Suicide Risk Assessment & Suicide Risk Assessment & Prevention For ProfessionalsPrevention For Professionals

Sue Heguy, LCSW Care Plus NJ, Inc.SueH@CarePlusNJ.org

About our Presenters:About our Presenters:

• Sue Heguy, LCSW

• Christopher Leonard,

LCSW, M.Ed

Did You Know…Did You Know…in one year, the number of in one year, the number of people who…people who…

• Die from suicide: 32,637– An average of 89 suicides per day

• Attempt suicide: (816,000)

• Have suicidal ideation: (5+ million)

Demographic Risk FactorsDemographic Risk Factors

Ethnic/Racial Differences:• American Indians and Caucasians are more likely to die by

suicide

Gender:• Females 3 times more likely to attempt• Males 4 times more likely to complete

Sexual Orientation:• LGBTQ youth are 2 to 3 times more likely to attempt suicide• Comprise 30% of the annual youth suicides

Why is it Important to Assess Suicidal Why is it Important to Assess Suicidal Risk?Risk?

• More survive than actually die from suicide

• Two out of every three students who attempt do not receive medical attention

• Most common causes for hospital admissions for adolescents

• Suicidal thoughts and behaviors are warnings

Thomas Joiner: Why People Die by Thomas Joiner: Why People Die by Suicide Suicide • Many people are depressed and hopeless, many

severely. Why do some choose to end their lives and others do not?

• Factors that mark those most at risk of death:

1. The feeling of being a burden on loved ones

2. The sense of isolation

3. The learned ability to hurt oneself.

Joiner’s Theory of Suicide Joiner’s Theory of Suicide Supported by ResearchSupported by Research

• For an individual to die by suicide, he or she must have both the desire for death as well as the capability for lethal self-injury.

• Without the presence of both components, one does not truly desire or seek death.

Risk Factors for Youth Suicide Risk Factors for Youth Suicide History of previoussuicide attempts

Family history of suicide

History of depression or othermental illness Stressful

life event or loss

Easy access tolethal methods

Exposure to the suicidal behavior of others

Incarceration

Verbal Warning Verbal Warning SignsSigns

“I wish I could disappear forever”“I want to run away”“Nobody cares, I may as well be dead”

“I want to go to sleep and not wake up”“I hate my life”“I just can’t take it anymore”

Non-Verbal Warning Non-Verbal Warning SignsSigns

• Social Withdrawal/Isolation

• Depression

• Lack of energy

• Unexplained weight loss or gain

• Increased alcohol or drug use

• Insomnia or Hypersomnia

• Dropping out of sports, hobbies, work or school

General Principles of Suicide Risk General Principles of Suicide Risk AssessmenAssessmentt

• Be calm and non-judgmental

• Ask open ended questions

• Never promise unlimited confidentiality

• Suicidal thoughts are not uncommon

• Don’t be afraid to say the word “suicide”

How to How to Intervene Intervene SEPPSEPP

Always treat suicidal behavior seriously

Eliminate access to firearms and potential toolsthat could cause harm

Involve a parent or guardian

Follow school protocol

Questions to Questions to AskAsk

Ask the person directly whether he or she is suicidal:

“Are you having thoughts of suicide?”“Are you thinking about killing yourself?”

Ask the person whether he or she has a plan:

“Have you decided how you are going to kill yourself?”“Have you decided when you would do it?”

How to HelpHow to Help• Concern

• Willing to help

• Express empathy

• Encourage the person to do most of the talking

• Thoughts of suicide are often associated with a treatable mental disorder

• Thoughts of suicide are common

• Suicidal thoughts do not have to be acted on

Keeping the Person SafeKeeping the Person Safe• Provide a safety contact number• Identify people that have been

supportive in the past• Are those supports still available?• DO NOT:

– Leave an actively suicidal person alone– Use guilt and threats to try to prevent suicide– Agree to keep their plan a secret

How to use 262- HELPHow to use 262- HELP

Resources to Provide Youth Resources to Provide Youth • Care Plus NJ Access Dept.

P: 201-986-5000, careplusnj.org• Sage Day

P: 201-843-3800, sageday.com• Trevor Project - Providing crisis intervention and suicide

prevention to LGBTQ youth.

P: 1-866-488-7386, Thetrevorproject.org• 2nd Floor - A confidential and anonymous helpline for New

Jersey’s youth and young adults ages 10-24.

P: 1-888-222-2228, 2ndfloor.org

ResourcesResources• Jersey Voice –Real stories from teens and young adults making it

through tough times

Jerseyvoice.net Reachout.com

• Arseneault, L., Bowes, L., & Shakoor, S. (2010). Bullying victimization in youths and mental health problems: ‘Much ado about nothing’? Psychological Medicine, 40(5), 717–729

• American Association of Suicidology, Prevention Division. (1999). Guidelines for school based suicide prevention programs. Washington, DC: American Association of Suicidology

• Assessing and Managing Suicide Risk (2008). SPRC

ResourcesResources• Zenere, F., & Lazarus, P. (2009). The sustained reduction of

youth suicidal behavior in an urban, multicultural school district. School Psychology Review, 18(2), 189–199

• Wang, J., Iannotti, R., & Nansel, T. (2009). School bullying among adolescents in the United States: Physical, verbal, relational, and cyber. Journal of Adolescent Health, 45(4), 368–375

• Dinkes, R., Kemp, J., Baum, K., & Snyder, T. (2009). Indicators of school crime and safety: 2009 (NCES 2010–012/NCJ 228478)

• Farrington, D., & Ttofi, M. (2009b). How to reduce school bullying. Victims and Offenders, 4(4), 321–326

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