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Presented by: Kendra WatsonPresented by: Kendra WatsonSam Houston State UniversitySam Houston State University
Ethics InstituteEthics InstituteFall 2004Fall 2004
After Counseling
““It is legitimate and necessary to It is legitimate and necessary to wonder whether life has a wonder whether life has a
meaning, therefore it is meaning, therefore it is legitimate to meet the problem legitimate to meet the problem
of suicide face to face.”of suicide face to face.”
Albert CamusAlbert Camus
Nobel Prize-winning authorNobel Prize-winning author
The Myth of SisyphusThe Myth of Sisyphus
Code of EthicsCode of Ethics
Marriage and FamilyMarriage and Family Texas Counseling AssociationTexas Counseling Association
American Counseling American Counseling AssociationAssociation
American School Counseling American School Counseling AssociationAssociation
Confidentiality: ExceptionsConfidentiality: Exceptions
You are in danger to yourself or othersYou are in danger to yourself or others
A court order to disclose informationA court order to disclose information
Disclosure of child abuse or elder abuseDisclosure of child abuse or elder abuse
Disclosure of a previous exploitation by a Disclosure of a previous exploitation by a helping professional in a therapeutic helping professional in a therapeutic relationshiprelationship
Other reasons specified by laws of this Other reasons specified by laws of this statestate
Usually stated on a counselor’s informed Usually stated on a counselor’s informed consent at the beginning of counselingconsent at the beginning of counseling
VideoVideo
Clip from Clip from Lethal WeaponLethal Weapon
Suicide Statistics• 30,000 suicides annually
• 83 per day, 1 every 17 minutes
• Eighth leading cause of death
• Most used method is firearms
• Ranks third as cause of death for the young. (Behind accidents and homicide)
• For each death by suicide there are usually 8 to 20 attempts
• Best predictor: feelings of hopelessness
• At least 4.4 million Americans are survivors of a loved one’s suicide
Source: www.suicidology.org “American Association of Suicidology
Males Method Females
66% Firearms 39%
13% Poison 40%
15% Strangulation 10%
1% Cutting 1%
5% Other 10%
How?
Where?
Rank State Rate1 Nevada 22.35 Alaska 15.514 Florida 13.439 Texas 10.050 New York 6.651 Wash. D.C. 5.8
Rating scalesSense of Worthlessness
Sense of Hopelessness
Social Isolation
Depression
Impulsiveness
Hostility
Intent to Die
Environmental stress
Future Plans
Surviving Loved OnesSurviving Loved Ones
Letter from a family memberLetter from a family member
Ethical Decision Making
What do you plan to do if this is your client?
The PlanDoes the client
have a definite plan?
have a method of carrying out the plan?
have accessibility to the method?
have previous psychiatric history?
have prior attempts
have a suicide note or instructions for survivors
use drugs or alcohol
Counselor’s OptionsCounselor’s Options
No Suicide ContractNo Suicide Contract Suicide WatchSuicide Watch Voluntary commitmentVoluntary commitment Involuntary commitment Involuntary commitment (can only be (can only be
done by a police officer or a guardian if the client is done by a police officer or a guardian if the client is under 17 and not married) under 17 and not married)
The Suicidal ThreatThe Suicidal Threat
What if I have a client that What if I have a client that threatens suicide often? threatens suicide often?
Do I really have to report it each Do I really have to report it each time when I know all they time when I know all they want is attention? want is attention?
What happens when you call the P O L I C E
1. Clearly state your problem
2. Give the location of your client and of yourself
3. Give the name of your client, age, sex, race, and address
4. Give the client’s phone number and cell phone number
5. Describe the client’s vehicle
6. Give any potential dangers such as children or other family members
7. Inform the police of the method and location of the lethal item
8. Ask for a phone call from the officer when he clears the call
What will the police do? What will the police do?
Their own assessment of Their own assessment of lethalitylethality
Informal OptionsInformal Options Contact family or friendsContact family or friends
Formal OptionsFormal Options HospitalizationHospitalization JailJail
PolicePolice
Video ScenarioVideo Scenario Crisis Intervention Team trainingCrisis Intervention Team training
How do police make their How do police make their ethical decisionsethical decisions
Police follow the Texas Mental Police follow the Texas Mental Health Code regarding the Health Code regarding the warrantless apprehension of warrantless apprehension of individuals in mental crisis.individuals in mental crisis.
http://www.capitol.state.tx.us/statutes/hstoc.htmlhttp://www.capitol.state.tx.us/statutes/hstoc.html HEALTH & SAFETY CODE CHAPTER 573. HEALTH & SAFETY CODE CHAPTER 573.
EMERGENCY DETENTIONEMERGENCY DETENTION
Texas Mental Health CodeTexas Mental Health Code
A police officer, without a warrant, A police officer, without a warrant, may take a person into custody if the may take a person into custody if the officer:officer:
Believes the person is mentally ill and Believes the person is mentally ill and because of that mental illness there is a because of that mental illness there is a substantial risk of serious harm to the person substantial risk of serious harm to the person or others unless the person is immediately or others unless the person is immediately restrained, andrestrained, and
Believes that there is not sufficient time to Believes that there is not sufficient time to obtain a warrantobtain a warrant
Future concernsFuture concerns
How can police and mental How can police and mental health professionals work health professionals work together for the best interest of together for the best interest of the client? the client?
Mobile Crisis Response TeamsMobile Crisis Response Teams Mental health courts to deal with Mental health courts to deal with
person whose impaired minds person whose impaired minds cause impaired behaviorcause impaired behavior
Future Vulnerable Populations
• Military returning from war on terrorism
• Teenagers
• Elderly
• Professionals in stressful careers
References
American Association of Suicidology
www.suicidology.org
Castellano-Hoyt, D. (2003). Enhancing police response to persons in mental health crisis. Illinois, Charles C Thomas Publisher.
DePaulo, J. R. (2002). Understanding depression. New Jersey, John Wiley and Sons.
Marcus, E. (1996). Why suicide? New York, Harper Collins Publishers.
Texas Mental Health Code http://www.capitol.state.tx.us/statutes/hstoc.html
