Determining the Risk

Excerpt from the book “Helping Your Depressed Teenager” by Gerald D. Oster, PhD and Sarah S. Montgomery, MSW

Approaching the suicidal teenager is difficult and can take much time and effort. The degree of risk must somehow be determined. Definitive steps must be taken to safeguard the teenager from immediate danger and to monitor his or her behavior. Finally, finding appropriate follow-up counseling is important.

Assessing the Danger

There are a number of specific questions to ask suicidal teenagers to determine their specific intentions. The answers you receive from the following questions will give you a strong indication of the seriousness of the threat.

  • “What has been occurring in your life that is making you think of suicide?” or “What happened that has made things so bad for you?”
  • “Do you have a plan to end your life?” (Remember, the more specific the plan is about method, place, time, and who will or will not be nearby, the greater the potential for suicide.)
  • “On a scale from 1 to 10, how much do you want to live (or die)?”
  • “How often do you think about dying?” “Is the feeling strong?” “How long does it last?”
  • “Have you or anyone else that you know attempted (or completed) suicide?”
  • “Do you know anyone who will try to stop you from committing suicide?”

This last question is important in determining backup support. It is crucial to obtain an answer. Ask for names, addresses, and phone numbers to plan immediate and future precautions. If the risk is determined to be high, then steps toward intervention must be made.

Steps Toward Intervention

The primary goal of intervening with a suicidal youth is to resolve the immediate problems and to mobilize the available resources, whether it be family, friends, or school personnel. In performing these actions, you are giving the message that alternative solutions can be found and that the teenager has more control than he or she realizes. For a positive resolution to occur, a well-coordinated, short-term plan must be established.

For the first 24 to 72 hours, an acutely suicidal teen needs supportive help and direction. An around-the-clock watch is necessary and should be arranged by family and friends staying with the teenager until the immediate crisis subsides. A written agreement with suicidal teenagers stating that they will not harm themselves during this time is often helpful. This contract should be specific in identifying all the activities and the people who will be around during this time. It should also mention that the person developing the contract will be notified immediately if actions even hinting of suicide persist.

By providing this guidance with confidence and reassurance, a strong message is being delivered that the crisis is short-lived and that a favorable outcome is expected. A foundation has also been laid showing that any future problem can be handled.

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