CHC08 Community Services Training Package. CHCCS521B Assess and respond to individuals at risk of suicide SAMPLE. Learner guide.

Transcription

1 CHC08 Community Services Training Package CHCCS521B Assess and respond to individuals at risk of suicide Learner guide Version 1 INDUSTRY SKILLS UNIT MEADOWBANK Product Code: 5679

2 CHCCS521ABAssess and respond to individuals at risk of suicide Acknowledgments The TAFE NSW Training and Education Support Industry Skills Unit, Meadowbank would like to acknowledge the support and assistance of the following people in the production of this learner resource guide: Writers: Marilyn Farrell Community Services Teacher TAFE NSW Project Manager: Jane Fisher Coordinator TAFE NSW Alcohol and Drug Unit Enquiries Enquiries about this and other publications can be made to: Training and Education Support Industry Skills Unit, Meadowbank Meadowbank TAFE Level 3, Building J, See Street, MEADOWBANK NSW 2114 Tel: Fax: The State of New South Wales, Department of Education and Communities, TAFE NSW, Training and Education Support Industry Skills Unit, Meadowbank, Copyright of this material is reserved to TAFE NSW Training and Education Support Industry Skills Unit, Meadowbank. Reproduction or transmittal in whole or in part, other than for the purposes of private study or research, and subject to the provisions of the Copyright Act, is prohibited without the written authority of, TAFE NSW. Training and Education Support Industry Skills Unit, Meadowbank. ISBN: Developed by Training & Education Support Industry Skills Unit, Meadowbank TAFE NSW 2012

3 Table of contents Introduction General introduction Using this learner guide Prior knowledge and experience Unit of competency overview Assessment Section 1 Identify and assess current risk of suicide Suicide myths Statistics and trends Vulnerable groups Cultural issues Mental health issues and suicide Imprisonment and suicide Verbal and behavioural indicators of risk Assessing the current level of risk Skills for working with clients at risk of suicide Section overview Section 2 Work actively with the person to reduce the immediate risk of suicide and increase safety Acknowledging the validity of the person's feelings and possible pain Work with the person to generate a safety plan Reduce the risk of further self harm Reduce risk of harm to others potentially at risk in the situation Facilitate the intervention of emergency medical help Consultation and supervision Work Health and Safety (WHS) issues Developed by Training & Education Support Industry Skills Unit, Meadowbank TAFE NSW 2012

4 CHCCS521ABAssess and respond to individuals at risk of suicide 2.8 Referral procedures Section overview Section 3 Facilitate and strengthen the individual s links to further care Explore the person s openness towards accepting help Provide ongoing support and follow-up Develop plans for accessing/ utilising informal supports and professional help 79 Section overview Section 4 Provide ongoing support when assessed there is no imminent risk Using a strengths based approach Support the individual to develop coping strategies Assisting with possible underlying issues Assist in seeking out additional resources Comply with relevant legal and ethical guidelines and policy requirements Comply with agency policies and procedures Section overview Answers to activities Section Section Section Section Glossary Resource List Books and publications Videos 112 Developed by Training & Education Support Industry Skills Unit, Meadowbank TAFE NSW 2012

5 Organisations and Web sites Resource Evaluation Form Developed by Training & Education Support Industry Skills Unit, Meadowbank TAFE NSW 2012

6 Section 1 of suicide Identify and assess current risk Acknowledgement Much of the section Learning Topic 1 has been adapted from the Department of Education and Training s (2006) Certificate IV Mental Health Work Non Clinical V1.0 Hybrid CD produced by the Centre for Learning Innovation State of New South Wales, Department of Education and Training. Written by David McKenzie, Additional Writer: Marilyn Farrell, Other contributors: Maree Morgan & Anne Finnane, Community Services, Health, Tourism and Recreation Curriculum Centre, TAFE NSW, Aidan Conway, Richmond Fellowship. Introduction As workers within the community services industry, it is important that we develop knowledge and skills to enable us to identify individuals who are at risk of suicide and to assess the level of that risk. This may be in relation to a person who is already a client of our agency, or someone who has approached the agency for the first time. Page 19 of 117

