Suicide and Risk Assessment Case Analysis
In this assignment you are required to perform a suicide/risk assessment utilizing the following assessment tool, located in the Resource section of your syllabus.
Suicide Check List: Ways to Assess Suicidality, also located in the Resource section of your syllabus.
It is suggested that you print the form and checklist, fill them out, scan and upload as a pdf files.
Review this week’s video and the article on suicide, as well as the reading assignments on suicide prevention and assessment. Using the above Assessment tools, please evaluate the following vignette for risk and suicidality. Please consider culture in your assessment. You are required to reference your work in APA format.
Fill out the forms, describing what you see in the vignette that supports your assessment responses. You may add additional information at the end of the forms to clarify your responses.
After you fill out the forms, write a paper discussing your assessment, possible interventions and prevention strategies that you might use when encountering similar situations in your professional work. Justify your responses by using and referencing the course text, the article you read and the video that you watched this week. All work must be written in graduate level English in APA format.
Your paper should be 1-2 pages plus a title and reference page.
Naomi, a 16-year old Native-American female, is brought to your office by her parents after they found scratches on Naomi’s wrist and a note saying, “I just wish I wouldn’t wake up in the morning”. Triggering event is reportedly seeing her boyfriend with another girl at school. The parents report that Naomi is an excellent student and always has been a happy child. During her adolescence, she reportedly became moody and irritable, with fits of rage when she doesn’t get her way. When she was 15, Naomi apparently told her best friend that she planned on overdosing on her father’s pain pills, but the best friend told Naomi’s parents and this was intercepted. The incident at that time was also over rejection by a boy at school. Currently, Naomi is an excellent student, has no physical ailments, denies substance use and shows no signs of psychosis or mania. Mother tells you that Naomi sleeps a lot, sometimes 12 hours on the weekends, eats very little at dinner, and has gotten quite thin. Father is worried about his daughter as she is not the same little girl that adored him. Both parents are fearful that Naomi will harm herself. In session Naomi appears annoyed and denies intent to harm herself. She tells you, “I’m fine. Everyone is over-reacting. My parents just need to chill. They’re smothering me with their ridiculous worry.”
Family history reveals suicide attempts by Naomi’s mother when she herself was an adolescent due to chronic abuse by her alcoholic father. Mother denies suicidal ideation at present, and is on antidepressant and antianxiety medications. She does reveal that her paternal grandfather was an alcoholic who “killed himself’ when his wife left him. Naomi’s father is a police officer, currently on disability. He suffers from chronic back pain, and is prescribed narcotics for pain management. Both parents are adamant that their medications are safely kept and that Naomi has no access them.
Assignment OutcomesRecognize the major issues related to sound and professional practice in psychology Assess and evaluate legal and ethical mandates in clinical context Describe local laws regulating the practice of psychology
Standard Suicide Risk Assessment
______________________________________________________________________________________
A comprehensive suicidality assessment was conducted due to: (check one about the nature of the referral)
___ Referral source identified suicidal symptoms or risk factors
___ Patient reported suicidal thoughts/feelings on intake paperwork/assessment tools (please attach a copy of the assessment instrument with applicable items circled)
___ Patient reported suicidal thoughts/feelings during the intake interview
___ Recent event already occurred (circle appropriate: suicide attempt, suicide threat)
___ Other:
In the following sections, circle Y for “yes” and N for “no” and provide accompanying details.
________________________________________________________________________
Describe the therapeutic alliance/relationship at the end of the initial session:
Poor————-Routine————-Good
If Poor, please indicate problems observed:
________________________________________________________________________
Precipitants to Consider:
Y N Significant loss Describe:
Y N Interpersonal isolation Describe:
Y N Relationship problems Describe:
Y N Health problems Describe:
Y N Legal problems Describe:
Y N Other problems Describe:
Nature of Suicidal Thinking:
Y N Suicide Ideation:
Frequency: Never Rarely Sometimes Frequently Always
Intensity: Brief and fleeting Focused deliberation Intense rumination
Other: _____________________________________
Duration: ____ Seconds ____ Minutes ____Hours
Y N Current Intent
Subjective reports(Provide quote): _______________________________________
Objective signs(behaviors): ____________________________________________________
Y N Suicide plan:
When___________________________________________________________
Where___________________________________________________________
How_______________________________________ Y N Access to means
Y N Suicide Preparation ___________
Y N Suicide Rehearsal_____________________________________________________
Y N Reasons for Dying:____________________________________________________
Y N Reasons for Living: ______________________________________________________
Y N Evidence of emergence of capability to suicide? _______________________________
History of Suicidal Behavior, Self-Harm
Y N History of Suicidality
Ideation_____________________________________________________________
Single Attempt_____________________________________________________________
Multiple Attempts____________________________________________________________
Y N History of Self-Harm (no intent to die)
Type: _______________________________________________________________
Frequency:___________________________________________________________
Duration: ____________________________________________________________
Symptom Severity:
Depression: Rating (1-10)________
Anxiety: Rating (1-10) )________
Anger: Rating (1-10) )________
Agitation: Rating (1-10) )________
Onset of symptom clusters:____________________________________
Duration of symptom clusters:__________________________________
Hopelessness:
Rating (1-10)___________
Onset:________________
Duration:______________
Perceived Burdensomeness:
Rating (1-10)___________
Onset:________________
Duration:______________
Sleep Disturbance:
Rating of severity: (1-10)___________
Initial, middle or terminal insomnia (circle)
Nightmares? Yes or No
Impulsivity/Self-Control:
Y N Impulsivity
Subjective reports: _____
Objective signs: _____________________________________________________________
Y N Substance abuse Describe:
Additional Factors to Consider:
Y N Homicidal ideation Describe:
Recent hospital discharge for suicidality? Y N
How long ago was the discharge? ______________________________________________
Additional risk factors: (check all that apply)
____ Age over 60 ____Male ____Previous Axis I or II psychiatric diagnosis
____ Previous history of suicidal behavior ____History of family suicide
____ History of physical, emotional or sexual abuse ___ Access to firearms
Mental Status:
Alertness: alert…..drowsy…..lethargic……stuporous……other:
Oriented to: person place time reason for evaluation
Mood: euthymic, elevated, dysphoric, agitated, angry,
Affect: flat, blunted, constricted, appropriate, labile
Thought continuity: clear and coherent, goal-directed, tangential, circumstantial, other:
Thought content: WNL, obsessions, delusions, ideas of reference, bizarreness, morbidity, other:
Abstraction: WNL, notably concrete, other:
Speech: WNL, rapid, slow, slurred, impoverished, incoherent, other:
Memory: grossly intact, other:
Reality testing: WNL, other:
Notable behavioral observations:
___________________________________________________________________________
Rating of Acute Risk (circle appropriate category)
None—–Mild—–Moderate—–Severe—–Extreme
___________________________________________________________
Presence/Absence of Chronic Risk (circle appropriate category)
Absent
Present
If present, summarize markers of chronic risk:
_____________________________________________________________________
DSM-5 Diagnosis:
P: At the current time, outpatient care can/cannot provide sufficient safety and stability.
Intervention plan for safety is:
1.
2.
3.
4.
Patient agrees to this plan: Y N
Patient was provided a written crisis response plan: Y N
Patient was provided a commitment to treatment statement: Y N
