SUICIDE ASSESSMENT AND INTERVENTION. Definition of Crisis. A student is in crisis when his/her normal coping skills are overwhelmed by current life events. The student experiences subjective distress and impaired social, academic, emotional and/or physical functioning. .
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A student is in crisis when his/her normal coping skills are overwhelmed by current life events.
The student experiences subjective distress and impaired social, academic, emotional and/or physical functioning.
This may include: suicidal or homicidal ideation or behavior, grief reaction to any type of loss, bizarre thoughts, drug intoxication, acute anxiety, impulse control problems, school problems, and developmental issues.
Statistics: Colorado has the fifth highest per capita suicide rate in the nation
Suicide is second highest cause of death in college students after accidents
Seventy-five percent (75%) of those who commit suicide will give clues (25% give no clues....just as important)
Ideation - suicidal thoughts - very common
Threat - saying or doing something that indicates a self-destructive desire
Gesture - a self-destructive act of low lethality, usually symbolic
Attempt - serious effort to end one's life
Age and Sex
Males attempt less often than females, but use more lethal means (i.e., more men commit, more women attempt).
However, the gap is closing and threats from women should never be taken lightly.
As age increases, suicidal risk goes up for both sexes, but the danger increases much more for males than females with age. However, college students also have increased risk and rates (2nd leading cause of death after accidents).
The less control a person has, the higher the immediate risk. Evidence of a loss of control:
Psychotic behavior – hallucinations
History of poor impulse control or poor judgement
Use of alcohol or drugs increases risk - intoxication plays a role in the majority of all completed suicides
RECENT LOSS - is indicative of higher lethality
If the person’s resources, financial ($, job) or emotional (friends and family) are lost, the risk goes up accordingly
Emphasis on feeling psychologically isolated, not just physically
The person who is a “loner” or feels very alone is a higher risk
Family History/Family or Campus Turmoil
Family history of depression, psychosis, suicide, abuse, alcoholism
Instability of relationships at home or on campus increases risk
Presence of incest, child abuse, spousal violence
If your gut feeling goes against the objective data, check out what you are feeling with the person. Trust yourself.
You will need to be more active and directive than usual, making decisions for the suicidal person that s/he is unable to make. Your ability to model calm, clarity, and decisiveness will nurture that part of the student
Avoid a philosophical discussion concerning the right to die. You can acknowledge that the student does have that option (responsibility). This is often a control issue. Once the student feels that s/he can retain this power, s/he is open to considering alternatives.
Assessment for Intent & Immediacy
“Help, what should I say or do?!!!”
Does the person think s/he would actually go through with it? And if so, how soon?
Do not be afraid to ASK to following questions….
Have you been thinking about taking your life?
How would you kill yourself? Do you have a plan?
Do you have the means available for the plan?
Have you ever attempted before?
Do you feel you will be safe for a short-time until we can arrange help?
What has been keeping you alive so far?
What does the future hold for you?
The more specific, well thought out, and serious the plan, the higher the risk that the situation is life threatening. The intervention need becomes more immediate.
If life threatening situation:
The most important intervention is to LISTEN!
If a person really wants to commit suicide, no one can stop him or her, including you. But, you can be prepared and do what you can.
It's important to look at overall patterns and not jump to conclusions based on a few significant signs. Nevertheless, some signs are most indicative of lethality: previous attempts, specific plan, availability of means, and drug use