What You Can Do To

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					                                                              Warning Signs of “High Risk”
             Counselling Tips                                          Behavior
1. Trust your suspicions that they may be               Verbal

    suicidal                                            Talking about suicide and death
2. Be calm and affirmative
3. Instill hope                                         Behavioral
4. Try to focus on the problem that is

                                                                                                         You Can
                                                        Changes in habits
    bothering them the most
                                                           ¨ Eating habits
5. Use yourself as an example when it is
                                                           ¨ Sleeping habits
                                                           ¨ Grooming habits
6. Ask if they have ever felt this way before

                                                                                                          Do To
                                                           ¨ School habits
7. Explore resentful feelings
8. Show sympathy and empathy in your                       ¨ Social habits
    statements                                             ¨ Personality habits
9. Help them to talk about their hopes,                 Suicidal Gestures
    dreams, and needed changes                             ¨ Self abusive behavior—cuts, burns, etc.
10. Help them to talk about their strengths,               ¨ Bizarre or sloppy appearance
    talents and skills                                     ¨ Daredevil tactics
11. Have them sign a contract agreeing not
                                                        Changes in Behavior
    to harm themselves
                                                           ¨ Sudden happiness after a long gloomy
12. Share your resources
13. Do not tell them about someone who has
                                                           ¨ Giving away of valuable possessions or
    it worse
                                                              making a will
14. Don’t use clichés
15. Help identify resources needed to                   Situational Warning Signs
    improve things                                          ¨ Broken home
16. Get them to agree to do something                       ¨ Drug/alcohol abuse
    constructive to help themselves                         ¨ Abuse: physical, sextual, neglect &
17. Stay in contact with the individual                         verbal
18. Encourage the person to seek further                    ¨ Not living at home
    help                                                Significant loss—divorce, death, breakup, etc.
19. Do not leave a high risk person alone

                                                        Anniversary of loss
20. Do not swear secrecy to someone who                 Schizophrenic personality
    has told you of suicide plans                       Previous suicide attempt
21. Encourage them to avoid thoughts of                 Suicide history (in family or friends)
    suicide                                             First born child
22. Call the police if the situation is                 Self-critic perfectionistic personality
    immediately life threatening
23. Give yourself credit for being willing to               Curriculum & School Services Division
    risk                                                          Department of Education,
                                                                   Government of Nunavut
Taken from: “Unveiling the Plague of Teenage Suicide”
                                                             P.O. Box 390, Arviat, NU X0C 0E0
                 by Mitch Anthony
         Suicide Risk Assessment                          7. History of suicidal behavior
                                                          ¨ Have there been previous suicide attempts? How                 Successful Intervention
The following factors should be taken into
                                                              many? When?
consideration when assessing the suicidal
potential of an individual…
                                                          ¨   Is there an escalating factor?                                 Caring—Dare to care
                                                          ¨   What happened as a result of previous attempts?
1.   Stated intention                                     People who have attempted suicide before are many                  Listen—Talk the talk
¨    Does the individual say he wants to die?             times more likely to commit suicide than are members
¨    How ambivalent is he/she?                            of the general population.                                         Act—Walk the walk
¨    What is his/her concept of death?                    8. Medical (including psychiatric) history
2. Demographic factors of the individual                  ¨ Previous psychiatric contacts? When?
                                                               Circumstances? Diagnosis?                                    Caring Confrontation
¨ Sex, age
¨ Marital status, etc. Newly divorced or separate are     ¨    Medical problems?
     most at risk                                         ¨    Drug/alcohol abuse?                                 Do not be afraid to ask directly if they
¨ Ethnic background                                       ¨    Is the individual currently in therapy?             have entertained thoughts of suicide
In many ways these categories are not very useful. All    ¨    Who are the persons the individual perceived to
groups are at risk, although suicide is very rare among        have been helpful?
children under 10 years of age.                                                                                        You really seem troubled lately, let’s
                                                          9.   Personality factors of the individual

3. Affective Component
                                                                                                                       talk about it.
                                                          ¨    Style of coping with problems and frustrations
¨ Degree and type of emotion expressed (anger,            ¨    Degree of internal/external control
     bitterness, depression, etc.)                        ¨    Impulsivity                                         ·   Have you ever thought of dying?
4. Suicide Plan                                           ¨    Tendency toward violence
¨ Is the individual vague about what he/she would         ¨    Legal/police involvement                            ·   Have you ever thought of suicide?
    do to carry out the suicide threats or is there a     10. Current life circumstances
    specific plan? (place, time, etc.)                    ¨ Number and type of stressors
¨ Is the individual specific as to the method of
                                                                                                                   ·   How were you thinking of doing it?
                                                          ¨ Available resources
¨ How available are the means?                            11. Circumstances of the present contact                 Low risk responses:
¨ Has the individual considered the possibility of        ¨ Did the individual initiate the contact? If so, why?
                                                                                                                      "Well, I haven’t thought of any way to
    rescue and planned how to achieve or avoid this?      ¨ Are there other people in the vicinity of the

The more detailed and thought out the plan, the                individual? (assuming a phone contact)                 kill myself."
greater the risk.                                         ¨    Who are they?
5.   Communication of suicidal intent                     ¨    Are they potential rescuers?                        Medium risk responses:
¨    Verbal or written?                                   ¨    Are they potential victims? (homicidal potential)     "I’ve thought of taking an overdose of

                                                               Individual’s physical condition? (eg. Has he been
¨    Directed to whom?
                                                               drinking?, etc.)
                                                                                                                     pills.", etc."
¨    What is actually said?
¨    What is the expected/actual response to the          12. In the case of an attempted suicide
     communication?                                       ¨ Why did the attempt fail?
                                                                                                                   High risk responses:
                                                          ¨ Degree of lethality of the method chosen?                 "I know exactly how I will do it!"
6.   Final arrangements

¨   A will, funeral plans, giving away property?          ¨ Actual vs. individual’s perception
¨   Perceived effect of death on significant others?      ¨ Who initiated the individual’s rescue?                 Rule for determining risk:
¨   Arrangements for survivors?                           ¨ Planned or accidental?                                    The more developed the plan, the
                                                          ¨ Individual’s attitude toward the failure of the

The more detailed and thought out the plan, the                                                                       higher the degree of risk.
greater the risk.                                              attempt? (relief, self-deprication)

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