The Risk of Intervention Strategies
Each of the three categories of suicide risk—low, moderate, and high—requires a different set of preventative measures. Clients at low risk for suicide may suffer fleeting discomfort and thoughts of suicide but lack a concrete strategy and purpose to carry them out. Clients in the middle-risk range have a specific goal in mind, but they also have certain safeguards in place and good reasons to keep living. Clients who are at high risk have a goal, an intention, and few buffers.
Clinicians evaluating a client for suicide risk would listen carefully for signs of suicidal thinking, intent, and planning. The MSE is useful for illuminating the complexity of the client’s thinking and emotional condition, such as prolonged emotions of grief, despair, or helplessness. A client may confess to obtaining lethal methods and expressing a clear intent to overdose on medicine. Clinicians in these situations are aware of the critical need to act swiftly to ensure the patient’s safety, which may include hospitalization and mental assessment.
The most immediate action, including hospitalization, is required for high-risk customers. Their mental illness may have rendered them severely crippled and dependent on others for daily needs. A patient who has a well-thought-out suicide plan, access to lethal tools, and no motivation to live might benefit from hospitalization. Someone’s mental health condition must be so severe that they are considered “gravely disabled” for them to be unable to care for themselves (Kanel, 2018). This idea is often associated with the practice of committing people to mental hospitals against their will when they pose a threat to themselves or others. It may include life-threatening actions such as not eating or otherwise neglecting oneself.
Self-Mutilation Differences
Both self-mutilation and suicidal conduct have certain similarities, but their causes and effects are distinct. Self-mutilation is a common kind of non-suicidal self-injury (NSSI), which refers to the intentional infliction of physical pain on oneself without the goal of suicide. This action is often used to alleviate the pressure of intense feelings or pressure from stressful situations (Kanel, 2018). Understanding the difference between self-mutilation and suicidality is essential in the helping professions. The purpose and goals of self-harm should be discussed with the client during assessments.
As an example, a client who cuts to self-medicate may benefit from therapies that teach them to better manage their feelings and cope with stress, while a client who is suicidal needs urgent crisis intervention and safety preparation. A mental status examination (MSE) is a thorough evaluation of a person’s mental health. Appearance, behavior, mental processes, thought content, mood and emotion, perceptions, cognitive functioning, insight, and judgment are all factors that must be considered.
Mental Status Exam
Aggression, anger, irritability, and thoughts or threats of hurting others may be symptoms of self-injury. Clinical indicators of anger, impatience, and impulsivity would emerge during the MSE. They may also look for hallucinations or delusions that might be fueling the violent behavior. Self-injury and suicidal ideation are all possible symptoms. Clinicians doing the MSE would investigate any symptoms of self-mutilation, scarring, or intentional harm (Kanel, 2018). They would also analyze the client’s feelings, such as discomfort, grief, or despair, as well as their understanding of the conduct.
When determining whether a client poses a threat to others’ safety, a counselor may notice aggressive conduct, such as the client yelling at and threatening other clients during a group therapy session. During the evaluation of self-inflicted injury, on the other hand, they could see new scars that the client had inflicted on themselves on their arms, as well as evidence of mental distress during a one-on-one therapy session.
Reference
Kanel, K. (2019). A Guide to Crisis Intervention (6th ed.). Cengage.