7 Before we explore the knowledge and skills required to respond appropriately to a client at risk of suicide, what is your current knowledge of suicide and self harm in Australia? After completing the quiz go to page 99 to find the correct answers. 1.1 Suicide myths Activity 1.1 Complete the following quiz exploring common myths about suicide. 1. Currently the highest rate of suicide in Australia is a) NSW b) Northern Territory c) Queensland d) Tasmania 2. Most people who die by suicide suffer from a mental health disorder True False Unsure 3. Talking to a depressed person about suicide increases their risk of suicide. True False Unsure 4. A person who talks about suicide or threatens to kill him/herself is just after attention and is not likely to do it. True False Unsure Page 20 of 117

8 Activity 1.1 (continued) 5. Overall, males have a suicide death rate approximately four times higher than the rate for females True False Unsure 6. The majority of people who suicide leave a note True False Unsure 1.2 Statistics and trends The Australian Bureau of Statistics provides periodic reports on suicide in Australia. These can be found at Measuring suicide rates is difficult, because researchers cannot always be sure if the person intended to die. Conversely, deaths that appear accidental may have been the result of suicidal or suicidally reckless behaviour. There is always a delay of two years as coroners findings take time to be finalised. The most recent review was conducted in There were 2361 deaths from suicide registered in Over three quarters (76.9%) of these were deaths of males. But many more females attempt suicide than males. Males die more often because the methods they use, hanging and firearms are more lethal. Page 21 of 117

9 Source: In 2010 the most frequent method of suicide was hanging (including strangulation and suffocation) which was used in half (56.2%) of all suicide deaths. Poisoning by drugs was used in 12.2% and poisoning by other methods (including by alcohol and motor vehicle exhaust) was used in 10% of suicide deaths. Methods using firearms accounted for 6.9% of suicide deaths. The remaining suicide deaths were from drowning, jumping from a high place, and other methods. Source: Page 23 of 117

10 1.3 Vulnerable groups Specific population groups are at greater risk of suicidal and self-harming behaviours, due to adverse environmental factors and a lack of coping abilities, including refugees, prisoners and ex-prisoners (particularly men in the first few weeks after release), older men, gay and lesbian people, Indigenous Australians (particularly young males) and people with a diagnosed mental health disorder. Evidence links suicide and suicide attempts with depression, schizophrenia, bipolar disorder and personality disorders. People with a mental health disorder have a ten percent risk of suicide within ten years of diagnosis. (Mental Illness Fellowship of Australia) Inc. Factsheet) For further statistics on mental health and suicide go to National Health and Medical Research Council For information on suicide and recently released prisoners see: Kariminia et.al, Medical Journal of Australia, 2007; 187 (7): ) There is also a connection between people who misuse drugs and alcohol and suicide, particularly heroin users, but statistics can be difficult due to the inability to differentiate between accidental overdoses and suicide. The National Drug and Alcohol Research Centre (NDARC) found in a 2002 study, that overall, heroin users are 14 times more likely than peers to die from suicide Risk and protective factors Risk and protective factors refer to the vulnerability and resilience a person has to attempting or dying by suicide. However, these are not lists to be ticked off when working with clients; the presence of one or more risk factors does not mean the person is likely to be suicidal. Risk factors help you determine who is at higher risk of suicide. You then need to work with that person to assess the risk further and plan appropriate support to help protect them from attempting suicide. Risk factors can be personal and affect people in different ways. A risk factor is affected by: the way a person has learnt to cope with problems in their lives Page 24 of 117

11 the way the person sees him or herself the ability and opportunity for the person to cope the availability of appropriate and effective support Risk factors The most important factors in assessing a person s imminent suicide risk are the current personal risk factors, including: the person s mental health status, e.g. hopelessness, despair, agitation, shame, guilt, anger, psychosis recent interpersonal crisis, especially rejection and humiliation recent suicide attempt recent major loss, trauma or anniversary alcohol intoxication or drug withdrawal chronic pain or illness financial difficulties, unemployment impending legal prosecution child custody issues cultural or religious conflicts lack of social supports unwillingness to accept help difficulties accessing help e.g. language barriers, lack of information, lack of support from mental health services prior to immigration. Source: NSW Health s Suicide Risk Assessment and management Protocols for General Community Health Service, 2004, p.2) Additional personal risk factors can include: either them or members of their family having a history of mental health disorders (particularly depression) a history of AOD dependency Page 25 of 117