Introduction
Suicidal behavior is a serious mental health concern that includes thoughts of self-harm, suicidal ideation, suicide attempts, and completed suicide. Proper assessment and timely intervention can save lives. Counsellors play a key role in identifying, evaluating, and managing clients who are at risk.
Assessment of Suicidal Behaviour
Assessment involves understanding the client’s mental, emotional, and situational state. It helps determine the level of risk and the steps needed to ensure safety.
1. Identifying Risk Factors
- Mental health disorders (depression, bipolar disorder, schizophrenia)
- Substance abuse
- Chronic illness or pain
- History of trauma or abuse
- Family history of suicide
- Recent loss, job failure, or relationship breakup
2. Warning Signs
- Talking about wanting to die or self-harm
- Withdrawal from family and friends
- Extreme mood swings or hopelessness
- Giving away possessions
- Sudden calmness after depression (may indicate decision to attempt suicide)
3. Direct Assessment
The counselor may ask specific questions like:
- Are you thinking about suicide?
- Do you have a plan?
- Do you have access to means (like pills, rope, weapons)?
Answers help determine the severity and immediacy of the risk.
4. Risk Level Classification
- Low Risk: Suicidal thoughts but no plan or means
- Moderate Risk: Suicidal thoughts with vague plan but no intent
- High Risk: Specific plan, intent, and access to means
Management of Suicidal Behaviour
Once the assessment is complete, the counselor must act quickly based on the risk level.
1. Ensuring Immediate Safety
- Remove access to means of suicide
- Do not leave the person alone
- Call emergency services if risk is high
2. Building a Support System
- Involve family or trusted friends (with client consent)
- Refer to mental health professionals if needed
3. Creating a Safety Plan
A personalized safety plan includes:
- Warning signs to watch for
- Coping strategies
- List of people to call
- Emergency contact numbers
4. Counseling and Therapy
- Cognitive Behavioural Therapy (CBT): Helps change negative thoughts
- Dialectical Behavior Therapy (DBT): Effective for managing intense emotions
- Supportive Counseling: Offers emotional support and hope
5. Medication
In some cases, doctors may prescribe antidepressants or mood stabilizers.
6. Follow-Up and Monitoring
Ongoing sessions and check-ins are important to ensure recovery and prevent relapse.
Role of Counselor
- Stay calm and empathetic
- Establish trust and rapport
- Act immediately in emergencies
- Empower the client to express emotions and find reasons to live
Conclusion
Assessing and managing suicidal behavior requires sensitivity, awareness, and quick action. Counselors play a vital role in identifying warning signs and offering support. Early intervention, proper safety planning, and therapy can significantly reduce the risk and help clients find hope and meaning in life again.