Assessing Suicide Risk

Finally, I found a ready-to-apply article on assessing suicide risk. Usually, articles are too brief to trust their application. Other times, they’re so theoretical that they require a lot of work to extract practical tips. Finding reliable information that is readily usable is important for staff personnel in academic settings, for example, who need to be aware of what signs are important, but are not going to be clinical experts in assessment. This article, “Strategies for Understanding and Assessing Suicide Risk in Psychotherapy,” appeared in the Winter 2007 issue of Annals of the American Psychotherapy Association which is one of the better journals I read regularly. Click here for the entire article.

Dr. Schwartz provides a handy assessment guideline from one of his previous publications:

· Low lethality — suicidal ideation is present but intent is denied, client does not have a concrete plan and has never attempted suicide in the past.

· Moderate lethality — more than one general risk factor for suicide is present; suicidal ideation and intent are present, but a clear plan is denied; and the client is motivated to improve his/her psychological state if possible.

· High lethality — several general risk factors for suicide are present, client has verbalized suicidal ideation and intent, client has a coherent plan to harm him or herself, and client reports access to resources needed to complete the plan.

· Very high lethality — client verbalizes suicidal ideation and intent, he or she has communicated a well thought out plan with immediate access to resources needed to complete the plan, client demonstrates cognitive rigidity and hopelessness for the future, he or she denies any available social support, and he or she has made previous suicide attempts in the past.

I would like to see an equally informative article explaining how to treat someone who has been assessed at a high level of lethality. Click here for a concrete example of what I’m looking for. Can anyone suggest resources for how to respond to each of the four levels mentioned: (1) Low, (2) Moderate, (3) High and (4) Very high levels of lethality?

Since teen suicides are on the increase in recent years, it’s good to know some warning signs for that age group. A website for helping troubled teens suggests the following:

Pay attention to these teen suicide warning signs:
Suicide threats, direct and indirect Teen depression
Obsession with death
Poems, essays and drawings that refer to death
Dramatic change in personality or appearance
Irrational, bizarre behavior
Overwhelming sense of guilt, shame or reflection
Changed eating or sleeping patterns
Severe drop in school performance
Giving away belongings

It seems to me that those who want to check out of life have very little hope in the future and a lot of pain in the past and present. I would like to think that finding our identity in Christ and finding our meaningful place in the Body of Christ would be a deterrant for despair and desperation. It was our Lord Jesus Christ who gave us all a promise,

“Come to Me, all who are weary andheavy-laden, and I will give you rest.” (Matthew 11:28)

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