Crisis and Suicide Assessment

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.

Suicide assessment is key in assigning low or high risk individuals. Please also review AIHCP’s Crisis Intervention program

 

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.

When one is in crisis, it is important to ask questions about self harm or hurting oneself and see if anyone is frequently thinking of it or planning it

 

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.

Additional Resources

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

Grief Counseling Training Program Article on Depression with Suicidal Thoughts

In times of crisis suicidal thinking can overtake, but it can also gradually creep into the mind of the person via depression.  Understanding and identifying suicidal depression is important and can save a life.

Helping some through suicidal thoughts takes indepth training. Please also review AIHCP’s Grief Counseling Program

 

The article, “Understanding Suicidal Depression” from Healthline explores the characteristics of suicidal depression.  The article states,

“When someone has clinical depression with suicidal ideation as a symptom, Marshall says it means that they are experiencing suicidal thoughts as part of their overall health symptoms. “However, it’s important to remember the vast majority of people who are depressed do not go on to die by suicide,” she explains.”

To read the entire article, please click here

It is important to never underestimate suicidal thoughts and to help individuals find the help and care they need if beyond one’s ability.  If someone is experiencing suicidal thoughts, it is important to delve deeper into how well thought a potential plan is and also the ability to carry out that plan. In addition it is important to make a pact that if someone feels they can no longer cope to call or let you know.

Please also review AIHCP’s Grief Counseling Training Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professional seeking a four year certification in Grief Counseling.

 

Grief Counseling Certification Article on Suicide Grief and Grieving

Making sense of suicide is difficult.  Loved ones who lose family to suicide suffer immensely in the days and months and years after.  Questions swirl around their minds.  What could one have done better, or why did one say this or that, or why was one not paying attention to the signs.

Processing the loss of a loved one to suicide is a very difficult process. Please also review AIHCP’s Grief Counseling Certification

 

Regret, guilt and intense grief can follow.  The very fact that suicide is a taboo subject can also intensify the grieving process.  Suicide grief hence has all the prerequisites and ingredients for a possible complication emotionally for the family.

The article, “Making sense of suicide grief” by Susan Quenelle looks deeper at suicide grief for family members trying to make sense out of the senselessness.  She states,

“September is National Suicide Prevention Month. This designation helps to serve as a reminder to all of us of the many people who struggle with emotional issues on an ongoing basis. But another related area of concern is those who are left behind after someone has committed suicide.”

Those left behind suffer the most and it is important to help them understand their grief.  To read the entire article, please click here

To learn more skills to help others through the process of losing a loved one to suicide, then please review AIHCP’s Grief Counseling Certification

 

Grief Counseling Training Article on Child Suicide

Losing a child is the greatest loss a parent can face.  How the child dies can make the loss even more unbearable.  The loss of a child through suicide is even a greater loss.  Many parents need emotional and professional support in dealing with such a loss.

The loss of a child through suicide may be one of the most painful losses. Please also review our Grief Counseling Training

The article, “How do you live after your child commits suicide & you never saw it coming? A grieving parent reflects” by Linda Collins explores this painful grief.  She  recounts from a book about such sad tales.

“Victoria was their only child. Three years after the incident occurred, Collins recounts her 17-year-old daughter’s suicide in this book, weaving in her daughter’s diary entries, personal memories and accounts from the people in her life.”

The article offers an excellent book for others to investigate and read.  If you would like to read the entire article, please click here

Please also review our Grief Counseling Training and see if it meets your academic and professional needs.

 

Christian Counseling Certification Article on Pastoral Care of Suicide

Suicide for the longest time was considered only to be a sin of despair.  It was a stigma and received more condemnation than care.  Today, individuals who attempt suicide are treated more like victims fortunately.  Family is also given the care and love they deserve from a pastoral perspective.

Suicide is not always a sin of despair but also sometimes a mental condition. Please review our Christian Counseling Certification

The article, “SUICIDE: MOVING BEYOND CONDEMNATION TO CARE” by Elizabeth Evans states,

“Numerous faith traditions have a history of criticising suicide as a sin – and one that leads to damnation.  But some faith leaders are now working not only to offer those facing despair help in addressing the root causes of suicide but to remove the stigma that keeps so many suffering families quiet after the death of a loved one.”

To read the entire article, please click here

Please also review AIHCP’s Christian Counseling Certification and see if it meets your academic and professional goals.

Grief Counseling Certification Article on Stigma Of Suicide

Suicide is a messy thing. It is filled with multiple emotions of loss and despair, but what modern science teaches is that is most of the time an illness.   Someone does not simply wish to end his or her life with a clear head.  It is because of this and many other factors that cloud judgement that many churches have removed the stigma of suicide itself.  Suicide while a horrible thing must not be shelved away but discussed in the open and understood a decision based upon mental illness.  If so, we as a society can move forward and deal with suicide survivors, as well as family survivors of a successful suicide of a loved one.

The choice of suicide is a result of a mental imbalance that leaves everyone in tears.
The choice of suicide is a result of a mental imbalance that leaves everyone in tears.

The article, “Opinion: Talk about suicide, end the stigma” by Natalie Sept looks closer at suicide and how it can no longer be seen simply as a rational choice but more so as a decision based in intense emotional instability.  It is time to stop treating it as a stigma and face it head on and recognize the surrounding demons of it.   The article states,

“When I received the news recently of his suicide, there was something in me that knew it would end this way. Jay struggled with addiction. Our family watched nervously as his jovial disposition became clouded with the pall of substance abuse that eventually pulled him into an irreversible decision.”

To read the entire article, please click here

To learn more about grief counseling and helping others with suicide, please review our Grief Counseling Certification.