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Suicide Risk Assessment. Bipolar and suicidality. Most likely during transition for cx with bipolar S/I=80% S/A=25% S/C=7-19% Intoxication increases impulsivity and impairs judgment, putting person at greater risk. A mnemonic: IS PATH WARM. ideation substance abuse purposelessness
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Bipolar and suicidality • Most likely during transition for cx with bipolar • S/I=80% • S/A=25% • S/C=7-19% • Intoxication increases impulsivity and impairs judgment, putting person at greater risk.
A mnemonic: IS PATH WARM ideation substance abuse purposelessness anxiety trapped hopelessness withdrawal anger recklessness mood changes
Your role • Recognize risk factors and respond appropriately • Assess seriousness of risk-Fig. D-1, pg 330 • What is wrong? • Why now? • How? • Where and when? • When and with what in the past? • Who is involved? • Why not now?
3. Consider appropriate responses-low level of risk • Talking about it • Address particular triggers • Contracting • Obtaining support from friends/family • Identify and plan use of crisis services • Explore reasons for not killing self • Refer to medication provider-ARNP or psychiatrist
Responses with higher level of risk • Schedule additional sessions • Eliminate potential methods, e.g. weapons, meds, etc. • Explore option of voluntary hospitalization • Contact CDMHPs for involuntary outpatient or commitment evaluation-206-461-3222 • 72 hours, 14 days, 90 days inpatient • 90 (adult) or 180 (youth) days of outpatient