Suicide Prevention Summary
Chinese sign for Crisis = Danger + opportunityQ – What feelings might you feel if a client talks about suicide?
- Eg responsible, incompetent, fearful, anxious, overwhelmed, out of control
Q – What can you do to help yourself?
- Panic – How do we recognize in ourselves?
- Accept your own fear and have the courage to address the issue
- Relax and stay calm, centered with client
- Recognise limits
- Don’t assume total responsibility for the situation
- Know what resources are available
- Have a framework to guide you
- Have clinical supervision available afterwards for debriefing
Q – How can we help the client?
- Don’t avoid the issue
- Be direct, not tentative. This de-stigmatises and normalises the feelings. It will not increase the risk of suicide. Think of suicide risk like a pressure cooker – your job is to help release pressure.
- Further normalise the feelings they have through your reactions and responses
- Ask about specifics – plans, attempts, what triggered, what stopped them.
- Express your own concerns about the risk and explain strategy with them
- Ask them to make a no harm agreement or contract with you
- Be yourself and focus on the relationship – listening, compassion, presence
- Trust that they want to live
Q – Why might clients not want to talk about it?
- Eg stigma, feelings of failure, need for support & loss of independence
Q – How do we assess risk?
- Suicide risk checklist
- Females more likely to self-harm
- Males more likely than females to suicide – why? o Less likely to talk about feelings
- Lethality of method
- Older men most at risk (75 and above), then 25-45 years next
- Other risk factors
- Mental illness
- Rural, isolated (also rural – more exposure to lethal methods)
- Young LGBT
- Lower socio-economic status
- Family issues – abuse, alcoholism etc
- Bereaved through suicide
Duty of Care in Suicide Prevention
- Assess risk – if client safety in doubt, implement plan.
- Consider level of risk and own confidence in continuing with client professionally. If risk medium or higher, referral to clinical psychologist is strongly recommended (may be in conjunction with you).
- Consider no harm agreement (see Procedures section).
- Low risk - request client contact support network person to collect them from clinic (or call them yourself). Explain situation to support person.
- Moderate risk – contact support person (if reliable) to collect, explain person should not be left alone and provide resources for ongoing support (local mental health unit, Lifeline)
- High risk – call support person AND Lifeline or Mental Health Unit
- If no one available, call Lifeline or local Mental Health Acute care unit.
- If client leaves without support against your advice, call Police.