Background: Psychological pain plays a central role in suicidal crises. This study examines the nuances of psychological pain between individuals with suicidal ideation and those who have attempted suicide. With the aim of improving understanding of its significance in the suicidal trajectory. Methods: The 10-item Mee-Bunney Psychological Pain Assessment Scale (MBPPAS) was translated into German and underwent validation and reliability testing. This scale was used to assess psychological distress in adult outpatients and inpatients. The study included n = 93 patients with a history of suicide attempts, n = 141 individuals with suicidal ideation but no history of attempts, and n = 139 non-suicidal clinical controls. Results: The German version of the MBPPAS demonstrated excellent internal consistency, with McDonald's omega ?? = .92. Substantial differences in psychological pain emerged between suicide attempters, suicidal ideation, and non-suicidal patients, F(2, 370) = 54.79, p < .001, ?2 = .23. Post hoc analysis revealed significantly higher MBPPAS scores in suicide attempters (M = 30.6, SD = 8.5) and suicide ideators (M = 27.3, SD = 7.8) compared to clinical controls (M = 20.4, SD = 7.0), p < .001. In addition, suicide attempters had significantly higher MBPPAS scores than those with suicidal ideation, p = .004. Conclusions: Assessment of psychological pain may help identify individuals at increased risk for suicidal behavior.