Discussion-
Low Risk: They can usually be treated as outpatient. Encourage them to make an appointment with a therapist. Low risk suicide clients will likely respond well to educational interventions. For example Show More Low Risk:
They can usually be treated as outpatient. Encourage them to make an appointment with a therapist. low risk suicide clients will likely respond well to educational interventions. For example suggesting non-fiction topic or situation related books. (Kanel, 2015) One could also provide plenty of empowering supportive comments.
Middle Risk:
Middle risk suicidal clients are the most common. One of the common suicide interventions used with middle risk clients is a no suicide contract. (Kanel, 2015) In the contact clients agree to give up the right to kill themselves for two or three days. During that time the client sees the crisis worker it is important to acknowledge that this type of intervention should not be used with a client that lives alone and/or has a weak or has no support system. A worker may enlist the help of family member . Asking them to say close and monitor the client. This shows the client that family really does care; and it's enough to invest energy into helping them.
High Risk:
If it is possible workers should try to get the client to admit themselves. However, there are going to be times that involuntary hospitalization will have to occur. Another popular option is partial hospitalization. partial hospitalization provides a sage environment and is less costly. (Kanel, 2015)
People do not always come right out and say that they want to kill themselves. As a worker it is our job to be able to read between the lines. Some red flags would be: writing a will, increased drug/alcohol use, recent death of a relative or friend, showing agitated depression, etc.
I don't really have a difficult time asking the client questions. I generally inquire about the client's general environment. That includes: home, family, friends, work, co-worker relationships, pets, hobbies, etc. This is a great start to being able to have some background knowledge not just on the client but also how the client perceives his/her life.
When assessing a suicide client some of the other questions or information that is pertinent to know would be:
Do you have thoughts of hurting yourself or others?
Have you developed a plan for suicide? If so what is that plan?
Who have you told about your thoughts and plan?
There are multiple important questions to ask! The questions that should be asked and how they should be asked depends on how the client is responding to the interview.
Just as there are people with suicidal thoughts there are also people who have homicidal thoughts. The crisis worker must take into consideration
Does the client have a history of violence?
What does the client's impulse control appear to be?
Is the client having delusions or command hallucinations?
Of course there are many other questions. This is just an example of a few!
The textbook gives us six questions that could be used to assess the client and his or her potential for harming others.
1. Is the subject actively or passively in violent or dangerous behavior?
2. Does the subject have a plan to follow through on?
3. Does the client say that he/she is going to follow through?
4. Is the client capable of following through? - As in does he/she have the means to do so?
5. Does the client have a history of violent behavior?
6. Has he/she followed through with violent plans in the past?
Some scenarios allow for you, as the worker, to attempt to help the client contain and work through their anger. These situations are a lot less intimidating. I have found that although the scenario may take longer, it is easier to talk to someone in this state than someone in a more severe state. The number one reason for this is because they are more responsive to conversation. And lets be honest, as a crisis worker, having conversation is what we do! ;) The biggest fear I have, especially in sever cases is safety. I once had a client's family member follow me home after work one night. ( I had to follow process for an involuntary hospitalization) In the middle of the night came back and was banging on the outside of my house and destroying the lawn and our yard decorations. This has been the only time that something like this had happened. It didn't change anything about how I do my work or how I feel about my work. However, I am much more aware of my surround at all times. I do not live in a constant state of fear about it, but I am so much more aware.
Questions:
There are a lot of questions, but those first three are critical. Many of our homicidal clients have some delusions, which is a dangerous situation because it may not have to do with anger. Plan, intent and means are the most important questions after homicidal ideation has been expressed.
Is the ideation specific? Is there a target?
Does the client have a plan to carry out the ideation?
Does the client intend to carry out the plan?
Does the client have access to any means (not just the one(s) in the plan) to harm others?
I can decide that I don't like my elected official and daydream about killing him. I can think about locking him up with no heat, light or food for three months in an apartment in northern Maine starting on January 20, but obviously this plan is unrealistic and I don't have the means to carry it out.
In Julie's case there is a danger of property destruction (even if the client was someone else). That person also could have been hospitalized, even though most of it may have been spontaneous.