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 theBlueprint for a Canadian National Prevention Strategy, developed by the Canadian Association for (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.

Accompanying documents include: • Working with the Suicidal Patient: A Guide for Health Care Professionals • Coping with Suicidal Thoughts • Hope & Healing: A Practical Guide for Survivors of Suicide

Project Management & Coordination Joti Samra, PhD, RPsych

Research & Writing Lynda Monk, MSW, RSW Joti Samra, PhD, RPsych

Editing Joti Samra, PhD, RPsych; Jennifer White, EdD; Elliot Goldner, MD

Ministry of Health Project Lead Gerrit van der Leer, Director, Mental Health and Addiction

The Ministry of Health sponsored development of the guide through the Centre for Applied Research in Mental Health and Addiction (CARMHA), at the Faculty of Health Sciences at Simon Fraser University.

This document is an adaptation ofPractice Principles: A Guide For Mental Health Clinicians Working with Suicidal Children and Youth (2001), prepared by Joanna Ashworth for the Suicide Prevention Information and Resource Centre (SPIRC) at the University of British Columbia, and funded by the British Columbia Ministry of Children and Family Development.

Copies of this document can be downloaded at no cost from: Centre for Applied Research in Mental Health and Addiction: www.carmha.ca B.C. Ministry of Health, Mental Health and Addiction: www.health.gov.bc.ca/mhd

Library and Archives Cataloguing in Publication Data Main entry under title: Working with the client who is suicidal : a tool for adult mental health and addiction services.

Produced by the Centre for Applied Research in Mental Health and Addiction (CARMHA), for the Ministry of Health. Cf. Acknowledgements. Available also on the Internet. ISBN 978-0-7726-5746-6

1. Suicidal behavior - Treatment. 2. Suicide – Risk factors. 3. Suicide – Prevention. 4. Suicidal behavior – British Columbia. 5.Mental health services - British Columbia. I. British Columbia. Mental Health and Addictions Branch. II. Simon Fraser University. Centre for Applied Research in Mental Health and Addiction.

RC569 W67 2007 616.85’8445 C2007-960091-3 Qualifying Statements

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 or