Crisis Management presentation

Crisis Management:Suicidality, Homicidality &

CPSDr. SOS

Executive Director of Community Wellnessat The Mount

What is a crisis?

A condition of instability or danger, as in a social, economic, political, or international affairs leading to a decisive change; a dramatic emotional or circumstantial upheaval in a person’s life (dictionary.com)

Who determines if a situation is a crisis?

The person who experiences it

May feel ill-equipped/ill-prepared to manage it

Crisis we are most concerned about...

Suicidal and homicidal threats

Child Protective Service concerns

Ideations vs Declarations

Ideations

I would be better off dead.

I just want to die.

Declarations

I’m going to kill myself.

When I see him, I’m going to kill him.

Assessing for Suicidality & Homicidality

History - previous attempts

Intent - how certain is the person that this is something they actually intend to do

Plan - has the person devised a specific plan to follow through with their intent to harm

Access - does the person have access to materials to follow through with the plan

So you say you’re going to kill him...& you mean

it!Foreseeable victim

Name

Reasonable Identity

Duty to Warn

Breach of confidentiality

Warn intended victim(s)

How do we warn?

Disclose the limits of confidentiality

Inform of duty to warn

Determine if other protective services need to be contacted

Contact Executive Leadership

Document your interactions and responses

I think she’s suicidal...

Willingness to act or motivation to die

Reasons for wanting to die

Preparation to act

Prep and rehearsal behaviors

I think she’s suicidal...

Capability to act

Previous attempt or self harm behavior

Experience of trauma

Barriers to act

Reasons for living

Faith beliefs

I think she’s suicidal...

Subjective intent

What she says

Objective intent

What she is doing or planning on doing

Hopelessness

Risk Factors

Biopsychosocial

Mental disorders (mood disorders, anxiety disorders)

Alcohol and other substance use disorders

Impulsive/aggressive tendencies

Physical illness

Family history

Risk Factors

Environmental

Job/financial loss

Relational or social loss

Easy access to lethal means

Local clusters of suicides (contagious influence)

Risk Factors

Social-cultural

Lack of social support

Stigma associated with help-seeking behavior

Barriers to accessing health care

Certain cultural/religious beliefs

Exposure to others who have died by suicide

Risk Factors

Demographic

American Indian/Alaska Natives; White

Male

15 - 24 y.o.

Divorced (men)

He is suicidal...now what?

Priority: Keep him safe

Remind him of the limits of confidentiality (if applicable)

Try to get him to agree to getting help (asap)

Do NOT leave him alone

He is suicidal...now what?

Suggest he contact a doctor or go to the hospital immediately

Contact a family member or other supportive person who can meet him and take him to the hospital

Call the community services board and they can assess and set up supportive resources

He is suicidal...now what?

Call 911 (if needed)

Contact Executive Leadership

Document your interaction

Somethings to keep in mind...

Most suicidal people want to live

Some suicidal people are determined to end their lives

We are limited in what we can do

We are not personally responsible for what someone else is determined to do

Remember the power of PRAYER

Child Protective Services

Mandatory Reporters

Virginia

Law Enforcement

Teachers

Health/Mental Health Care

Social Workers

ME or Coroners

Child Care Providers

Clergy (privilege)

Privileged Communications

Clergy (Virginia)

Have the right to maintain confidential communications between professionals and their congregants

The requirement to report shall not apply to any regular minister, priest, rabbi, imam, or duly accredited practitioner of any religious organization or denomination usually referred to as a church

Mandatory Reporters

North Carolina

Everyone is a mandatory reporter...if you suspect child abuse, you “shall” report

Reporting Requirements

Virginia

Can be anonymous (would prefer name)

Reporter confidentiality maintained (unless suspected false report)

North Carolina

Must include name, address, telephone number of reporter

Reporter confidentiality maintained

CPS vs Criminal Report

We are only required to report to CPS

A CPS issue exists if...

Abuse perpetrated by an individual serving in the role as a care giver at the time of the abuse

Criminal issue exists if...

Abuse perpetrated by a non care-giver

If you suspect child abuse...

Assess the level of danger for the child and do the following in the order most appropriate based on safety concerns for the child

Notify parent/guardian

Encourage parent/guardian to contact CPS

If you suspect child abuse...

Advise parent/guardian of your mandate to report to CPS

If parent/guardian is suspected abuser, determine if environment is safe enough for child to return home - start process of reporting to CPS so they can start investigation

If you suspect child abuse...

If you are concerned the environment is not safe enough for the child to return home and he/she is imminent danger - call 911.

Attempt to alert your Ministry Leader or Executive Leadership prior to involving authorities when at all possible

Definitely notify Executive Leadership in all cases - especially those involving the authorities

If you suspect child abuse...

Create a detailed report

Remember...you are not responsible for determining if abuse occurred or not...you are responsible for reporting suspected abuse and CPS will investigate accordingly

Helpful information to report to CPS...

Name, address, and phone number of child and parent(s)/guardian

Child’s birth date or age, gender, race

Nature and extent of the abuse or neglect

Names and ages of other persons, if known, who reside with the child

Persons/alternatives available to the child to provide protection

Info regarding the suspected abuser

National Child Abuse & Neglect Hotlines

7 Days a week/24 hours per day

1.800.552.7096 (VA Child Abuse Hotline)

1.800.442.4453 (National Child Abuse Hotline)

1.800.354.5437 (NC Committee for Prevention of Child Abuse)

Questions or Comments