Assessing Whether a Client Is Harmful to Self or Others

Risk Assessment Checklist Identifying Basic Criteria Assessing Whether a Client Is Harmful to Self or Others In the U.S., suicide rate is relative to homicide rate, increasing at a yearly rate of fifty percent. One individual takes his/her life every sixteen minutes in the U.S., making the nation's average suicide rate 89 per day. Suicide has affected over 5 million individuals in the U.S. Of all suicide cases, 52% are performed using firearms kept at the victim's home.

More than 90% of suicide victims usually suffer from major psychiatric ailments while taking their lives. Of these, substance abuse and mood disorders are most common. Knowledge of client history is imperative while evaluating self-harm risks among clients (Berman, n.d.). Traumas can be defined as anxiety-creating objective events injurious to individuals' feelings of well-being (Herman, 1997). The individual must perceive an occurrence to be extremely threatening for any trauma to spark a crisis.

Crises resulting from trauma are characterized by emotional and mental confusion triggered by a threat's perception (Berman, n.d.). Alcohol/drug abuse, unprotected sex, drunk driving, smoking, gunplay or weapon involvement, involvement in criminal justice, known mental health or medical conditions, and other static factors ought to be taken into account. Also to be considered in the assessment of patient self-harm risks are static factors like history of violence or impulsivity, prior suicide attempts and self-mutilation behaviors predict behaviors.

Prior involvement in activities of a high-risk nature, accessibility of lethal means, major medical/mental illness, impulsiveness, prior suicide attempts and history of violence all indicate increased likelihood of self-harm. A continuum should be used for evaluating all behaviors. Every behavioral change must be either reported or observed, by some third party, or by the patient him/herself (Berman, n.d.). Checklist Sr. Statement Yes No 1. Apparent use of alcohol/drugs 2. Depression 3. Anxiety 4. Despondency 5. Remorsefulness 6. Agitation 7. Anger 8. Appetite Change 9.

Lethargy or sleeplessness Professionals must be aware of the distinction between plans, ideation, and means. Ideation implies experiencing or thinking about killing or hurting oneself (Berman, n.d.). If the client answers "yes" in this regard, practitioners must explore the following: Sr. Statement Yes No 1. Is the patient stating intent, talking about suicide, or making gestures or threats? 2. Is he/she expressing innuendos -- (that is, suicidal statements like I wish to die or the world will be much better off if I'm gone)? 3.

Is he/she pre-occupied with the idea of dying and death? 4. Is he/she fantasizing about suicide and its possible repercussions? (for adolescents) 5. Is he/she trying to access means? 6. Are thoughts of dying recurrent? 7. Is the patient experiencing command hallucinations? Plans refer to whether the patient has thought through some concrete ways of committing suicide. The plan's immediacy and lethality should be evaluated. The main question is whether the patient possesses actual ability of, or access to actual means of, carrying out this intent or not (Berman, n.d.).

The questions listed below need to be covered while talking to the patient: Sr. Statement Yes No 1. Has the patient inflicted self-harm or attempted to do so, or threatened to do so earlier? If so, when and how? Did this end in him/her being brought to the emergency room or being admitted to a psychiatric/medical hospital? 2. Does the client lose control or display inability to contain emotions? 3. Is he/she psychotic? 4. Is he/she particularly labile? 5. Is he/she hearing.