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Working With the Client Who is Suicidal: A Tool for Adult Mental Health and Addiction Services

Working With the Client Who is Suicidal: A Tool for Adult Mental Health and Addiction Services provides an overview of recommended practices in assessing and treating suicidal behaviour in adults. This document is consistent with the goals identified in the Blueprint for a Canadian National Suicide Prevention Strategy, developed by the Canadian Association for Suicide Prevention (CASP) in 2004. Specifically, this document responds to the following goals as identified by CASP: to increase training for key gatekeepers, volunteers, and professionals regarding recognition of risk factors, warning signs and at-risk behaviours; to provide effective interventions; and to develop and promote effective clinical and professional practice to support clients, families and communities. Main entry under title: Working with the client who is suicidal : a tool for adult mental health and addiction services. This guide is not a prescribed standard of care, and therefore cannot and does not stipulate a single correct approach for all clinical situations. This document should be used as an information and planning tool only. Decisions regarding specific procedures for specific suicidal individuals remain the responsibility of the attending professional(s). Sophisticated clinical judgment is always a requisite, and it is important to always err on the side of safety. The text has been prepared to advance and strengthen the ongoing work of mental health and addiction practitioners. The target audience is assumed to be conversant with, and knowledgeable about, basic terms and practices in mental health and addiction settings, including: diagnostic categories, assessment procedures, therapeutic alliance, and clinical record-keeping. Throughout this document, information on various treatment modalities and orientations is provided. It is important to acknowledge that reading this guide does not imply that a clinician is conversant in a particular treatment modality. Clinicians who are interested in further training and treatment are encouraged to pursue further continuing education activities. The bulk of the existing empirical literature on suicide focuses on risk assessment, and there is a notable dearth of evidence-based research focused on treatment of suicidality. However, reliable risk assessment and prediction of suicide remains an elusive task: the decision-making process is difficult to describe, and is not captured by simple compilation of risk factors. To be maximally useful, assessment must always occur within the context of a therapeutic alliance. The role of the clinician is to move beyond simple assessment of risk factors, toward clinical management of risk, and therapeutic treatment of underlying contributors to suicidality. …