Crisis Management: Suicidality, Homicidality & CPS Dr. SOS Executive Director of Community Wellness at The Mount
Crisis Management presentation
May 15, 2015
How to manage a crisis in instances of suicidality, homicidality & engaging Child Protective Services.
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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
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