Suicide

Question 1

Assessing for suicidality

Answer 1

Intent
Imminence
Plan
Means 
Ideation

Question 2

Suicidal clients

Answer 2

Assess clients competence to undergo treatment, what can they cope with

Assess for physical, emotional or cognitive impairment that impairs competence for treatment

Complete full assessment in first and second session. Establish DSM-5 diagnosis

Look out for mood disorders, impulsive behavior, history of suicide with client or family, history of hospitalizations, sudden elevation of mood, giving away possessions.

Consult with previous health care providers if appropriate (with release from client)

If client is seeing a psychiatrist, after obtaining a release of information, contact psychiatrist

Question 3

Crisis work

Answer 3

Assess emotional state each session and document

Be aware of clinical issue becoming a crisis: sudden loss/life event, overwhelmed, inability to cope, substance abuse, loss of ego strength

Crisis can manifest as: anxiety, physical problems, denial, obsessions, projections, worry

Goal is to help patient get out of crisis and stabilize emotions

Question 4

Risk factors

Answer 4

History of suicide attempts

suicidal ideation (past/present)

history of suicide in family

lack of social support

social isolation

substance abuse

sexual abuse

hospitalizations

first two weeks of antidepressants