Suicide risk assessment is a significant activity because it allows social workers to identify clients’ suicide ideation and offer some ways to minimize it. Dr. Sommers-Flanagan utilized a comprehensive approach to working with Tommi, and he performed a few essential steps. The social worker began with a cognitive assessment to identify whether the client had depression (Sommers-Flanagan & Sommers-Flanagan, 2014).
It was followed by focusing on physical symptoms and social relations (Sommers-Flanagan & Sommers-Flanagan, 2014). Since Tommi indicated having depression, sleep issues, and unsatisfactory social connections, it is logical that the social worker directly asked about her suicidal thoughts. When the client revealed direct suicidal thoughts and disclosed two attempts, the social worker focused on a safety plan and reframed reasons to live (Sommers-Flanagan & Sommers-Flanagan, 2014). Since there is no exact formula for assessing suicidality, it is possible to mention that Dr. Sommers-Flanagan successfully coped with the task.
As Tommi’s social worker, I would draw sufficient attention to safety planning if I were put in place. In the first week, it would be reasonable to develop a personalized safety plan (National Institute of Mental Health, 2017). For example, I would explore what activities or conditions help the client escape thoughts about suicide. This information is essential because it can allow Tommi to minimize the effect of suicidal ideation by focusing on positive issues. Furthermore, a suitable option would be to ask the client to write down the reasons to live and refer to them every time when negative thoughts come. In addition to that, the National Institute of Mental Health (2017) stipulates that follow-up phone calls can be effective in minimizing suicide risk. That is why I would make supportive phone calls to Tommi in the first months to determine how she manages her condition.
It is reasonable to use additional tools to determine how Tommi’s risk level changes over time. In this case, the Cultural Assessment of Risk for Suicide (CARS) measure seems appropriate. This tool focuses on those cultural factors that are typically ignored by traditional instruments (Chu et al., 2013). In particular, this measure focuses on what effect cultural beliefs, social connections, and family relationships have on a person’s suicide thoughts (Chu et al., 2013).
It is rational to use the CARS tool in addition to other instruments to receive a complete understanding of the problem. A few factors justify the use of this measure in the case under analysis. On the one hand, Chu et al. (2013) stipulate that a cultural background significantly affects a suicide risk, which means that it is necessary to assess this domain. On the other hand, the CARS tool is relevant because a research team developed and tested it. Consequently, it will be helpful to apply this instrument to Tommi.
When it comes to assessing Tommi’s suicidal ideation, it is necessary to remember her cultural background. The client is a Native Alaskan, and Caetano et al. (2020) stipulate that a significant part of this population suffers from alcoholism and suicide. That is why it is necessary to address substance abuse issues when working with Tommi. Simultaneously, Allen et al. (2021) clarify that religious belief about the value of a person’s life is one of the leading factors that prevent Alaskan youth from committing suicide. Consequently, it can be suitable to remind Tommi of her religion to minimize the risk. It is possible to expect that these enhancements can be helpful for the client.
Diagnostic Summary and MSE
- Identifying Data/Client demographics – Carl is 19 years old, and he is a student at Trapper Creek Job Corps.
- Chief complaint/Presenting Problem – Carl has adjustment struggles and eccentricities, has arguments with voices inside his head.
- Present illness – not available.
- Past psychiatric illness – not available.
- Substance use history – not available.
- Past medical history – not available.
- Family history – Carl admits that some of his family members were Wiccan.
- Mental Status Exam (Be professional and concise for all nine areas)
- Appearance – proper hygiene, appears the staged age.
- Behavior or psychomotor activity – psychomotor agitation, repetitive movements, tick-like mannerisms, loud sighs, coughing.
- Attitudes toward the interviewer or examiner – cooperative with the examiner,
- Affect and mood – the patient is feeling “calm,” he rates his mood at five as per a 0-10 scale; mood is appropriate; he is anxious and defensive when it is challenging to answer a question.
- Speech and thought – speech is understandable and rapid; latency is present; sounds, voices, and pictures get stuck in Carl’s head; Carl has arguments with the voices.
- Perceptual disturbances – Carl sees ghosts and talks to voices inside his head.
- Orientation and consciousness – knows date, day of week, time, and place.
- Memory and intelligence – excellent intermediate memory because Carl remembered all three words; good concentration, decent mathematical skills.
- Reliability, judgment, and insight – good capacity to make responsible decisions; Carl does not admit that he has any mental issues.
Analysis of MSE
Based on the information above, I can state that collecting follow-up data in a few MSE areas will be reasonable. On the one hand, it refers to perceptual disturbances, meaning that it is essential to know when Carl started hearing voices inside his head and seeing ghosts. These data can identify the life period when such phenomena occurred. On the other hand, it can be helpful to explore the affect and mood area to find what makes Carl feel bad (Morrison, 2014). Finally, it is necessary to collect the client’s health and family history to identify whether he or his relatives suffered from any mental issues.
I believe that gathering the information above can be helpful in making a diagnosis. It is necessary to rely on cross-cutting symptom measures to identify whether the client has specific symptoms that refer to a particular disorder spectrum. First (2014) stipulates that the first step in determining a person’s mental state is to identify whether they are subject to substance abuse. This information can demonstrate that particular drugs cause a client’s problems. If any signs of substance abuse are found, it will be required to subject the patient to further investigation to assess the connection between this behavior and mental disorders.
At present, it is challenging for me to diagnose Carl in any specific way. The rationale behind this statement is that the collected information can qualify for various mental health issues. For example, Morrison (2014) stipulates that hallucinations can be a sign of psychosis or schizophrenia. Simultaneously, some evidence reveals that Carl can suffer from substance use disorder that also causes hallucinations. In particular, the fact that the client justifies using marijuana by his friends and his indifference to bestiality can indicate drug abuse (Morrison, 2014). Consequently, Carl’s answers do not provide sufficient information to make a diagnosis.
At this point, I would not discuss any possible diagnosis with Carl. The reasoning behind this statement is that the collection of all the required information can indicate that only one diagnosis affects the client (Morrison, 2014). Consequently, revealing all the possible diagnoses would subject Carl to adverse experiences and negatively affect his mood. That is why I would be cautious not to place a label on the patient. Instead of it, I would invest in collecting the data that were discussed above because they would help me make a more precise diagnosis.
References
Allen, J., Rasmus, S. M., Fok, C. C. T., Charles, B., Trimble, J., Lee, K., & the Qungasvik Team. (2021). Strengths-based assessment for suicide prevention: Reasons for life as a protective factor from Yup’ik Alaska Native youth suicide. Assessment, 28(3), 709-723. Web.
Caetano, R., Kaplan, M. S., Kerr, W., McFarland, B. H., Giesbrecht, N., & Kaplan, Z. (2020). Suicide, alcohol intoxication, and age among Whites and American Indians/Alaskan Natives. Alcoholism, Clinical, and Experimental Research, 44(2), 492-500. Web.
Chu, J., Floyd, R., Diep, H., Pardo, S., Goldblum, P., & Bongar, B. (2013). A tool for the culturally competent assessment of suicide: The Cultural Assessment of Risk for Suicide (CARS) measure. Psychological Assessment, 25(2), 424-434. Web.
First, M. B. (2014). Handbook of differential diagnosis. American Psychiatric Association.
Morrison, J. (2014). Diagnosis made easier: Principles and techniques for mental health clinicians (2nd ed.). Guilford Press.
National Institute of Mental Health. (2017). Suicide prevention. Web.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (Producers). (2014). Clinical interviewing: Intake, assessment and therapeutic alliance. Kanopy. Web.