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Understanding Suicide Risk Assessment: Myths, Questions, and Strategies

Explore myths and questions surrounding suicide, assess risk factors, and learn effective strategies for intervention. Gain insights into mental disorders with high suicide rates and understand the risk continuum. Discover risk factors and statistics related to suicide.

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Understanding Suicide Risk Assessment: Myths, Questions, and Strategies

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  1. Suicide Risk Assessment

  2. Thoughts, myths, questions about suicide • Is suicide a form of manipulation? • Will asking about suicide lead to suicidality? • When a person talks about suicide are they “just” seeking attention?

  3. Assessment of Suicide Risk

  4. Client’s current state: IS PATH WARM ideation substance abuse   purposelessness anxiety trapped hopelessness   withdrawal anger recklessness mood changes

  5. 2. Mental disorders with very high rates of suicide • 90% have a diagnosable mental disorder • Eating disorders: 258/100,000 • Bipolar: as high as 20% • Schizophrenia: 15% • Antisocial personality: 5%; 46% attempt • Borderline personality: 5-10% • Major depression: 6%

  6. 3. Risk Continuum • No indications • Suicidal ideation • Suicidal plan • Access to plan • History of attempt

  7. Watch dvd for example

  8. Role Play to Assess Risk • In triads, rotate the three roles. • Counselor- • What brings you in today? • Use observational skills and watch for risk factors • Ask questions intentionally • Observer- • Observe the client for incongruities, nonverbals, etc. • Watch how client responds to questions asked. • Client- • Use the scenario given

  9. Problem Solving and Crisis Management

  10. Respond according to risk level • Low level of risk • Talk about it • Address particular triggers • Contract • Obtain support from friends/family • Identify and plan use of crisis services • Explore reasons for not killing self • Refer for psychiatric evaluation

  11. Responses, cont. • Higher level of risk • Schedule additional appointments • Eliminate potential methods, e.g. weapons, meds, etc. • Develop a safety plan • 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

  12. Risk factors for suicidality-American Association of Suicidology • Hopelessness • Rage, uncontrolled anger • Vengeful • Reckless, impulsive or risky bx. • Feeling trapped • Increased use of alcohol/drugs • Dramatic mood change • Anxiety or agitation • Sleep disturbance…too much or too little • No reason to live

  13. Some stats-2005 • National rate=11/100,000 • Washington rate=14.6/100,000 • Varies by age: • 75+=16.9/100,000 • 5-14=.7/100,000 • Varies by ethnicity and gender • Highest: white male=19.7 • Lowest: black females=1.8 • The rate of suicide for black teen females has increased in recent years. Recent study: 7% will attempt.

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