Suicidal Clients
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PROGRAMS AND SERVICES MANUAL
POLICY
SUICIDAL CLIENTS
The AIDS Committee of Toronto (ACT) recognizes that there is a difference between rational suicide; that is, the planned death of an individual who is in the end stages of HIV disease, and situational suicide brought on by emotional distress. This policy deals with situational suicide.
Situational suicide refers to a stage in a person's life where he/she considers killing him/herself due to stressors in his/her life or mental illness, including depression which may interfere with rational decision making processes. Some of these stressors include: a new HIV diagnosis, the end of a relationship, the onset of an opportunistic infection, depression, and other life changing events.
1. A client who states that he/she is thinking about suicide, either through the hotline or in person, is to be assessed by the counsellor-on-call (or the client's counsellor if that counsellor is available). This assessment includes questions about the client's intention to carry out a suicide, whether or not the client has a suicide plan, and the client's history of suicide attempts. Counsellors may wish to use the Suicide Risk Assessment Checklist (sample follows) from the Distress Centre to assess the client's risk factors. A service user who approaches an outreach worker or off-site volunteer should be referred to the Distress Centre or the Gerstein Centre which have the ability to respond on a 24 hour basis, or to the ACT counsellor-on-call, if during office hours.
2. If, in the opinion of the counsellor, the client presents as a high risk for suicide, the client should be referred to a psychiatrist (the client's own or Mount Sinai Hospital -Clinic for HIV-Related Concerns), the client's family doctor, or to the nearest emergency room that has a psychiatry department (Clarke Institute, Toronto Hospital, Toronto East General) for immediate treatment. If the client refuses treatment, the counsellor should explain the obligation (especially if the counsellor is a member of a profession which is regulated under the Health Professions Act) to assist the client in receiving treatment. It would be important to know why the client called/came in to the office, and what the client hoped ACT would help with. Does the client want someone to come and look after a pet after he/she has died? Are there other tasks that the client hopes we can look after? It is imperative that staff document their interaction with the client.
3. All interactions with suicidal service users are to be reported to the staff person's manager. Volunteers should report encounters with suicidal clients to their supervisors.
