Suicide Risk Assessment of Adolescents CE Course

Target Audience

Marriage and Family Therapists, social workers, psychologists, psychiatrists, nurses, substance abuse counselors, allied health professionals, and students, interns, and trainees of these disciplines who have professional contact with teen-agers.

Underlying Need for this Course

The purpose of this course is to provide nurses with the information necessary to perform a basic suicide risk assessment, upon initial contact and/or in an ongoing relationship, with adolescent patients.

  1. Clinicians require knowledge of risk and protective factors related to suicide in the adolescent population.
  2. Clinicians need competency in assessing suicide risk in adolescents.
  3. There is a lack of suicide-specific training for mental health professionals.
  4. Adolescents will not volunteer suicidal intent if they feel they are not taken seriously.
  5. Confidentiality limits need to be addressed with adolescents to help establish an environment of trust.

In the US, suicide continues to be the second leading cause death in the 10 to 24 year-old population.  The suicide rate in adolescents has been on the rise for the last decade.

Clinicians need to have information on basic suicide-related statistics and epidemiology.  Clinicians need information on ways to perform an independent risk assessment of self-directed violence upon initial contact and in ongoing relationship with adolescent patients.

  • Need to be knowledgeable in signs/symptoms/triggers/risk factors.
  • Need to be competent in assessing, interviewing, questioning which leads to providing a safe and understanding environment for disclosure.
  • Need to be able to be specific/direct in addressing and asking about suicidal thoughts, behaviors, and attempts.

Suicide is 10th leading cause of death, 3rd for individuals 15-24 years old.  Over 90% have significant mental health issues/diagnosis and/or substance abuse issues which are often undiagnosed, untreated, or both.  There are many mistakes a clinician can make during an interview /questioning which decrease the validity of the assessment or the accuracy /honesty of the responses.  90% of individuals who die by suicide communicated their intent.

  • Clinicians require knowledge of risk and protective factors related to suicide in the adolescent population.
  • Clinicians need competency in assessing suicide risk in adolescents.
  • There is a lack of suicide-specific training for mental health professionals.
  • Adolescents will not volunteer suicidal intent if they feel they are not taken seriously.
  • Confidentiality limits need to be addressed with adolescents to help establish an environment of trust.

Learning Objectives

Upon completion of this course, nurses should be able to:

  1. Identify risks and protective factors related to suicide.
  2. Review suicide-related statistics and epidemiology.
  3. Describe steps in process of assessing risk of suicide in adolescent patients.


Meet your instructors:
 Roberta Freeman, RN, MSN, CS
is a certified Psychiatric and Mental Health Nurse with over 35 years of experience as a practitioner, educator, consultant and researcher in the Adolescent Unit at UCLA Resnick Neuropsychiatric Hospital.  She has collaborated in program evaluation, assessing interventions to improve care, conducted comprehensive evaluation/assessment of adolescents who have been referred for treatment in the Eating Disorder program, established and monitored patient care standards, provided group therapy for adolescents, collaborated with interdisciplinary treatment team in evaluating, diagnosing, and coordinating patient care throughout hospitalization and disposition planning, and much more. She is an active member of the Academy for Eating Disorders and Advanced Practice Nursing Association.

Linda Reynolds, RN, BAN is a retired nurse with over 38 years of experience in both adolescent and adult inpatient psychiatric nursing.  Linda served patients, staff and the public in many different capacities over the years and has held positions as a clinical nurse and supervisor at both Harvard and UCLA teaching hospitals.  At UCLA-NPH, Linda also served as the Nurse Educator for Mental Health in the psychiatric hospital as well as the medical centers in the UCLA Health Care Systems and was an Assistant Clinical Instructor and lecturer at the UCLA School of Nursing.  Linda has consulted with other medical centers in Southern California and have served as an Expert Witness and for the California Board of Registered Nursing and the US Department of Justice.

References

  1. American Academy of Pediatrics (2008); Teen Suicide; Facts for Families, No. 10
    http://www.aacap.org/galleries/FactsforFamilies/10-teen-suicide.pdf
  2. American Psychiatric Nurses Association Resource Center; Psychiatric-Mental Health Nurse Essential Competencies for Assessment and Management of Individuals at Risk for Suicide; February 2015
    https://www.apna.org/i4a/pages/index.cfm?pageID=5684
  3. Cash, Scottye J Ph.D.; Bridge, Jeffrey Ph.D.; Epidemiology of Youth Suicide and Suicidal Behavior; Current Opinions in Pediatrics; Oct. 2009, 21(5); 613-619
  4. Centers for Disease Control (2018); National Center for Injury Prevention and Control, Division of Violence Prevention; Suicide: Risk and Protective Factors
    https://www.cdc.gov/violenceprevention/suicide/riskprotectivefactors.html
  5. Centers for Disease Control (2016) Data and Statistics (WISQARS); Fatal Injury Report for 2016
    https://www.cdc.gov/injury/wisqars/fatal.html
  6. Gray, Barbara P. PhD, RN, CPNP; Dihigo, Sharolyn K. DNP, CPNP-PC; Suicide Risk Assessment in High Risk Adolescents; The Nurse Practitioner, 40(9), 30- 37
  7. Kar, Nilamadhab; Mohanty, Manoj K.; Bastia, Binaya K.; Scale Assessment of Lethality of Suicide Attempt; Indian Journal of Psychiatry, 2014 Oct – Dec; 56(4) 337- 343
  8. National Institute of Mental Health; ASQ Suicide Screening Information Sheet and Brief Suicide Safety Assessment 2017
    www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials/index.shtml
  9. National Institute of Mental Health; Suicide Statistics (2018)
    https://www.nimh.nih.gov/health/statistics/suicide.shtml
  10. Rudd, M.D., Berman, A.L., Joiner, T.E., Nock, M.K., Silverman, M.M., Mandrusiak,M., Witte, T. (2006); Warnings for Suicide: Theory, research and clinical applications; Suicide and Life Threatening Behavior, 36 (3), 255-262.
  11. Suicide Prevention Resource Center, Educational Development Center, Inc. (2009);
    Suicide Assessment Five Step Evaluation and Triage for Mental Health Professionals
    www.sprc.org/resources-programs/suicide-assessment-five-step-evaluation-and-triage-safe-t-pocket-cardTaliaferro, L.A., Borowsky, I.W. (2011); Physician Education: A Promising Strategy to Prevent Adolescent Suicide; Academic Medicine, 83(3), 342-347
  12. Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005-2017. Journal of Abnormal Psychology, 128, 185-199.