Suicide is vital in any counseling whether clinical or pastoral. Pastoral counselors should refer patients or members of the community to a professional counselor if he or she feels the person is experiencing depression and suicidal ideation. In most cases, suicide assessment will consider a person to be low risk or high risk. As opposed to low risk, high risk individuals have a far worst depression and a more lethal plan.
When anyone feels depressed, especially over time, it can become overwhelming. This is why when helping depressed and grieving individuals to probe and ask questions about suicide. It is critical to ask if one wishes to hurt or harm oneself when interviewing the patient. It is important to see if those types of thoughts or ideas are entering the person’s mind. If someone who is experiencing depression states they feel hopeless, then this is definitely a warning sign. Not all hopeless individuals commit suicide, but anyone who has ever attempted or committed suicide definitely felt hopeless.
If the seriousness of an assessment manifests, then one needs to determine if one is low risk or high risk. Many individuals in pain or depressed may think occasionally of killing oneself, but do not have the intention, desire or capability to do so, but as thoughts of suicidal ideation become more frequent and loud, then an assessment is definitely needed. Hence after assessing symptoms of depression and the thought or at least implicit idea of suicide within the patient’s mind, it is important to access whether this person is low or high risk. High risk individuals will require more intense observation and measures, while low risk will require less intense intervention.
If one makes comments about harming oneself, the next question is to determine lethality of the plan. Is the plan doable? Are the means, times and places for the event possible? If someone dictates one would like to shoot oneself, then access if this person has access to firearms. A person who points out that he owns a gun that is at home and currently loaded in his closet poses a severely high risk. Hence the more detailed the plan the higher the risk level. If a person has access to the weapon named in the thought and a time planned, then immediate intervention is required. Police should be called or the person should be submitted to a psych ward for observation. If the person on the other hand does not have access or ability to commit immediately, one should be immediately referenced to professional counseling for depression.
Someone who is high risk has more detailed plans, numerous thoughts, deeper depression, more drinking and drug issues, and access to carry out the plans. High risk individuals are also individuals who have survived past attempts. So it is important to ask these questions as well, but also including family history of suicide. Unfortunately, many individuals due to mental health stigmas, keep their sadness and depression to themselves. No-one is aware of the high risk involved with the loved one or friend. Many times, friends and family miss the subtle comments about life and death or the anxiety and depression someone is enduring. Awareness, questions and listening are key in helping depressed individuals find the help they need. Assessments can later be employed to determine the risk level.
If anyone manifests any level of suicidal ideation, it is important to convince the person to make a no-suicide contract in which the individual promises to call someone if the person feels low, hopeless, or ideation of killing oneself manifests. This last outlet may be the helping hand one needs not to take it to the next step. In this type of contact, the person promises to call a loved one or yourself if ideation manifests. Sometimes this last call for help is the difference between life and death. It is also important to discuss the frequency of alcohol and drug use during this period of time and how it can play a role in poor decisions.
Individuals kill themselves not because they want to die but because they do not feel life is worth living. Many of them are not in the proper state of mind due to depression, trauma or extreme pain. These individuals need counseling and help so they do not fall victim to suicide itself. With so many stigmas surrounding suicide, it is important to remember that someone who commits it or attempts is dealing with temporary mental illness. One should not blame but try to help. It is not a true sin in the classical sense that once was attributed to it but a true mental state of imbalance.
Pastoral caregivers can play a key role in helping members of the congregation work through suicidal thoughts. They can be the first line of defense for those who have noone to talk to or discuss their feelings with. They can mentor, guide and help individuals find hope when they are depressed. Christian Counselors, pastoral counselors and those in ministry should all have crisis intervention training and suicide prevention training. This will enable them to better help individuals suffering from these types of thoughts.
Please also review AIHCP’s Grief Counseling, Christian Counseling and Crisis Intervention Counseling Programs. The programs all to some extent touch on suicide. The Grief program discussing the role of depression and loss in suicide. The Christian Counseling Program discusses the pastoral implications from a Christian perspective and the Crisis Intervention Program discusses suicide prevention, assessment and helping individuals who are in a state of acute crisis. All the programs are online and independent study and open to qualified professionals who work in the counseling and ministry fields. Please review and see if the program meets your academic and professional goals.
Again, if in any type of counseling, whether professional or pastoral, be sure to have a complete understanding and working suicide assessment list. Also, if anyone is feeling worthless or hopeless, please call the National Suicide Hotline and seek help. Simply dial 988. Hurting oneself is never the answer.
988 Suicide & Crisis Lifeline. Access here
“Suicide Assessment”. Access here
“How to assess and intervene with patients at risk of suicide”. Clay, R. (2022). APA. Access here
“Adult Outpatient Brief Suicide Safety Assessment Guide”. National Institute of Mental Health. Access here