1. WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
Jeff Bright, LCSW, BCN

2. WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
Introductions
Understanding the Risk
Tools to Assess Risk
Art and Science of Assessing Risk
Practice
Additional Resources
WILL HE REALLY DO IT? ASSESSING SUICIDE RISK

3. Introductions WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
Jeff Bright, LCSW, BCN
Worked with children and adolescents since 2001
Big Brothers Big Sisters, Child Protective Services, Utah Youth Village, NeuroTherapy and Trauma Center of Utah, Davis Hospital and Medical Center
Who are you?
DCFS/DJJS Caseworkers/Case Managers, Mental Health Clinicians,
Medical Providers, Social Services Administrators, Educators….
Introductions WILL HE REALLY DO IT? ASSESSING SUICIDE RISK

4. Understanding the Risk WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
Nationally, Suicide 3rd leading cause of death 15-24yrs (CDC)
Nationally, Suicide 4th leading caused of death yrs (CDC)
In Utah Suicide is the Leading (#1) Cause of Death among Teens 11-17
Suicide #1 in Utah (video) and KUTV newscast (video)
About 17% of high school students seriously think about suicide, 13% made a plan (nationally in 2013)
Females more likely to have suicidal thoughts
Males 4x more lethal attempts (firearms)
Poisoning is leading cause of death for females
Blue Whale Challenge
Game encourages participants to hurt themselves for 50 days and then commit suicide suicide-game-prompts-denver-public-schools-to-warn-parents
Understanding the Risk WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
*CDC report

5. When to Assess WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
When do you formally assess?
Immediate Risk
Talking about wanting to die or kill oneself
Looking for a way to kill oneself, searching online (etc)
Talking about feeling hopeless or having no reason to live
Serious Risk
New or Increased…
Talking about feeling trapped, unbearable pain, being a burden to others
Behaving recklessly (increase substance use, more rage, seeking revenge)
Sleeping too little or too much, withdrawing or feeling isolated, extreme mood swings
Worst case scenario – The above Behavior(s) plus…
Someone close committed suicide recently (family/friend)
High Impulsivity w/ or w/o substance use
Decrease self care
When to Assess WILL HE REALLY DO IT? ASSESSING SUICIDE RISK

6. Tools to Assess Risk WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
Why Use a Tool to Assess Suicide?
Rating Scales Predict Suicide Attempts
Columbia Suicide Severity Rating Scale/Screen (CSSRS)
Most evidence supported suicide risk screen available
Recommended by The Joint Commission
Clear guidelines for when to take the next steps
Removes clinician’s interpretation and classifies a persons risk
Has 99% Reliability
Iasis Healthcare Suicide Risk Assessment Scale
Simple to use
Clear 0-3 rating scale
Prioritizes highest risk behavior
Tools to Assess Risk WILL HE REALLY DO IT? ASSESSING SUICIDE RISK

7. Assessing the right information
Intention
Plan
Past Attempts
Support System
Coping Skills
Noticing the Red Flags
Rating the severity of responses
Mild, Moderate, Severe
At the end ask “Will you commit to be safe and not harm yourself?”
Assessing Risk - the science WILL HE REALLY DO IT? ASSESSING SUICIDE RISK

8. Assessing Risk - the art WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
Establishing Rapport (can be done quickly)
Double check our non-verbal body language, eliminate judgement
Speak with genuineness and compassion
Ask direct questions, no beating around the bush
Ask for specifics, especially when you’re confused
Assess sincerity of the other person, are they truthful?
Assess congruency of body affect with language (how they behave vs what they say)
Lack of emotion is concerning
Assess the ‘why’, intent + behavior = The Why
Assessing Risk - the art WILL HE REALLY DO IT? ASSESSING SUICIDE RISK

9. Risk Assessed. Now What? WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
Safety Plan
Components of a good plan
Refer to SafeUT Phone App
Refer to County Mental Health Crisis Lines
Refer to Hospital
Call Police to escort to ER
Levels of Commitment
Blue Sheet (medical/clinical)
Pink Sheet (law enforcement or designee)
White Sheet (courts/county mental health/psychiatrist)
Mental Health Court – Commitment
Forced Medication
Risk Assessed. Now What? WILL HE REALLY DO IT? ASSESSING SUICIDE RISK

10. Practice WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
Review of CSSRS and Iasis Healthcare Screening Form
CSSRS - If person answers “yes” to questions 3, 4, or 5 steps should be taken to keep them safe. Added behavior increases risk.
Iasis – If score falls in moderate or high risk steps should be taken to keep them safe
More examples (video)
Demonstration of CSSRS
CSSRS in Action
Practice Time (case scenario)
Q&A – How did it go?
Practice WILL HE REALLY DO IT? ASSESSING SUICIDE RISK

11. Additional Resources WILL HE REALLY DO IT? ASSESSING SUICIDE RISK
7 Essential Steps Parents Can Take to Prevent Teen Suicide
Common Signs of Someone Who May be Suicidal
of-someone-who-may-be-suicidal/
Utah Suicide Prevention Coalition
Meets 2nd Monday of every other month – open to public
Crisis Lines for each County
Salt Lake County Mobile Crisis Outreach Team (MCOT)
Copies of CSSRS and Iasis Healthcare Risk Assessment Scale, this training, link to videos, and additional resources found at
Additional Resources WILL HE REALLY DO IT? ASSESSING SUICIDE RISK