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Suicide Risk Assessment

Suicide Risk Assessment. 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?. Assessment of Suicide Risk. Client’s current state: IS PATH WARM.

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Suicide Risk Assessment

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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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