The standard model of the suicide continuum suggest people start with thoughts of escapist ideation, and, if things don’t get better, gradually progress through the dimension of non-morbid escapist ideation, to morbid ideation, to passive suicidal ideation to active suicidal ideation, etc. The research doesn’t support this progression. Up to 75% of those who die by suicide denied suicidal thoughts in their last visit behavioral health visit prior to their death. Many that attempt and survive suicide deny recalling suicide thoughts until just upon their attempt. We clinicians need to have a better understanding of the limitations of our suicide risk models and adopt new approaches when working with our clients.