People who follow through with suicide are usually :"first timers" and use highly lethal means such as guns, jumping from high places, etc. There is usually litle room for them to change their mins. 50-70% of successful suicides speak of an intent to commit suicide. Males commit suicide 3 to 4 times more than women while women attempt suicide 3 to 4 times more than men. Highest suicide rates are amog people with Affective Mood Disorders and Drug and Alcohol abuse/dependence.

Intervention

"Suicide is a permanent solution to a temprorary problem."
I can't work with you if you're dead."

When client displays depresion, it is necessary to explore the possibility of suicide.

Risk Factors

*panic attacks          *loss of enjoyment of life      
*alcoholism               *loss of libido (sex Drive)    
*negation of help ("I'm in pain but I don't want help.")
*negative self evaluation

Legal obligation/Ethics - Tarasoff Ruling

*Confidentiality ends where public peril begins and there lies the end to trust. It is better to have a client be angry with you and terminate counseling than to have a dead client.

*Legal responsibility - we are responsible for *procedure* not outcome; that is, we are to assess and document intent, motive, means, and immediate danger and, if warranted, break confidentiality with a duty to warn.

Assess: Plan/Intent, Motive, Means, and Immediate Danger

*Plan/Intent: When, where, how
*Motive: Reason for feeling hopeless,such as loss of job, sexuality, divorce, etc...
*Means: Access to means, such as a gun, rope, pills, etc...Do they already possess means or need to buy it.
*Immediate danger: If by the end of the session client has not contracted to end plan or remove weapon and still reports same intent, then you have a duty to warn. You can tell client or report anonymously. Must be documented.

Home      History       Hotline      Transidentity      Resources     News