

Every three months

The citizen receives an opportunity to complete the assessment.

During the assessment

Threshold, Likelihood, trajectory, protective factors, and acute suicide indicators are evaluated.

Immediately afterward

The individual sees their own results and receives personalized guidance.

When necessary

The person can connect with family, friends, healthcare professionals, community services, or government-funded support.

At the population level

Identifiable information is protected while aggregate data reveal changes in national and regional vulnerability.

At the policy level

Government responds to the conditions producing deterioration.

At the next assessment

The system measures whether the situation has improved.

The result is a continuous public-health feedback loop:

Measure → Understand → Intervene → Change policy → Measure again.

22. A New Standard of Government Accountability

Governments routinely measure economic growth, unemployment, inflation, education, healthcare access, and mortality.

A society could eventually add another dimension:

psychological and social resilience.

A government should not merely ask:

"How much did the economy grow?"

It could also ask:

"Are people becoming more capable of coping with adversity?"

It should not merely ask:

"How many hospitals were constructed?"

It could also ask:

"Are people experiencing less debilitating psychological distress?"

It should not merely ask:

"How many suicide interventions occurred?"

It should also ask:

"Are fewer people reaching the point at which intervention becomes necessary?"

This creates a fundamentally different conception of public policy.

Government is not merely responsible for preventing death.

It is responsible for creating conditions under which people have a greater opportunity to live stable, meaningful, and resilient lives.

23. Potential Global Significance

More than 700,000 people die by suicide globally each year. Even a relatively modest reduction in mortality would therefore represent tens of thousands of lives saved annually. (who.int)

However, the framework should not claim in advance that it will reduce suicide mortality by a specific percentage.

The scientifically defensible proposition is that if the assessment can reliably identify deterioration and if timely intervention based upon that information improves outcomes, then a large-scale implementation could have substantial population-level effects.

That proposition can be tested.

If the framework proves ineffective, it should be abandoned or redesigned.

If it proves effective, its value could be enormous precisely because it would operate upstream of crisis.

24. Beyond Suicide: Measuring Whether Society Is Becoming Happier

The logic of this framework may ultimately extend beyond suicide.

At the end of the system, governments could introduce a complementary Happiness or Well-Being Assessment.

The purpose would be fundamentally different from the Suicide Threshold and Suicide Likelihood measures.

The suicide framework asks:

How vulnerable are people becoming to suicidal crisis?

A happiness and well-being framework would ask:

How well are people actually living?

Together, the two systems would create a broader measure of national social health.

A country could have a declining suicide rate while its population's happiness, purpose, connection, or life satisfaction is deteriorating.

Conversely, a country could improve its economic indicators while experiencing worsening psychological well-being.

A serious government therefore needs measures that capture not only whether people are alive, but also whether their lives are becoming more bearable, meaningful, connected, and fulfilling.

The quarterly self-assessment model could eventually provide the infrastructure for both.

The government would establish the standards.

Citizens would voluntarily participate.

Individuals would receive insight into their own condition.

Government would receive appropriately aggregated information about the condition of society.

And the results would provide something governments rarely possess with sufficient precision:

a recurring measure of whether public policy is actually improving the lived psychological condition of the population.

That would transform the framework from a suicide-prevention proposal into something broader:

a system for measuring, protecting, and ultimately improving the psychological health of society itself.

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Limitations of Voluntary Self-Assessment

A voluntary system creates an attrition problem: those experiencing the sharpest rise in Suicide Likelihood and decline in Suicide Threshold may be least likely to complete the assessment. Severe depression, isolation, addiction, or hopelessness can reduce motivation and executive functioning. The framework therefore cannot rely on self-assessment alone and must be complemented by families, communities, healthcare systems, and other existing points of contact.

It also faces a self-report paradox. People with reduced emotional awareness may fail to recognize their deterioration, while highly self-aware individuals may report distress more readily. Self-report should therefore remain central, but should be complemented, where appropriate, by longitudinal changes, professional judgment, and observations from trusted individuals.

Why the Existing "At Risk" Model Is Not Enough

The conventional distinction between "at risk" and "not at risk" is too static to capture the continuous nature of suicide vulnerability. A person may not currently be classified as at risk while their Suicide Threshold is falling and their Suicide Likelihood is rising. Another may have significant risk factors while possessing strong protective capacity.

Suicide prevention therefore requires more than identifying whether someone has crossed a risk threshold. It requires measuring severity, trajectory, and interaction: how vulnerable a person is, whether that vulnerability is increasing, what is driving it, and what protective factors remain. The purpose of the proposed framework is to identify deterioration before a person reaches the conventional category of "at risk."

References

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