Practice Skills in Social Work and Welfare by Jane Maidment Ronnie Egan

Author:Jane Maidment, Ronnie Egan [Jane Maidment, Ronnie Egan]
Language: eng
Format: epub
ISBN: 9781741757149
Barnesnoble:
Goodreads: 8786877
Publisher: Allen Unwin
Published: 2004-04-01T00:00:00+00:00

SUICIDE RISK ASSESSMENT

Given what we know about Cherise’s present situation, suicide-prevention risk assessment may also be relevant. However, as with domestic violence risk assessment, there are important ethical dilemmas to consider when conducting suicide risk assessments from anti-oppressive and strengths-based perspectives.

Research indicates that suicide ideation and/or attempts are common to victims/survivors of violence (Anthony et al. 2000). Perhaps the most telling indicator that flags the need to conduct a suicide risk assessment with Cherise is the fact that she has disclosed that she feels hopeless and helpless. In focusing on assessing the risk of further violence or harm to self, however, workers need to ensure that they do not neglect the emotional well-being of the victim/survivor. The skills of normalising and validating can be extremely important here, as they involve recognising and conveying to Cherise that her feelings, thoughts, responses, and actions are legitimate and understandable given the situation she is in and the experiences she has endured, rather than medically labelling or pathologising her experience (Fook & Morley 2005).

One of the most comprehensive risk-assessment tools available in Australia is the Barwon Health Mental Health Risk Assessment, which was developed by Paul Hantz in 1999 (see Appendix 2; Hantz 1999; Barwon Health 2014). This suicide risk-assessment tool investigates a broad range of risk factors, including suicide ideation, suicide plan, access to means and prior attempts. It also looks at the person’s state of mental health in relation to feeling angry, hostile, impulsive, depressed, anxious, disorientated/disorganised, having a sense of hopelessness, and so on. It assesses whether identifiable stressors are present, the client’s medical status, whether there are symptoms of psychosis present, substance abuse issues, their current social supports, coping strategies, current role functioning, their history of psychiatric treatment, level of withdrawal from others and other factors such as coping strategies, and access to supportive others (Hantz 2014).

To use this tool in working with Cherise, we may conduct a semi-structured interview to ask her about each of these risk factors. We would then record this information, which might help us to prioritise what (if any) preventative measures might be relevant. The tool would direct us to ask Cherise some direct questions to assess her level of suicidal ideation, such as ‘Do you ever think about ending it all/killing yourself?’ or ‘How strongly do you have thoughts of suicide?’ (Hantz 1999). Additionally, the tool prompts workers to ask about past suicide attempts, as this is considered to be an important risk factor (Hantz 2014).

In exploring these issues with Cherise, we need to be aware that the questions we ask her will influence the meaning she attaches to her experience, and ultimately shape the way she tells her story. Hence, applied uncritically, suicide risk assessments that ignore social context, and perpetuate deficits-based narratives, may inadvertently compound Cherise’s suicidal thoughts and feelings.

The Barwon Health Risk Assessment Tool ultimately aims to assess whether people are at low, moderate or high risk (Hantz 2014). Depending on the rating, the tool prescribes a level of intervention according to the risk.

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