Suicide Written Risk Assessment

Suicide Written Risk Assessment
CONSIDERATIONS FOR SUICIDE RISK ASSESSMENT SPECIFIC TO FASD CLIENTS1) Past and current history of suicide attemptsand/or ideation.2) Past diagnosis and medication or diagnosis ofdepression or other mental illness.3) Past diagnosis of ADHD1. Resources: Physical and emotional systems which the caregiver andindividual perceive as supportive. Major component in establishing apreventative intervention plan.? Safe structure? Routine? Consistency (predictability)? Staff supervision? Relationships/friends/family? Pets, inanimate objects? Individuals own connection to personal resilienciesComments:2. Current Suicide Plan: (This may not be relevant as FASD individualsrarely plan)ADHDImpulsivity Severity Level LOW………….HIGHAwareness of Consequences Severity Level LOW………….HIGH3. Prior Suicidal Behaviour:Previous attempts (from historical information) LOW………….HIGHPrevious self harm that could result in death? LOW………….HIGHFamily member and/or friend attempt/died by suicide? LOW………….HIGHConsider:? Was the suicide witnessed by the individual?? Does the individual have an awareness of an attempt or completion ofa family member?? Has the individual had recent exposure to visual selfharm/suicide/violence? (i.e., movie, TV, pictures)? Awareness of the possibility of role modeling, mimicking or parrotingbehaviourHow long ago? ___________ By what method? _________________Comments:4. Mental Health Concerns: Consider the possibility of COMORBITITY(diagnosis of other mental health concerns that may increase the risk ofsuicide attempts).5. Situational Considerations:To what extent has there been a change in the following areas:Medication LOW………….HIGHStructure LOW………….HIGHRoutine LOW………….HIGHStaff LOW………….HIGHCircumstances LOW………….HIGHRecent Abuse (Physical, Sexual & Emotional) LOW………….HIGHComments:6. Symptoms: (Note: Awareness of an individuals unique patterns, habits,and behaviours is essential in assessing significant change.)To what extent has there been a change in the following areas:Physical (appearance, hygiene, eating, sleeping) LOW………….HIGHActions (withdrawn, reckless, self harm, drug use) LOW………….HIGHSelf Talk (“I wish I was dead”/”It will all be over soon”) LOW………….HIGHEmotions (hopeless, helpless, worthless) LOW………….HIGHNote: Individuals with FASD have difficulty processing emotions andfeelings; however, this does not mean that they do not experience emotionsand feelings.Comments:7. Current Level of Risk:LOW RISK MID RISK HIGH RISK8. Plan for Intervention:(Dubé, J. & Massey, D. (2001). Lethbridge Family Services, Lethbridge, AB, Canada.Revised June 4, 2002, Outreach Program, Lethbridge Family Services.)