Suicide Prevention 101
This term describes thoughts about suicide that can range from occasional thoughts to more persistent or serious consideration.
What is suicidal ideation?
T/F: Suicide risk only needs to be assessed when a person first enters treatment
What is false?
Risk can change as circumstances, symptoms, stressors, and protective factors change.
This major change in behavior can include an outgoing person suddenly distancing from friends and social activities.
What is isolation? (or social withdraw)
During a home-based session, a client casually says, "Sometimes I wish I could just go to sleep and not wake up." They immediately change the subject and continue the activity.
What would you do?
Don't ignore the statement. Pause and check in with the client about what they meant and whether they're experiencing thoughts of suicide or self-harm.
This protective factor involves having people in your life who provide encouragement, understanding, and a sense of belonging.
What is social support?
Contrary to a common myth, directly asking someone about this does not increase their risk of attempting suicide.
What are suicidal thoughts?
T/F: Someone who talks about suicide may be at risk even if they express no intention of acting on their thoughts.
What is true?
This warning sign can include statements such as "I can't do this anymore," or "Everyone would be better off without me."
What is hopelessness?
You receive a message from a client's caregiver at 9:00pm stating that the client has been talking about suicide. You are not in a position to immediately assess the client.
What would you do?
Provide appropriate guidance, including determining whether emergency assistance is needed and notifying your supervisor. If there is no immediate safety concern, use the next session to revisit the client’s safety plan, assess for any changes in warning signs or risk factors, and address any additional support needs.
Helping a client identify activities they enjoy, goals they want to work toward, and things that give their life meaning can help strengthen this protective factor.
What is hope?
What are protective factors?
Only a licensed mental health professional can help someone who is at risk.
What is false?
Everyone has the ability to actively participate in suicide prevention by stepping in, listening, and aiding the individual in receiving the proper support.
An individual experiencing suicidal ideation may begin engaging in this behavior when they feel disconnected from or no longer have a need for the items that once held personal meaning.
What is giving away possessions?
A client returns to services following a suicide attempt and says, "Everyone is treating me like I'm fragile now. I don't want to talk about what happened." The client is frustrated that family members and providers keep bringing up the attempt. You are determined to re-engage with the client.
What would you do?
Respect the client's autonomy and feelings while still addressing safety. Reassess current needs/risk, allow the client to process the experience at an appropriate pace, avoid judgment or shame, and collaborate with the client on what support will be helpful moving forward.
These are healthy ways a person can manage stress or difficult emotions, such as exercising, journaling, listening to music, or practicing grounding techniques.
What are coping skills?
This collaborative document typically includes a client's warning signs, coping strategies, sources of support, and ways to access professional or emergency help.
What is a safety plan?
T/F: The vast majority of individuals who die by suicide have a diagnosable and treatable mental health condition.
What is true?
Clinical estimates suggest that up to 90% of people who die by suicide have a diagnosable mental health condition, though public health data indicates that only about half have a known diagnosis at the time of death.
A sudden and significant change in this area (sleeping much more or less, changes in appetite, or neglecting personal care) can be a warning sign worth exploring.
What are changes in basic functioning or daily habits?
A client from a marginalized community reports feeling isolated and says, "Nobody at school understands me, and I feel like my family doesn't listen to me." They deny having a plan but express feeling "exhausted" with life. You know that in order to properly support this client, you first need to consider the appropriate factors.
What would you do?
Explore the client’s social environment, identity-related stress, experiences of discrimination or stigma, family and community support, safety, and protective factors, and consider how these factors impact their mental health.
Connecting clients with these can reduce isolation and provide additional support outside of their immediate treatment team.
What are community resources?
During a session, a client says, "I've been thinking about committing suicide lately, but I don't have a plan." The provider should not assume the absence of a plan means the concern ends here. Name two areas the provider should explore next when assessing the client's current safety.
Suicidal intent, access to lethal means, frequency/intensity of thoughts, previous suicidal behavior, protective factors, or current stressors, etc.
T/F: Suicide is the 3rd leading causing of death for people ages 10-24.
What is False?
Suicide is actually the 2nd leading cause of death for this age group.
This behavioral shift can sometimes mean a person has found relief after deciding to attempt suicide.
What is a sudden improvement in mood?
You receive a call from the parent of your teenage client the morning after the teen came home past curfew smelling of alcohol. The parent reports that after a small argument, the teen made a statement alluding to suicide. The parent is frustrated and says, "They were just trying to get attention. They say things like that whenever they don't get their way."
What would you do?
Avoid dismissing the statement as attention-seeking and explain that any statements suggesting suicidal thoughts or a plan should be taken seriously. Explore the context of what occurred in the teen’s life before, during, and after the incident. Assess for current safety concerns and the teen’s substance use, including the circumstances surrounding the alcohol use. Also explore recent stressors, warning signs, protective factors, and available supports, while helping the parent understand how to respond supportively rather than minimizing the teen’s statements.
This method of care includes working together with the client, family, treatment team, and other appropriate supports to help create a more coordinated approach to suicide prevention.
What is collaborative care?