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Suicide Risk

While the procedures used to conduct suicide risk assessments vary by agency/school, there are important foundational processes and tools one must thoroughly understand. As someone on the front line and in direct contact with clients/students, counselors need to be able to understand and implement suicide risk assessment in an instant, without hesitation. Due to this, it is critical that counselors are aware of risk factors, suicide risk assessments tools, interventions, and safety planning on the individual level.

Assignment Directions
Present a background of suicide, including:
Identify and explain key terms associated with suicide intervention, such as suicidal ideation, suicide plan, suicide attempt, etc. Briefly address terms no longer used in the field.
Identify risk factors for suicidal behavior, with a focus on cultural aspects presented and previous mental health diagnoses.
Identify prevalence/statistics within various populations (LGBTI, males, military, American Indians/Alaska Natives, etc.).
Report on suicide risk screeners and assessment tools.
Identify the difference between a suicide risk screening and assessment.
Present several instruments used (IS PATH WARM, SAFE-T, PHQ-9, etc.).
Application to case.
Choose either the Patient Health Questionnaire-9 (PHQ-9) or Columbia Suicide Severity Rating Scale (C-SSRS) from the Suicide Prevention and Management Webinar and apply it to the case of Anna in Chapter 7 (page 151), reporting on what her ratings on either scale would be.
Identify the following for Anna (or David): risk factors, protective factors, lethality, plan, and mandated reporting issues.

Sample Answer

Understanding Suicide Risk Assessment for Effective Intervention

Background of Suicide and Key Terms

Suicide: The act of deliberately ending one’s own life.

Suicidal Ideation: Thoughts, wishes, or fantasies about ending one’s own life.

Suicide Plan: A specific thought or strategy for ending one’s own life, including details like method, time, and location.

Suicide Attempt: Any intentional injury, self-harm, or action aimed at ending one’s own life, regardless of outcome.

Full Answer Section

Terms No Longer Used: Commit suicide (implies criminality), self-inflicted death (lacks empathy), taking one’s own life (ambiguous).

Risk Factors for Suicidal Behavior

Cultural: Stigma, lack of social support, access to means, historical trauma, and minority stress.

Mental Health: Depression, anxiety, PTSD, personality disorders, substance abuse, and bipolar disorder.

Previous Attempts: Strongest predictor of future attempts.

Other: Hopelessness, hopelessness, impulsivity, access to firearms, and life stressors.

Note: Risk factors are cumulative and interact, not individual predictors.

Prevalence Statistics

LGBTI: Higher rates of suicidal ideation and attempts due to minority stress and discrimination.

Males: Higher rates of completed suicide, possibly due to cultural norms and help-seeking behaviors.

Military: Increased risk due to combat stress, PTSD, and access to firearms.

American Indians/Alaska Natives: Disproportionately high rates due to historical trauma, social disparities, and lack of access to care.

These are just a few examples, and it’s crucial to acknowledge the complex interplay of factors contributing to suicide risk within various populations.

Suicide Risk Screeners and Assessment Tools

Screeners: Brief instruments (e.g., PHQ-9) to identify individuals needing further assessment.

Assessments: Comprehensive tools (e.g., C-SSRS) to understand risk severity, intent, and lethality.

Key Difference: Screeners are initial filters, while assessments provide deeper evaluations.

Examples of Instruments

PHQ-9:Measures depression severity and suicide risk.
C-SSRS:Comprehensive assessment of suicidal thoughts, intent, and plan.
IS PATH WARM:Identifies risk factors, protective factors, and lethality.
SAFE-T:Assesses suicide intent and potential for dangerous behaviors.

Remember: No single tool is perfect. Use them in conjunction with clinical judgment and cultural sensitivity.

Applying to a Case Study (Anna or David)

Unfortunately, I don’t have access to the specific details of Anna or David’s case in Chapter 7. However, I can provide a general framework for applying a chosen assessment tool:

Choose a Tool: Select either PHQ-9 or C-SSRS based on available information and desired depth of assessment.
Administer the Tool: Follow the instrument’s instructions and score it accurately.
Analyze Results: Identify scores related to:

* **Risk factors:** Any areas of concern highlighted by the tool.* **Protective factors:** Strengths and resources identified in the assessment.* **Lethality:** Intent, plan, and access to means as indicated by the tool.

Consider Cultural Context: Interpret results with cultural sensitivity and awareness of potential biases.
Identify Mandated Reporting: Follow legal and ethical guidelines for reporting potential harm based on your assessment.

Remember, this is a general guide. Always consult the specific tool’s manual and seek consultation with a qualified professional for complex cases.

Additional Resources:

National Suicide Prevention Lifeline: 988
American Foundation for Suicide Prevention: https://afsp.org
National Alliance on Mental Illness (NAMI): https://www.nami.org

By understanding risk factors, using appropriate tools, and considering cultural context, counselors can effectively assess suicide risk and implement interventions to keep individuals safe.

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