The Suicidal Caller Again....
The suicidal caller again…..
Our service provides a Intake Triage for a large mental health agency in Michigan. Telephone triage consists of a brief phone assessment of their mental health needs where we consistently ask people about their thoughts of self harm. As you would expect there are as many variations of people’s thoughts as there are people. These high risk cases become the cases that we ponder most often. For mental health professionals, this probably comes as no surprise but many of the people calling for a first time appointment are experiencing some thoughts of self-harm. The continuum of these thoughts is broad.
Recently I experienced a call of concern and worked diligently to intervene with the person.
Ring, Ring….How may I help you?
“I am feeling really depressed. I talked with my daughter and she suggested that I call. I lost my husband 3 years ago and I just can’t seem to get over this. She says she has tried everything she can think of…going to church, going to counseling and a support group. Nothing has really helped much.
Tell me more about how you are feeling and thoughts of self harm?
She says even though she is in her 60’s, most of her other friends still have their spouses. “Sometimes I wish I could kill myself and just go to heaven but I can’t. I cry all the time. It’s just not fair that other people have their spouses and I don’t. I fear I will never be happy again. I don’t have much time left away. My kids are grown and on their own.”
You mentioned that you can’t harm yourself?
“Yeah, if I do this I won’t go to heaven and I want to be with my husband in heaven. I have a gun that my husband gave me...I know how to use it. I have had it for protection for years.” She is crying now…she feels trapped…
We discuss the risk of having a loaded gun in the home with the combination of the level of her depression. She agrees to give the gun to a friend and come in to see a therapist to discuss coping skills. We discussed a couple of useful skills on the phone and she agreed to come in for a face-to-face evaluation.
Was she suicidal? She was having thoughts, she had a plan but her intent was low at the time of the call. Her risk of self harm increases with age and increases if she was male. She had strong reasons to keep from harming herself. She wanted help and she agreed to reduce the risk for self harm. She understood that at times when she has been depressed that she has not been thinking as rationally as she normally does.
Craig will be providing further education about risk assessment and intervention techniques for the intoxicated, suicidal, paranoid, hostile/threatening, domestic violence, and child abuse caller-types. Craig will be providing a one day seminar training on High Risk Mental Health Triage in May 2006 in Arizona. See this seminar at PESI.
Our service provides a Intake Triage for a large mental health agency in Michigan. Telephone triage consists of a brief phone assessment of their mental health needs where we consistently ask people about their thoughts of self harm. As you would expect there are as many variations of people’s thoughts as there are people. These high risk cases become the cases that we ponder most often. For mental health professionals, this probably comes as no surprise but many of the people calling for a first time appointment are experiencing some thoughts of self-harm. The continuum of these thoughts is broad.
Recently I experienced a call of concern and worked diligently to intervene with the person.
Ring, Ring….How may I help you?
“I am feeling really depressed. I talked with my daughter and she suggested that I call. I lost my husband 3 years ago and I just can’t seem to get over this. She says she has tried everything she can think of…going to church, going to counseling and a support group. Nothing has really helped much.
Tell me more about how you are feeling and thoughts of self harm?
She says even though she is in her 60’s, most of her other friends still have their spouses. “Sometimes I wish I could kill myself and just go to heaven but I can’t. I cry all the time. It’s just not fair that other people have their spouses and I don’t. I fear I will never be happy again. I don’t have much time left away. My kids are grown and on their own.”
You mentioned that you can’t harm yourself?
“Yeah, if I do this I won’t go to heaven and I want to be with my husband in heaven. I have a gun that my husband gave me...I know how to use it. I have had it for protection for years.” She is crying now…she feels trapped…
We discuss the risk of having a loaded gun in the home with the combination of the level of her depression. She agrees to give the gun to a friend and come in to see a therapist to discuss coping skills. We discussed a couple of useful skills on the phone and she agreed to come in for a face-to-face evaluation.
Was she suicidal? She was having thoughts, she had a plan but her intent was low at the time of the call. Her risk of self harm increases with age and increases if she was male. She had strong reasons to keep from harming herself. She wanted help and she agreed to reduce the risk for self harm. She understood that at times when she has been depressed that she has not been thinking as rationally as she normally does.
Craig will be providing further education about risk assessment and intervention techniques for the intoxicated, suicidal, paranoid, hostile/threatening, domestic violence, and child abuse caller-types. Craig will be providing a one day seminar training on High Risk Mental Health Triage in May 2006 in Arizona. See this seminar at PESI.
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