Danger Signals for Suicide

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Steps in Crisis Intervention

1. Define the Problem. Explore and define the problem from the patient's point of view. Use active listening, including open-ended questions. Attend to both verbal and nonverbal communications.
   
   
2. Ensure Personal Safety. Assess lethality, criticality, immobility and seriousness of threat to patient's physical, emotional and psychological safety. Assess internal impact as well as environmental situation.
   
   
3. Provide Support. Communicate (by words, voice, body language) a caring, positive, nonpossessive, nonjudgmental, acceptant, personal involvement with the one in crisis and the family.
   
   
4. Examine Alternatives. Assist in brainstorming choices available now. Search for immediate supports. Ask later about possible consequences of each option.
   
   
5. Plan. Develop a plan with your patient which:
   • provides something concrete and positive for the patient to do now with definite action steps which the patient can own and comprehend; a variety of constructive psychomotor activities may be considered whenever appropriate.
     
   • is realistic in terms of the patient's coping ability.
     
   • uses appropriate and available referral resources.
     
   • includes many forms of collaboration {prayer, relaxation techniques, etc.}
     
     
6. Commitment. Help the patient commit to a definite action step.
   
   • a. Ask the patient to verbally summarize the plan and commitment.
     
   • b. Demonstrate your part of the commitment if you collaborate.
     
   • c. Follow up on the patient's performance or in obtaining assistance.
     

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