Suicide is one of the three leading causes of death among adolescents. It is estimated that in 2001 there were approximately 9.9 completed suicides per 100,000 adolescents in the 15-to24-year age group and 1.3 suicides per 100,000 children in the 10-to14-year age group (National Institute of Mental Health, 2004).
Suppose you had a 17 year old female student come to your office. She is terribly distraught that her boyfriend that she has been with for the past year has cheated on her and wants nothing to do with her. She can hardly keep her composure and keeps saying that she wants to die and she is going to kill herself. She tells you exactly how she will go about taking her own life. She states that she is going to take a bottle of aspirin and down it with a pint of vodka. How would you assess this situation? What do you think is the degree of lethality of this suicidal ideation? What would be your course of action?
Suppose you had a 17 year old female student come to your office. She is terribly distraught that her boyfriend that she has been with for the past year has cheated on her and wants nothing to do with her. She can hardly keep her composure and keeps saying that she wants to die and she is going to kill herself. She tells you exactly how she will go about taking her own life. She states that she is going to take a bottle of aspirin and down it with a pint of vodka. How would you assess this situation? What do you think is the degree of lethality of this suicidal ideation? What would be your course of action?
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I would take this threat of suicide seriously. She expressed a desire to kill herself and detailed a plan of action. I think the degree of lethality is fairly high. First, I would call someone to stay with the student while I made necessary phone calls. I would document everything regarding this case, notify the parents and make referrals to appropriate centers or hospitals. I would also follow up to make sure the parents got her the help she needs.
I agree with Laura. WIth a potential suicide case, you want to assess the situation thoroughly and find out what the degree of intent is. The girl seemed to have clear intent and a plan of what she was going to do. She needs help right away and shouldn't be left alone. Her parents should be called along with a hospital that could help her.
This situation is hard though because teenagers are temperamental and she could have just been saying that and being dramatic. However, we'd have to do the right thing and get her help. It's our job to properly assess each person and judge their suicidal ideation and determine how much help they need.
It is obvious that this 17-year-old girl is seriously depressed and is thinking of committing suicide. She has a formulated plan how she is going to take her own life (Suicidal ideation) and needs to be taken seriously! It’s important to keep in mind that even though “most patients with suicidal ideation do not ultimately commit suicide, the extent of suicidal ideation must be determined, including the presence of a suicide plan and the patient's means to commit suicide. (http://www.aafp.org/afp/990315ap/1500.html).” As a school psychologist, I would not take any chances and would send her for a psychiatric evaluation.
Also, I would talk to the school administrators and familiarize them with this situation as well as call her parents to let them know that this 17-year-old student needs to go for a psychiatric evaluation ASAP since she has seriously thought about committing suicide. This student’s parents need to take their daughter to a nearest hospital for a psychiatric evaluation and she cannot return to school until she is cleared of any possible risk to herself, as well as to others.
This threat needs to be taken seriously, especially since the girl expressed a plan of how she would take her own life. After the girl states that she does have a plan in mind, action must be taken. The girl must be evaluated in order to determine how great her intention is of committing suicide. Her parents should be notified immediately, and the girl should be taken to a hospital. It is important that she receives all the help necessary, in order to save her life.
It is obvious that this situation needs to be taken seriously and with as much caution as possible. This young woman seems to be seriously depressed and it's obvious that not only is she having suicidal ideations, but she has also thought about a plan to actually end her life. Even though, like Tjasa stated, not all suicidal patients actually commit suicide, it's level of risk must still be evaluated and the appropriate action taken. I would definitely not risk someone's life. Aside from documenting everything that was said to me, I would create a suicide contract with the girl so that at least some time is saved while the appropriate action is taken place. I would get someone to stay with this girl in the room so she wouldn't be able to hurt herself. I would then immediately call her parents to inform them of the situation and let them know that their daughter needs to go to a hospital. A psychiatric evaluation is definitely needed and since the girl's level of risk seems to be pretty high, the approrpiate meausures and treament should be administered ASAP so a precious life can be saved! Once she is getting help, programs and outside groups may also be of benefit so she feels she is not alone with her problems and can have other people to sympathize and help her through the process, people that have gone through what she is currently going through.
Not only has the student told me she will kill herself but she also told me exactly how she plans to go through with it. This is a high risk threat so of course I would handle this situation very seriously. My first course of action would be to notify the parents or guardians of this girl. They have to be informed of this risk of suicide so they can increase their supervision, preferably not leave her alone, and remove access to weapons or anything she can possible harm herself with (in this case medication and alcohol) from their home. After the parents have been notified (and hopefully on their way down to the school to pick her up), I would talk with the teen and let her know that the end of her relationship should not be taken as a sign of the end of her life. She should seek further counseling and as the school psychologist I would refer her and her parents to another mental health professional who has expertise in working with suicidal youth. After documenting everything that occurred, I would inform other staff and administrators who have contact with the girl to increase supervision as well.
I would absolutely take this seriously. I would require that she get psych clearance from a hospital or therapist to come back to school.
I understand that she was upset and caught up in the moment and that she may not mean what she is saying, but I would not want anyone's blood on my hands.
And given how upset she is, even if she wasn't making such threats she is obviously very distraught and could probably use some counseling to get her through this tough time.
I would take this threat of suicide very seriously. She is clearly extremely upset and recently suffered from the loss of something very important to her. Many times in the eyes of a 17 year old having a boyfriend of a year cheat on you and then completely abandon you would seem like the end of the world. She has described in detail how she plans to carry out the suicide in a manner that can be very effective (vodka and asprin) especially if she were to have other health factors involved. As everyone above has mentioned I would contact the girls parents immediately and refer her for psych/suicide screenings and counseling groups. I would create a suicide contract as Angelica has mentioned including in it numbers and people she can talk to if in the middle of the night she gets the urge to carry out her plan.
Another possible risk if she decides to turn her hurt outward and direct harm to the ex-boyfriend or the other girl, so I would watch for signs of possible violence to others as well.
I think that I would take this case very seriously. When a person mention suicide and indicates that they have already decided how they will do it they are of utmost concern. I would make sure that the student first was under constant watch. I would speak to her parents and suggest possibly putting her in a hospital for a psychiatric evaluation.
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