Sept 3 - SI and Homicide

Question 1

When is it appropriate to ask about suicide/SI?

Answer 1

Every patient contact

Question 2

List risk factors for SI. (13)

Answer 2

Sex (Male), Age (middle aged), depression, previous attempt, ETOH, loss of rational thinking, lacking social support, plan in place, single, access to lethal means, illness, family history of suicide, impulsivity

Question 3

List protective factors for suicide/SI. (8)

Answer 3

support systems, relationships, spirituality, sense of purpose, coping and problem-solving skills, responsibility to family, resilience, access to care

Question 4

When doing a SI risk assessment, what is the first question to ask and what is the follow up?

Answer 4

1. Are you currently thinking of taking your life?

2. When was the last time you thought about taking your life?

Question 5

Beyond the first 2 questions, what are 3 other critical questions to ask when doing a SI risk assessment?

Answer 5

1. What keeps you from acting on thoughts?
2. Do you have a plan to take your life?
3. Access to means or preparatory actions?

Question 6

State four questions to ask when doing a HI risk assessment.

Answer 6

1. Are you having thoughts of hurting anyone else?
2. Is there a specific person you plan on hurting?
3. Do you have a plan to hurt this person?
4. What would happen if you saw this person today?

Question 7

Define passive, active, and imminent SI.

Answer 7

Passive: patient says something like “I just wish I wouldn’t wake up in the morning”
Active: Having thoughts with a plan
Imminent: Attempt is happening at this very time

Question 8

What is important to include in a safety plan for a SI patient? (5 components)

Answer 8

Warning signs
Coping strategies
People and settings that provide distraction
Ways to make the environment safe
Suicide hotline and other similar contacts

Question 9

What are 2 absolutes to maintain safety in the clinical setting?

Answer 9

Patient never between you and the door

Never be in exam room with the door locked

Question 10

What 3 criteria must be met to place patient on a 72-hour hold?

Answer 10

1. Threat to self or others
2. Person can reasonably benefit from treatment
3. Hospitalization is least restrictive alternative mode of treatment available

Question 11

List five components of a treatment plan to manage an SI patient.

Answer 11

1. Short and long term goals
2. Medication treatment plan
3. Safety plan
4. Involvement in psychotherapy, referral
5. Follow up care, next appointment