Transcript Report what, to who, and why??

Aka: Do I take this serious?
Dr Lisa Arieta Hayes
 We
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are required to report suspected:
Physical abuse
Sexual abuse
Serious neglect
Suicidal ideation with intent
Homicidal ideation with intent
 Age
 Sex
 Stress
 Symptoms
 Prior
Suicidal behavior
 Current degree of planning
 Resources
 Female
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Most at risk ages 15-19
 Male
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Youth
Most at risk ages 20-24
 Female
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Adults
Ages 50-59
 Male
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Youth
Adults
Ages 70 years and above
 Helpless/hopeless
 Anger
or fighting
 Insomnia or hypersomnia
 Self inflicted injuries
 Giving away belongings
 Developing will and/or saying goodbye
 Making threats to kill self/others
 Unrealistic
guilt
 Isolating from friends and family
 Resentment and hate
 Increased alcohol and drug abuse
 Poor appetite or overeating
 Poor self care and hygiene
 Crying
 Poor health
 Intent
 The client
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makes verbal statements
“I wish I was dead”
“I want to die”
“I’m gonna kill myself!
The client has thoughts
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“I can’t go on”
“I’m in too much pain but I can’t tell anyone”
 Passive intent – no real plan
 “I want to die but haven’t thought
 “I just wish a car would hit me”
 “I wish I just wouldn’t wake up”
 Clue is person has No Active Plan
how I would do it”
 Plan
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Time line of when
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How
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E.g. anniversary of husband’s death
Pills, gun, hanging etc…
Where
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At home after everyone leaves
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The client shares a clear plan then 5150
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The client has no plan – then no harm contract
and constant monitoring
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Check in each time you see them and renew each
week
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Lethality
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Method will likely result in death
Has easy access to the method
In possession of the method
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Not lethal e.g. jump out of plane, take birth control pills
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History of previous attempts
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Must get details of each attempt and what happened
e.g. took bottle of aspirin, hospitalized, stomach
pumped
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No as serious attempts e.g. superficial cuts; taking
medication that is not lethal or not taking enough e.g.
took 2 valium
 Contracting
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Contracts does not mean a client will not commit
suicide
Even is a client signs a contract it does not mean
that they will not change their mind
Contracts represent good faith effort and
agreement of client with you to work together on
this problem
Important to have with clients who have no plan
but often has thoughts of suicide/death
 Includes
agreement not to harm self
 Promises not to harm self unless contact
therapist, crisis/suicide hotline, or agency’s
24 hour answering services first
 Time limited
 Reviewed and documented constantly
 Agencies usually have boiler plates to use –
ask your supervisor for a copy or where to
find on agency shared drive
 Find
out protocol for your agency
 Seek out policy and procedure with
supervisor
 Review no harm contract
 Seek out supervision IMMEDIATELY when you
have any questions regarding suicide
Questions?