Crisis Situations - Risk Assessment Flashcards
Describe FOUR short term risk factors and FOUR long term risk factors;
Short Term:
- Current Suicidality - thoughts, plan, intent -when?
- Recent Stresors - Job loss, personal prob, work prob
- Acute Mental or Phsyical Illness - Hopelessness, Helplessness, Despair
Long Term;
- Personal History of: previous suicide attempts (note lethality of attempts); self-harm
- Family History of: Suicide attempts/completions; Psychiatric illness
- Long-term problems:
- Interpersonal (History of Divorced/widowed/single)
- Unemployed/retired
- Physical illness
- Psychiatric illness (especially inpatient care)
- Personality disorder / Personality Structure
- Forensic history
- Substance abuse
- Problem solving ability (inc. Impulsivity)
- Male gender
What is the Risk Equation/Model?
The Risk Equation is a template made up of 4 components:
- Long term risk;
- Short term risk;
- Hazards; and
- Protective factors.
What are the risk equation protective factors?
- Female gender
- No history of self-harm
- No psychiatric history
- No mental illness
- Lives in supported circumstances
- No substance abuse
- Stable relationships
- Employed
- Note: being employed isn’t automatically a protective factor:
- e.g., the employment itself may cause a lot of stress for the individual; and
- some occupations have better access to means than others, e.g., doctors, vets, nurses, etc).
- Help seeking behaviour
- Personal coping skills and resilience
- Identifies reasons to Live/Barriers to attempting
- Inc. sense of meaning, spiritual faith, belief suicide is wrong
- Willingness to engage with services
- Therapeutic alliance
Describe THREE factors you would take into consideration when assessing for imminent risk of suicidal behaviour?
- Past attempts
2. Means
- Plan/Imminence
4. talking about death
5. Dramatic mood changes
6. Risky Behaviours
7. Giving away posessions
8. Hopelessness
You are asked by a local radio station to comment on air about the relationship between media reporting and suicide. What 3 key points would you choose to address?
In the past there has been instances where media reporting has influenced the rates of suicide so it is essential that (South Korean Reporting);
- Method and location should not be reported
- Should not sensationalise, glamorise or trivialise or stigmatise
- Reporting should not be given undue prominence, and done so in moderation
- Published material should be accompanied by information regarding appropriate 24-hour support
- Avoid the use of derogatory terminology
- Avoid inferring that people with mental illness are violent, unable to work, are weak or are unable to recover
When would you call the Police in the matter of suicide risk?
If the client could not promise to keep safe
If the client was clearly a risk; means; plan; past threat
HEADS Model of Risk Assessment for Young People;
What does Heads Stand For?
H: Home and health
E: Education and employment
A: Activities, ambition and affect
D: Disease and drugs
S: Suicide
Areas to cover in Addressing Risk & Some questions;
Opening -
- Have you ever had thoughts of suicide?
- Do you ever feel like you don’t want to be here anymore?
Ideation -
- When do you have suicidal thoughts?
- How often do you have these thoughts?
Plan
- Do you have a plan to end your life?
- How would you do it? Do you have access to those means?
- When would you do it?
Lethality
- Are you sure that it would complete suicide?
- Is your plan reversible if you change your mind?
Intent
- How strong is your intention to end your life?
- How much control do you have of your suicidal thoughts?
Protective
- What stops you from completing suicide?
- What makes you feel better/ suicidal thoughts go away?
- Who can you call/ be with to manage suicidal thoughts?
What are some of the goals of Crisis Intervention?
There are some clear goals to managing crisis situations. These goals include:
- to calm the person
- to reduce the immediate risk of suicide (prevent/limit access to means; supportive networks in the person’s life)
- to reduce the threat to others who may be involved (particularly children)
- to enhance hope and confidence (ensure the person knows how your service/ other services can help)
- to improve effectiveness in tackling problems
- to arrange treatment of mental disorder/illness.
Crisis Intervention Plan- What are the six stages?
Stage 1 Define the problem
Stage 2 Ensure safety
Stage 3 Provide support
Stage 4 Examine alternatives
Stage 5 Make plans (a ‘no suicide plan’)
Stage 6 Obtain commitment
•Hawgood & De Leo (2002)
