Impact of Client Suicide on Psychologists in Australia

Objective

This research aimed to assess the frequency and impact of client suicides on psychologists in Australia.

Method

Participants were 178 psychologists who completed an online self‐report questionnaire concerning the frequency of occurrence and impact of client suicide.

Result

Fifty six (31.5%) participants reported one or more client suicides. Psychologists with more years of experience reported more client suicides. Participants who had experienced a client suicide reported a range of emotional, cognitive and behavioural reactions as well as professional impacts. Ratings of responsibility, preventability and predictability of a client suicide were associated with emotional and/or professional impacts. Beneficial coping responses included talking to supervisors and colleagues, recognising the psychologist is not responsible and having increased acceptance of a client suicide.

Conclusions

The findings have important implications for training, workplace practices and research.     

Using the Linehan Risk Assessment and Management Protocol With a Chronically Suicidal Patient: A Case Report

The Linehan Risk Assessment and Management Protocol (LRAMP) is an empirically supported, comprehensive framework used to assess suicide risk and protective factors, and provide a guide for the therapist to consider reasonable options for intervening on suicidal behavior. This protocol includes a structured checklist for assessing, managing, and documenting suicide risk. It also structures the documentation to clearly describe the presentation, assessment, in-session interventions, decision-making process, and follow-up to other members of the treatment team. This paper describes a case in which the LRAMP was used to guide the assessment, intervention, and documentation of the suicidal behavior of a patient, “Ann,” being treated with outpatient Dialectical Behavioral Therapy in a community mental health clinic. Each section of the LRAMP is discussed as it was used with this complex patient, who had history of high utilization of acute psychiatric services. Application of the LRAMP included the assessment of risk and protective factors, and the use of an individualized crisis plan that engaged the patient, her family, the therapist, and the clinical team, to decrease acute risk, continue outpatient treatment, and avoid inpatient hospitalization. The considerations for documenting clinical decision-making with chronically suicidal patients are discussed.     

Assessment and Management of Suicide Risk in Children and Adolescents

This article presents a pragmatic approach to assessing and managing suicide risk in children and adolescents. We first present general recommendations for conducting risk assessments with children and adolescents, followed by an algorithm for designating risk. Risk assessment and designation should be based on both distal (i.e., a prior history of self-harm behaviors) and proximal (i.e., suicide ideation, plans, intent, and preparations) predictors of suicide attempt. We then discuss safety planning as an easy-to-implement approach for intervening and managing suicide risk when working with children and adolescents. We end with a case example illustrating the implementation of risk assessment, risk designation, and safety planning with an adolescent client and her mother.     

Identifying the role of sociodemographic factors in major depressive disorder and suicidality among Spanish-speaking Latino patients in a federally qualified health center

Rates of suicide and major depressive disorder (MDD) are currently at the highest point in the history of the United States (US). However, these rates are not distributed evenly among the population and Latinos show disproportionately high rates of both suicide and MDD. Yet, past research has infrequently explored factors related to suicide and MDD in primary care settings that serve as the major community portal for mental health among the Latino population. Thus, the current study investigated sociodemographic variables (marital status, nativity, education, employment, primary language, age, and gender) in terms of their relations with suicidal ideation, suicide risk, MDD, and MDD symptom severity among Latino primary care patients in a Federally Qualified Health Center (N = 634, M _age = 39.46, SD = 11.46, 87.1% female). Results indicated that gender and Nativity were associated with suicidal ideation, older age was associated with suicide risk, and higher education and having a partner were negatively associated with MDD and depressive symptom severity. These results provide novel insight into the role of sociodemographic factors predicting suicide and MDD among Latinos in primary care, and suggest greater scientific and clinical attention can be focused on certain sociodemographic factors to offset mental health disparities among this group.     

Réflexions sur la fin de vie

The following reflections have to do with the \"end of life\" and are presented here as a lecture addressed to high school and preparatory school student attending a Parisian institute. They were developed with the aim of finding where a current citizens' debate called for by the executive branch and timeless, age-old questions might overlap. When we begin to ponder ultimates such as birth or death, we owe it to ourselves to take into consideration all the nuances involved; this is the only way to process the complexity of these topics. The goals of this course are, first of all, to situate the current debate within the ethical and juridical history of France, and then proceed towards making necessary conceptual distinctions. Finally, we will consider, as much as possible, what is at stake with the options at hand.     

Terror as Usual: The Role of the Model Minority Myth in Asian American Women’s Suicidality

ABSTRACT

This article examines the influence of the model minority myth on the formation of suicidal tendencies among Asian American women. These women experience fractured realities under the myth as a form of everyday trauma, or “terror as usual,” which may influence their suicidal thinking or attempts. Using interview data collected from 44 Asian American women suicide survivors, this study employs narrative analyses of the interviews, drawing from the theoretical frameworks of women of color feminism, critical race studies, postmodern psychology, and critical anthropology. The first part of this article deconstructs the model minority thesis as a problematic framework for understanding Asian American achievement. The second part examines how these pressures are experienced by Asian American women as destructive material and psychic constraints. Specifically, the model minority myth contributes to Asian American women’s suicidality in three major ways: (a) the pressure to succeed creates unbearable stress for individuals as they try to live up to the stereotypical image of Asian American success; (b) the dissimulation of the myth as a social fact influences Asian American women to internalize model minority expectations and thus blame themselves if they are unable to succeed; and (c) the image of model success contributes to Asian American women becoming over-looked in the distribution of needed help and resources, further exacerbating their suicidal conditions. The article concludes with a discussion of implications of this study for both clinical and nonclinical practices needed to create social conditions for Asian American women’s mental wellness.