Suicide-Risk Assessment & Reporting 

Generally, Thriveworks offers mental health services to clients with little or no risk of imminent harm to themselves and no previous suicide attempts.  Sometimes, however, suicide occurs. While clinicians are not expected to predict or control their client’s actions, they are expected to identify the presence of risk factors for suicide. Whether self-harm was foreseeable, is a fundamental concern when a client dies by suicide. Foreseeing suicide is not the same as predicting it,  and will be evaluated based on the information available to the clinician during the course of treatment.  In any event, our exposure to liability can be minimized when suicide risks are identified and addressed. 

The following are a few tips to keep in mind when encountering a suicidal client.

Tips to reduce the risk of liability:

• Always practice within your scope of competency, based on your education, training, and experience.  Understand your limitations and when referral to a higher level of care is necessary.

•  Observe and remain mindful of warning signs.

• Conduct an appropriate client risk assessment for suicide (initial and ongoing), investing the time, energy, and skill in collecting all available client information.

• Don’t shy away from asking about suicidal thoughts. If present, peel back the layers, even if denied, as a risk may still be present. 

• Consistently and thoroughly document treatment efforts, including careful reasoning for assessments, recommendations, treatment plans, and appropriate preventive measures, if needed.

• Be sure to document using the client’s words, and as contemporaneously as possible!

• Seek guidance from your RCD, if unsure as to the appropriate level of care for a client exhibiting any behavior, or other risk factors, of concern.  

• Act promptly to transition the client to a higher level of care, when necessary.

Tips on communicating with surviving family members:

• Remember, HIPAA privacy rules continue after the death of the client.  Explain confidentiality rules, if necessary.

• Seek written authorization, from a deceased client’s legal representative, before releasing a client’s records.  

• Remain focused on expressing sympathy for the death, rather than discussing details of the therapy treatment.

• Don’t make statements second-guessing your treatment, or statements assuming responsibility.

• Avoid commencing therapy sessions with the family, for the risk of creating a dual relationship.

Again, clients experiencing suicidal thoughts, struggling with self-harm, or expressing other safety concerns that need treatment, generally require a higher level of care to attend to their mental health needs. 

In the event of a client suicide, the tragic occurrence should be reported to the RCD and a clinical incident report found HERE must be immediately submitted.