Guide To Suicide Assessment

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Guide to Suicide Assessment Developed by David J. Knesper MD, Department of Psychiatry University of Michigan; last revised 3/03 1. Facts That Pertain to Risk and/or Trigger Suspicions: Self-assessments (e.g., Beck Suicide Scale): Like risk factors, self-rating scale information is used to alert you to intent, deceit and estimates of probability. SAD PERSONS (risk factors): Sex, Age, Depression (especially with global insomnia, severe anhedonia, severe anxiety, agitation, and panic attacks), Previous attempt, recent Ethanol abuse, Rational thought loss, Social supports lacking, Organized plan, No spouse, Sickness. Other Facts: Diagnoses (especially major depression, bipolar illness and/or psychosis), available means/weapons,…show more content…
The Examination: A detailed interview determines immediate dangerousness. Absent suicidal ideation is misleading! Initial Approach: Never accept the first “No.” The first attempt is the last for the bulk of all inpatient suicides. Be non-judgmental, calm and matter-of-fact. Validate the patient’s right to view suicide as a rational solution. Understand the detailed, step-by-step evolution of thought and behavior. Empathize: Explicit questions about suicide intent are best explored after the person’s situation is understood and validated (e.g., “When people are very upset….”). Suicidal behavior may be understood as a communication or solution. Over the course of understanding, cognitivebehavioral techniques may transform the suicide crisis and develop problem-solving skills and alternative solutions. Look for self-denigration, overgeneralization, catastrophic and/or black-or-white thinking, and other cognitive distortions. (Strategies) & Questions: a. (Normalize): When someone feels very upset, they may have thoughts that life just isn’t worth living. Have you had such…? b. (Challenge): Your “No” does not convince me. Why wouldn’t you want to kill yourself with all that’s

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