Adolescent suicide is actually the third leading cause of death after homicides and accidents among young people between the age of fifteen and twenty-four. Research indicates that adolescent suicide rates are increasing at an alarming rate. Any form of suicide attempt, contemplation or completion is assumed as a suicide zone of risk. Determining the adolescents at this suicide zone of risk is a significant step towards responding appropriately to reduce the chances of suicide among adolescents. Suicide assessment protocol therefore in an important tool for use by hotline workers, counselors, health workers among others who interact with adolescents who might be in the suicide zone of risk.
Adolescent suicide assessment protocol is divided into four distinct domains. These include contextual, clinical, historical and protective domains. Historical domain insinuates the historical contexts of prior attempted suicides or family histories of suicide attempts or completion. This domain is important in that it allows clinicians to understand the contextual behaviors and thus outline the best approach to help the adolescent in question. Clinical items include the presence of anger, hopelessness or depression. Further, clinical items might include current ideas of suicide and communicating suicidal wishes. This component is important since it allows diagnose if the suicidal case is brought about by clinical conditions. Contextual or environmental factors include lack of peer support, recent losses, the absence of family or access to firearms (Wenzel, Brown, & Beck, 2009). These are the environmental conditions which might aid suicidal attempts or thoughts. The protective domain includes a current treatment or reasons for living.
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Protective domain though is an emerging area, I would not include it in the assessment protocol. This is because the protective domain outlines that one would show suicidal tendencies or commit suicide for that matter because of an existing treatment. However, individuals under treatment in most cases have undergone psychological counseling and are dedicated to their recovery. Additionally, people have various reasons for living and this would not translate to an individual attempting or completing suicide. In essence, there must be other underlying issues which can be classified in other domains of adolescent suicide assessment.
Suicidality means the suicidal ideation including the thoughts of taking individual life, suicide attempts and suicide plans. Self-mutilation, on the other hand, means the act of deliberately injuring the individual body. Suicidality is quite severe compared to self-mutilation in the sense that, suicidality has all the indicators pointing towards suicide while self-mutilation would mean a form of coping behavior (Goldston, 2003). As such, an adolescent presenting suicidality is more likely to commit suicide than the one depicting self-harm. Additionally, adolescents would depict self for a number of reasons including to feel better, to communicate their emotional pain, to punish themselves or to feel a sense of control. On the other hand, suicidality points all to suicide and there is no alternative.
Generally, suicidality of suicidal behaviors is more severe compared to self-mutilation with regard to suicide attempt or completion. In the event that an adolescent is diagnosed as being at high risk for suicidal behaviors, and increased therapeutic cared is warranted (Weintraub, Loo, Gitlin, & Miklowitz, 2017). It is strongly recommended that these individuals be referred to day treatment, crisis or voluntary hospitalization. Further, adolescents at high risk of suicidal behaviors are quite vulnerable to act of their suicidal thoughts with little or no warning signs. As such, these adolescents should be monitored for any suicidal ideations and the most appropriate care outlined for them as soon as possible.
References
Goldston, D. B. (2003). Measuring suicidal behavior and risk in children and adolescents . American Psychological Association.
Weintraub, M. J., Loo, M. M., Gitlin, M. J., & Miklowitz, D. J. (2017). Self-Harm, Affective Traits, and Psychosocial Functioning in Adults With Depressive and Bipolar Disorders. The Journal of Nervous and Mental Disease, 205 (11), 896-899. doi:10.1097/nmd.0000000000000744
Wenzel, A., Brown, G. K., & Beck, A. T. (2009). Cognitive therapy for suicidal patients: Scientific and clinical applications . American Psychological Association.
