5.8. SUICIDE RISK ASSESSMENT
When assessing suicide risk in individuals with both schizophrenia and substance use disorder, it’s important to be sensitive and structured.
The goal is to understand the risk level, recognize protective factors, and plan effective ways to support them.
Encourage open, non-judgmental dialogue
Starting with open-ended questions helps create a safe space where the person feels comfortable sharing their thoughts.
A caregiver might say: “Would you like to talk about what’s been on your mind lately? Are there moments when things feel especially tough?“
This approach allows them to express difficult feelings without fear of judgment, making it easier to discuss suicidal thoughts and emotions.
Creating a safety plan when needed
For those at higher risk, having a safety plan can be a helpful tool. This plan might include:
A well-thought safety plan provides reassurance and practical steps to follow when things feel difficult.
Offer regular check-ins and ongoing support
Suicide risk assessments shouldn’t be a one-time event.
Checking in regularly after an initial suicide risk assessment can be important, especially for those with dual diagnoses.
These follow-ups offer opportunities to reassess risk, adjust any necessary interventions, and continue providing support when needed.
A simple check-in can go a long way in offering continued support.
Looking Beyond Risk Levels
While understanding the risk level is crucial, it’s also helpful to explore other factors that can influence intervention planning. These factors ca be:
Identifying these elements helps in creating a plan that meets the individual’s specific needs.
Example conversation for suicide risk assessment
Caregiver: “I’d like to check in and see how things have been going for you. Sometimes, having a lot on our minds can feel overwhelming. Are there times lately when it’s been difficult to manage things on your own?”
Individual: “Sometimes, yeah. It’s hard to explain. Some days are just really heavy.”
Caregiver: “That sounds challenging. Let’s talk about some things we can try when it feels that way. I’m here to help you find ways to get through those moments safely, and I’d like to support you in any way I can.”
This kind of conversation creates a safe and open dialogue, helping the person feel heard and supported, which leads to a more effective assessment and intervention.
Communication Techniques
Use open-ended questions:
This encourages the individual to share more about their feelings and experiences. Avoid questions that can be answered with a simple “yes” or “no.”
Active listening:
Repeat back or summarize what the person is saying to show that you are listening and understand. This builds trust and cooperation.
Non-stigmatizing language
Avoid judgmental terms. Use neutral language to discuss substance use and mental health symptoms to prevent the person from feeling criticized or ashamed.
Validate their experience
Validate their feelings and struggles without judgment, letting them know that their experiences are real and understandable.
Stay calm and patient:
Schizophrenia can cause disorganized thinking, and substance use can increase confusion. Be patient and don’t rush the conversation, allowing them the time to gather their thoughts.
Offer reassurance, not solutions:
Sometimes, individuals are not ready for solutions and may just need someone to listen. Offer comfort and the opportunity to talk rather than trying to “fix” things immediately.
Example: “I’m here for you, and we can work through this together.”
