Butcher, Cha. 24: Assessment of Suicide Risk

Question 1

What is the standard of care?

Answer 1

• Using appropriate assessments
• Protecting the client
• Covering your butt

Question 2

With regards to standard of care, explain use of appropriate assessments to assess the client risk of suicide/homicide.

Answer 2

• Very thorough assessment, document EVERYTHING

- This is not the time to leave things out for ethical issues

Question 3

With regards to standard of care, explain protecting the client when assessing their risk of suicide/homicide.

Answer 3

• Tell them, “I am professionally bound to call and express my concerns about your welfare”
• If they walk out, you must let them, but try to find out where they’re going…make every possible effort to let people know your concerns (family, police, magistrate)
• If there is a specific person/place, contact that person/place and let them know!
• Document it
• Try to contact the person to come back in

Question 4

With regards to standard of care, explain protecting your butt when assessing client risk of suicide/homicide.

Answer 4

Must document 2 things in order for client to be committed

• Must be a threat to themselves or others
• Must document a real, serious mental illness

Do not state, “I am attempting to predict suicide;” instead, say “I am attempting to predict suicide risk

Question 5

What two things must be documented for the client to be committed?

Answer 5

• Must be a threat to themselves or others

- Must document a real, serious mental illness

Question 6

How do we predict risk of suicide/homicide?

Answer 6

• Clinical History
• Mental Status Exam
• Consulting with significant others (third parties)
• Specificity, lethality, and availability of means
• Assessments to help with risk: Beck Depression Inventory, Beck Hopelessness Scale, and Beck Suicide Ideation Scale.

Beck theorized that high levels of hopelessness are more predictive of suicidal attempts than depression
-People get emotional blinders - cannot see a way out

Question 7

What is a delusion?

Answer 7

A belief that is not real that is held very close to the person (bizarre and not bizarre, grandeur and persecution). They don’t necessarily go away once treated for whatever issue they have