Assessing Suicide Risk Milwaukee Police Department Crisis Intervention Team

Assessing Suicide Risk: High Risk - Depression Depression for 2 or more weeks History of past severe depression Physical Symptoms of depression including: trouble sleeping, appetite, concentration, social contact, general functioning School or job performance problems Strong family history of depression/mental illness

Assessing Suicide Risk: Lower risk - depression No symptoms, brief symptoms, or symptoms related to a specific situation (criminal charges, relationship problems, etc) No physical symptoms or only minor symptoms Actively involved with a therapist or doctor Only minor disturbance of general functioning On medications or willing to accept help Minimal or no family history of depression/mental illness

Suicide Plan or Attempt: Higher Risk Potential lethal attempt. Requiring medical attention, attempt was thought out or planned. Subject had intent to die Suicide note indicating to die Specific plan- lethal potential of plans No obvious secondary gains from attempt Attempt was concealed Subject did not want intervention History of suicide of close family or friends.

Suicide plan or attempt: Lower risk No injury or superficial injury No specific death wish, but desire to escape or influence Suicide statements without plan or vague plan Secondary gains (support, sympathy, avoiding problems) Clear desire to manipulate Subject notified someone of attempt Made suicide gesture in front of others No history Impulsive act No planning for death Not influenced by others’ suicide.

Alcohol/Drug Abuse Issues: Higher Risk Intoxicated or influenced by alcohol/drug use Recent history of drug and/or alcohol problems

Alcohol/Drug Abuse Issues: Lower Risk Sober No problems with AODA

Thought Process: Higher Risk Psychotic: presence of hallucinations or delusions; nonsensical or incoherent speech; poor reality testing; judgment impaired to the extent that it’s unlikely they can maintain their own safety Recent bizarre or unpredictable behavior History of psychiatric problems or hospitalization

Thought Process: Lower risk Logical or coherent thought process No hallucinations or delusions Appears competent and capable of using good judgment Speech makes sense No unusual behaviors

Mood/Presentation: Higher Risk Depressed: “washed out” helpless to influence Positive changes, feels hopeless about the future Anxious/panicky Angry Guilty Volatile mood swings

Mood/Presentation Lower Risk Subject feels like they have some control over their situation Stable mood Has future orientation Calm Positive self image

Personality Type: Higher Risk “Hot headed” …or… “too calm and collected” History of violence Impulsive Needs to be in control

Personality type: Lower risk Calm Rational Thinks before acting

Current Stresses: Higher risk Recent severe loss (relationship, job, financial) Chronic health problems or pain

Current Stresses: Lower Risk No severe loss or dramatic changes Self esteem intact Healthy

Available Resources: Higher Risk Lives alone Socially isolated Not well integrated with family, peers, and/or recent withdrawal from usual social interaction(s).

Available resources: Lower Risk Has a caring person available to them now Involved with family, friends, church or social group

Demographical Risk Factors: Higher risk Male Older (55+) Caucasian Native American

Demographical Risk Factors: lower risk Female Younger African American

Case Studies: Assessing risk