Suicide Intervention

Suicidal behaviour is the most frequent mental health emergency. The goal of crisis intervention in this case is to keep the individual alive, so that they can reach a stable state and explore alternatives to suicide. In other words, help the individual reduce their distress and survive the crisis.

Assessment

The suicide intervention will begin with an assessment of how likely the individual is to kill him/herself in the immediate future. The assessment will have various components. The professional will assess –

Does the individual have a plan for how the act should be committed?

How deadly is the method? Overdosing? Shooting?

Do they have the means e.g. Access to a gun?

Is the plan detailed or vague?

Their emotional state – depression, hostility, anxiety and so on.

Past suicide attempts.

Completed suicides amongst their family and friends.

Current crisis events such as illness, accident, unemployment.

Treatment Plan

The professional and client will devise a safekeeping contract that is signed by both of them. This confirms that the individual agrees not to commit suicide, will complete various actions and will contact family/friends/emergency personnel/the counsellor if they have thoughts of suicide again.

The contract may include coping strategies to enable the client to reduce their distress. If the individual feels they are not able to do this, they may think that medical treatment is required or voluntary/involuntary psychiatric hospitalisation may be required. Educating family and friends is also an important part of suicide intervention. Family therapy, individual therapy, substance abuse treatment or psychiatric medication may be recommended. This will depend on the other problems that the person is experiencing.

Professional Ethics and Suicide

We covered ethics in lesson two, but suicide is a tricky area, as the person has “chosen” to end their life, so counselling and supporting a person at that time can be difficult. The conduct of clinicians should be guided by ethical codes that provide protection to suicidal clients. The code will be drawn on the principles of –

• Autonomy – respect for the individual’s right to self-determination. This includes respect for the person and their rights, telling the truth and giving all the facts (disclosure) and fidelity (being there for the client) and confidentiality.
• Beneficence – doing the greatest possible good. This means acting in the best interests of the client.
• Non-maleficence – preventing or minimizing harm.
• Justice – fair and equal access to care. So treating clients fairly.

Suicide and Autonomy

This principal affects the professional response to suicidal individuals. It calls for dignity, respect and choice. Suicide is the result of psychological dehabilitation. By extending autonomy to people who have experienced that, we may be facilitating their suicide. So it is important to respect the client, but realise that it may be important to recognise their vulnerability and potential risk to them. Client also deserve the truth.

Some mental health professionals will have strong views on suicide, they may not feel able to support a client because of this. If this is the case, they may have to refer them to another counsellor/mental health professional.

Confidentiality can also be a real dilemma, as it can be fatal for the counsellor to maintain secrecy for a suicidal person, but if they tell another, they may breach their confidentiality.

Mental health professionals should also be faithful to their clients (fidelity) so ensure that the risk of suicide is taken seriously. Fidelity also means that counsellors/mental health professionals should update their knowledge and skills as outdated views of suicide can put the person at risk.

 

Learn More about Counselling and Psychology -

           See our range of Psychology and Counselling courses-Click here