Domenique Harrison— a licensed therapist, small business founder and racial equity strategist/consultant— said that high-risk populations for dying by suicide include queer and trans youth; disabled teens; men; veterans; individuals who are experiencing considerable mental and extensive chronic pain without consistent medical or therapeutic treatment; elderly isolated adults; individuals impacted by substance abuse; and members of indigenous and native communities. She added that additional risk factors of these groups being affected are their experiences with oppression, bullying, being turned away from support/resources and harsh living conditions.
If a person observes signs or symptoms that someone is exhibiting suicidal thoughts that may lead to a crisis situation, an appropriate response should be a direct and thoughtful inquiry about what is being observed. “Are you having thoughts about harming yourself, thoughts about suicide, thoughts about ending your life?” are some of those questions, according to Harrison.
Dangerous objects should be identified and removed from an at-risk person’s environment or home. Harrison answered specific questions that shed a light on suicide awareness.
Q: What are a few reasons why someone may reach the point of considering suicide?
A: A few reasons someone may consider suicide are feelings of hopelessness. For example, folks who have experienced severe abuse and violence; discrimination; oppression; abandonment; isolation; and bullying often feel alone in their struggles and incapable of getting away from harm and danger. Another reason someone may consider suicide is that individuals who live with undiagnosed and unsupported mental health disorders and illnesses can no longer live with the debilitating, disorienting and challenging effects of their experience. Additionally, folks experience intense social isolation, community disconnection and social judgment/ostracization from their peers/partners/families.
Q: What is a suicide-focused treatment plan?
A: A suicide-focused treatment plan is a plan that supports someone at-risk of dying by suicide, attempting suicide, or who has consistent suicidal ideation to help and improve their well-being practices, safety needs, potential medication adherence and overall quality of life. The plan is, first and foremost, about reducing as many risk factors and symptoms as possible while responding correlatively to the signs of the individual’s crisis experiences. Many suicide-focused treatment plans are created in collaboration with the client or patient and involve identifying social supports, safety measures, crisis mitigation, and coping strategies during moments of emotional overwhelm and distress.
A plan can include specific alternative activities to self-harm. Identify which people in the person’s life are immediate, short-term and long-term resources. Eliminate the person’s access to harmful objects— drugs, guns and knives. Name coping skills to be used immediately. Name the locations of hospitals to support the patient’s care and crisis helplines to call to augment the therapist/counselor’s support.
Q: How important is developing a suicide-focused treatment plan if someone attempted suicide in the past?
A: Completing/developing a suicide-focused treatment plan should be prioritized if someone has attempted suicide in the past, and the treatment plan should be done in the most collaborative and supportive way. Remember, once created, the suicide-focused treatment plan doesn’t just go on a shelf or in your file. It needs to be discussed often, updated as the person’s physical/emotional/mental/social experiences change, and potentially scaled down once the person and therapist see that suicidality is not as prominent in the person’s life.
Q: What is the official rule about someone being a danger to themselves or someone else? Who makes these determinations?
A: When someone poses a threat to themselves or others, mental health professionals, such as licensed counselors, social workers, therapists, psychologists, and psychiatrists, typically conduct one to three sessions to clinically assess their suicidality, suicidal thoughts and previous suicide attempts. They also examine the person’s present and near-future safety, utilizing their clinical expertise, direct communication and written assessments.
During this process, mental health professionals collaborate with individuals in crisis, providing them with a compassionate, non-judgmental, and safe space to express their challenges, fears and needs.
If the person is deemed in immediate danger, mental health professionals may consider initiating an involuntary hold at an inpatient mental health facility and implementing other safety and emergency-oriented measures to ensure the well-being of the person and those around them.
Q: What is supposed to happen legally?
A: After assessing a person’s crisis level and danger to self and others, mental health professionals should identify voluntary and involuntary measures, such as a short to long-term hospital stay to support the person and their community’s well-being.
Harrison’s website is https://theracialequitytherapist.com.