Social Work Interns’ Social Work Interns’ Training:Training:

Suicide EvaluationsSuicide Evaluations

ByBy

Riley Bassford Riley Bassford

Spring 2011Spring 2011

Facts about Adolescent Suicide Facts about Adolescent Suicide Suicide is the 3Suicide is the 3rdrd leading leading

cause of death in cause of death in adolescents aged 15-24 adolescents aged 15-24 in the United states in the United states

Risk for a repetition of a Risk for a repetition of a suicide attempt is suicide attempt is highest 3-6 months highest 3-6 months after first attemptafter first attempt

Suicide rates for males Suicide rates for males aged 15-19 in the aged 15-19 in the United States are four United States are four times higher than the times higher than the rate for their female rate for their female peerspeers

1 in 4 suffer from 1 in 4 suffer from depression or mood depression or mood disorder, most go disorder, most go undiagnosed and undiagnosed and suffer psychological suffer psychological pain pain

Most parasuicide Most parasuicide occurs because there occurs because there are firearms in the are firearms in the home or while home or while incarceratedincarcerated

Risk Factors Risk Factors

Psychiatric disorder Psychiatric disorder Depression Depression Family history of Family history of

suicide suicide Low family/peer Low family/peer

supportsupport IsolationIsolation Self-hating thoughtsSelf-hating thoughts Talking about suicideTalking about suicide Age range 15-24 or Age range 15-24 or

75-8575-85

Unemployment Unemployment Feelings of Feelings of

hopelessnesshopelessness Criminal behaviors Criminal behaviors Substance use Substance use History of abuse History of abuse Physical illnessPhysical illness Male Male Same sex orientation Same sex orientation Low SESLow SES

Protective Factors Protective Factors

Supportive family Supportive family Connectedness to Connectedness to

school or other school or other organizations organizations

Good social and Good social and coping skillscoping skills

Self confidence Self confidence Willingness to seek Willingness to seek

helphelp Access to health Access to health

servicesservices

Community supportCommunity support Conflict resolution and Conflict resolution and

skill buildingskill building Family cohesion and Family cohesion and

marital status marital status Parenting skillsParenting skills School environment School environment

Vital Questions to Ask Vital Questions to Ask

Have your problems been getting Have your problems been getting you down so much that you have you down so much that you have been thinking about hurting yourself?been thinking about hurting yourself?

How would you hurt yourself?How would you hurt yourself? Do you have the means available?Do you have the means available? Have you ever tried to hurt yourself? Have you ever tried to hurt yourself?

If so how did you do it?If so how did you do it? Has something happened to where Has something happened to where

you think life is not worth living?you think life is not worth living?

Suicide Lethality ScaleSuicide Lethality Scale

Going-down Coming-Up Going-down Coming-Up _X___________________________X_______X___________________________X______

BottomBottom

Questions ContinuedQuestions Continued

What has been helping you stay alive so farWhat has been helping you stay alive so far Why do you feel this is the time to hurt Why do you feel this is the time to hurt

yourself? Why now?yourself? Why now? Have you used alcohol or drugs?Have you used alcohol or drugs? Why do you want to live?Why do you want to live? How frequently do you have these thoughts?How frequently do you have these thoughts? How long do these feelings last?How long do these feelings last? Is there anyone or anything that could stop Is there anyone or anything that could stop

you from hurting yourself? Who do you you from hurting yourself? Who do you trust?trust?

Sample Suicide Contract Sample Suicide Contract SAMPLE NO SUICIDE CONTRACTSAMPLE NO SUICIDE CONTRACT

I,____________________, agree not to kill myself, attempt to kill I,____________________, agree not to kill myself, attempt to kill myself, or cause any harm to myself during the period myself, or cause any harm to myself during the period from__________ to__________, the time of my next appointment.from__________ to__________, the time of my next appointment.

I agree to get enough sleep and eat well.I agree to get enough sleep and eat well. I agree to get rid of things I could use to kill myself-my guns I agree to get rid of things I could use to kill myself-my guns

and pills.and pills. I agree that if I have a bad time and feel that I might hurt I agree that if I have a bad time and feel that I might hurt

myself, I will call _____________, my counselor, immediately, at myself, I will call _____________, my counselor, immediately, at #____________________ or the Crisis Center #____________________ or the Crisis Center at______________________. at______________________.

I agree that these conditions are part of my counseling I agree that these conditions are part of my counseling contract with ________________________. contract with ________________________.

SIGNED:________________________________SIGNED:________________________________ WITNESSED:_____________________________WITNESSED:_____________________________ DATE:_______________________________DATE:_______________________________

Verification of Emergency Verification of Emergency Response ConferenceResponse Conference

I, or we, __________________________________, the parents of I, or we, __________________________________, the parents of ________________, were involved in a conference with school ________________, were involved in a conference with school personnel on _____________. We have been notified that our child is personnel on _____________. We have been notified that our child is suicidal. We have been further advised that we should seek some suicidal. We have been further advised that we should seek some psychological/psychiatric consultation immediately from the psychological/psychiatric consultation immediately from the community. We have been provided with a list of community community. We have been provided with a list of community services. The school district has clarified its role and will provide services. The school district has clarified its role and will provide follow-up assistance to our child to support the treatment services follow-up assistance to our child to support the treatment services from the community. from the community.

_______________________________ _______________________________ ____________________________________________________________

Parent/Legal Guardian Parent/Legal Parent/Legal Guardian Parent/Legal Guardian Guardian

_______________________________ _______________________________ ____________________________________________________________

School Staff member & Title School Staff School Staff member & Title School Staff Member & Title Member & Title

(Poland: “Suicide Intervention in the Schools”)(Poland: “Suicide Intervention in the Schools”)

List of Resources List of Resources 1. Didi Hirsch Suicide Prevention Center: (877) 7-CRISIS or (877) 727-4747- 1. Didi Hirsch Suicide Prevention Center: (877) 7-CRISIS or (877) 727-4747-

Toll free in Los Angeles or Orange CountyToll free in Los Angeles or Orange County

2. USA National Suicide Hotline: 1-800-SUICIDE or 1-800- 784-24332. USA National Suicide Hotline: 1-800-SUICIDE or 1-800- 784-2433

3. Youth Crisis Hotline, 24 hours a day 1-800-HIT-HOME (448-4663)3. Youth Crisis Hotline, 24 hours a day 1-800-HIT-HOME (448-4663)

4. The Trevor Project. www.thetrevorproject.org or 1-866-488-73864. The Trevor Project. www.thetrevorproject.org or 1-866-488-7386 5. 2-1-1 “http://www.211oc.org” Get Connected. Get Answers 5. 2-1-1 “http://www.211oc.org” Get Connected. Get Answers

6. Local Toll free Number for Emergency Psychiatric Evaluation in Orange 6. Local Toll free Number for Emergency Psychiatric Evaluation in Orange County – 24 hour a day, 7 days a week 365 days a year:   866-830-6011  County – 24 hour a day, 7 days a week 365 days a year:   866-830-6011  or  714-834-6900or  714-834-6900

7. Orange County Government Website 7. Orange County Government Website http://egov.ocgov.com/ocgov/Health/Mental%20Health/Suicide%20Prevention

8. www.suicide.org8. www.suicide.org

The EndThe End