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Suicide Written Risk Assessment

CONSIDERATIONS FOR SUICIDE RISK ASSESSMENT SPECIFIC TO FASD CLIENTS
1) Past and current history of suicide attempts
and/or ideation.
2) Past diagnosis and medication or diagnosis of
depression or other mental illness.
3) Past diagnosis of ADHD
1. Resources: Physical and emotional systems which the caregiver and
individual perceive as supportive. Major component in establishing a
preventative intervention plan.
? Safe structure
? Routine
? Consistency (predictability)
? Staff supervision
? Relationships/friends/family
? Pets, inanimate objects
? Individual’s own connection to personal resiliencies
Comments:
2. Current Suicide Plan: (This may not be relevant as FASD individuals
rarely plan)
ADHD
Impulsivity Severity Level LOW………….HIGH
Awareness of Consequences Severity Level LOW………….HIGH
3. Prior Suicidal Behaviour:
Previous attempts (from historical information) LOW………….HIGH
Previous self harm that could result in death? LOW………….HIGH
Family member and/or friend attempt/died by suicide? LOW………….HIGH
Consider:
? Was the suicide witnessed by the individual?
? Does the individual have an awareness of an attempt or completion of
a family member?
? Has the individual had recent exposure to visual self
harm/suicide/violence? (i.e., movie, TV, pictures)
? Awareness of the possibility of role modeling, mimicking or parroting
behaviour
How long ago? ___________ By what method? _________________
Comments:
4. Mental Health Concerns: Consider the possibility of COMORBITITY
(diagnosis of other mental health concerns that may increase the risk of
suicide attempts).
5. Situational Considerations:
To what extent has there been a change in the following areas:
Medication LOW………….HIGH
Structure LOW………….HIGH
Routine LOW………….HIGH
Staff LOW………….HIGH
Circumstances LOW………….HIGH
Recent Abuse (Physical, Sexual & Emotional) LOW………….HIGH
Comments:
6. Symptoms: (Note: Awareness of an individual’s unique patterns, habits,
and behaviours is essential in assessing significant change.)
To what extent has there been a change in the following areas:
Physical (appearance, hygiene, eating, sleeping) LOW………….HIGH
Actions (withdrawn, reckless, self harm, drug use) LOW………….HIGH
Self Talk (“I wish I was dead”/”It will all be over soon”) LOW………….HIGH
Emotions (hopeless, helpless, worthless) LOW………….HIGH
Note: Individuals with FASD have difficulty processing emotions and
feelings; however, this does not mean that they do not experience emotions
and feelings.
Comments:
7. Current Level of Risk:
LOW RISK MID RISK HIGH RISK
8. Plan for Intervention:
(Dubé, J. & Massey, D. (2001). Lethbridge Family Services, Lethbridge, AB, Canada.
Revised June 4, 2002, Outreach Program, Lethbridge Family Services.)