1. Advanced Crisis Assessment & Petition Writing
Meghan Finn, AM, LCSW
HECMA Roundtable
June 20,2018

2. What Are We Going To Do Today?
Advance suicide assessment skills
Develop an understanding of the basics of petition writing and how to complete a petition.
Develop understanding of the benefits of consultation, and partnership within the student affairs community and local care systems to create safety for students.

3. National Suicide Data
Third leading cause of death among 15- to 24-year-olds and the second leading cause of death among college students*
Suicide rate peaks among 20- to 24-year-olds*
1,100 students die of suicide each year
One in 12 U.S. college students makes a suicide plan*
Less than 20% seek MH help
Females are more likely to attempt suicide; males are more likely to die by suicide**

4. Work Through A Multicultural Lens
Overcoming barriers to ensure safety begins with understanding the need for use of multicultural framework in every session. Consider context and the multiple systems of power your client must navigate in their life’s experience, as well as the impact systems can have on identity and or intersecting identities.
Be thoughtful in your approach to working with students who may experience additional vulnerabilities.
Blind spots: I have them, you have them, we all have them.

5. Check In On Your Bias

6. Be A Learner
Create relationships with your institution’s student groups, and work to understand their perspectives on mental heath care, their needs, and their concerns.
Get to know your institution’s (or community) police force.
Can you request an officer to assist you who has specialty training in crisis or mental health work?
Can you request officers who hold specific social identities if your student requests this/would feel more comfortable?

7. Suicide Assessment
Suicidality exists on a spectrum. Taking some time before your suicide assessment to ensure your client understands that you are not there to ‘hit the panic button’, but instead to ensure their safety, can be key to accurate information gathering.
Take into consideration your office’s confidentiality policy and ensure your client understands that risk of immediate harm could be reason for further evaluation at a hospital.
The difference between escape fantasy, morbid rumination, and suicidal ideation
Defining intent, gesture, rehearsal, attempt, aborted attempt, and interrupted attempt
The challenge of assessing in terms of passive vs. active
Documentation as a skill (ex: do not document ‘no SI/HI’ alone)

8. What NOT To Say
You’re not going to do something stupid or selfish, are you?
You’re not thinking about suicide, right?
Think about all the things that you should be thankful for!

9. Suicide Assessment Questions
Have you been having suicidal thoughts?
What are they?
How often do they occur?
For how long have you had them?
Have you had suicidal thoughts historically?
Do you have a plan?
What is your plan?
Have you ever googled means or method?
Do you have access to means?
Are you a FOID card holder?
Do you have access to a firearm?
If you have a firearm, where is it?
Have you ever attempted to purchase a firearm?
Do you have access to any other weapons?
Do you have a history of AOD use?
Do you have a history of impulsivity?
Do you have a family history of completed suicide?
Are you adherent to treatment?
Are you sleeping?

10. Further Considerations In Suicide Assessment
Means Restriction
Protective Factors
Future Oriented Thinking
Alcohol and Other Drug Use & Impulsivity

11. Petition Writing Petition For Involuntary/Judicial Admission:
What is a petition?
When is a petition needed?
Who completes the petition?
How long do I have to complete a petition?
What does a ‘good’ petition look like? (Bullet points)

12. Bullet Point Example
Student X walked into the counseling center this afternoon (6/20/18) requesting in person/immediate support, and reported suicidal ideation with a plan to walk into the lake, and intent to do so tonight.
Student X reports having rehearsed their suicide plan 3x in the last week.
Student X has a dx of MDD, and has been out of treatment for the last 7 months.
Student X has mismanaged psychotropic medications (broken up pills, not taken medication daily to ‘stretch’ the prescription out) for the last 3 months.
Student X reports that they have not gotten more then 3-4 hours of restful sleep/night for the last 2 weeks.
Student X reports a recent breakup and limited local social/emotional supports.

13. Further Considerations In Petition Writing
Where can I find my state’s version of a petition?
Who can complete a petition in my state?
How long is a completed petition valid in my state?

14. You’ve Written The Petition – What’s Next?
Does your center call listed emergency contacts? Are you the staff responsible for calling? Be sure to weave conversation regarding emergency calls into the conversation you have with the client to prepare them for ‘what comes next’.
3rd Party Consultation
Consult with the hospital, including faxing or delivering your completed petition and speaking with the charge nurse or crisis worker.
Consult with appropriate university offices including the Dean of Students Office, Residential Life, University Police, or the Counseling & Psychological Services (if you are not a clinician).
Update the client’s community treatment provider if applicable.

15. You’ve Written The Petition – What’s Next?
Develop an understanding of your local hospital’s method of assessment and admission. Get to know the behavioral health inpatient unit staff, and their discharge planning process.
Partner with the Dean of Students staff to ensure that your client has all needed information from the university regarding their return to campus, support services, and the importance of self care.
Continued case management and treatment planning as needed.

16. Resources QPR – Question, Persuade, Refer training
Ulifeline – Online Resource for College Mental Health
National Suicide Prevention Hotline *Information also available in Spanish language
NAMI – National Alliance on Mental Illness
The Jed Foundation – Protecting emotional health, preventing suicide

17. Questions?