Potentially Suicidal Cases

After reading the following brief cases describing potentially suicidal cases, indicate whether you believe the suicidal risk is acute or chronic and low, moderate, or high risk. Also indicate the warning signs, protective factors, and demographically relevant information.

Case A

Kelson is a 22-year-old White male infantryman who has just spent 27 months in the Middle East. He is headed home for an extended furlough, and he does not understand why he is fidgety and agitated on the 18-hour plane trip home. When he arrives home, he learns that his girlfriend from before he went on active duty is now involved with one of his high school buddies, which he found out about from another friend while running an errand. In addition, his dad has remarried a woman whom Kelson has not met before. The marriage occurred nearly two years ago when he had been deployed for just four months. His new stepmother has moved into the house where Kelson used to live before deployment. His younger brother, in the meantime, graduated from high school and is now in college two states away from home. Kelson goes on a drinking binge the first night he is home and gets into a scuffle at the bar. As a soldier, he knows how to use firearms.

❏ Acute risk or ❏ Chronic risk

❏ Low risk ___________________________________________

❏ Moderate risk _____________________________________________

❏ High risk Risk factors: Warning signs: Protective factors: Demographically relevant information:__________________________________

Case B

Devon is an African American college student who has learned to cope by “doing more.” If having one part-time job is good, then two part-time jobs are better. She is prone to getting overinvolved in extracurricular activities, as she thinks that by really overachieving she will be selected for her preferred sorority in college. She has been seeing a counselor because she just cannot seem to focus in class and her grades are not quite good enough to meet the requirements of her desired sorority. Her counselor has asked her if perhaps she is depressed. She was bullied as a teenager by others regarding her appearance and being overweight, and she states that her father also treated her gruffly her entire life. She is bright, attractive, and likeable, but she does not view herself that way. She cannot explain why she is crying all the time, as she believes that she is working as hard as anyone can to “keep it together.” She feels that she has put a big strain on her mother and her friends for not “having it together.” She has daydreamed about taking a bunch of pills

❏ Acute risk or ❏ Chronic risk

❏ Low risk ❏ Moderate risk ❏ High risk

Risk factors: _______________________________________

Warning signs: _________________________________________

Protective factors: ___________________________________________

Demographically relevant information:_____________________________________

Case C

Charles is a White male, aged 77 years. During his retirement, he has played a lot of tennis and spent time at his hunting cabin with friends. One of his long-time tennis buddies of over 30 years died suddenly from a heart attack on the tennis court only minutes after Charles had left the club. In addition, Charles’s wife has been diagnosed with lymphoma and is undergoing treatments. While she is doing well in spite of the fatigue of the treatments, Charles is very worried about the possibility of her imminent death (before his own), and since his adult children have busy lives and reside in another region, he is primarily the sole caregiver for his wife. Together, they have made a decision to not get out and socialize as much as they had formerly, and they seem to be more socially isolated, except for his occasional tennis matches. On a recent visit to his physician, the doctor became worried and asked him if he was thinking of suicide.

❏ Acute risk or ❏ Chronic risk

❏ Low risk ❏ Moderate risk ❏ High risk

Risk factors: ____________________________________________

Warning signs: _______________________________________________

Protective factors: ________________________________________________

Demographically relevant information:______________________________________

Case D

Dakota is a Native American, aged 34 years, who has struggled with substance abuse for many years. Because he feels that his drinking is a loyal gesture to his friends, he has had difficulty in abstaining or understanding the risks of chemical dependence. His father committed suicide when Dakota was 16 years old, and as the eldest son, he was urged to become the head of the family, take care of things, and not repeat the mistakes of his father. Last night, Dakota got a second drunk driving charge. He is in a panic about the shame and embarrassment that this will bring on his family. He has told a friend that he is going to the cliffs to fly with the eagles.

❏ Acute risk or ❏ Chronic risk

❏ Low risk ❏ Moderate risk ❏ High risk

Risk factors: ___________________________

Warning signs: ____________________________________

Protective factors: _________________________________________

Demographically relevant information: _____________________________________________

Case E

Sandra is a White female, aged 47 years. She has just finalized a divorce from her third husband. For most of her life, she has placed a high premium on having a relationship with a partner, yet her commitments and marriages have seemed rushed and not very thought out, according to some friends and relatives. She is devastated when things do not go well, and her pattern of relationships has been somewhat chaotic and often conflicted. Similarly, she has seen a number of counselors over the years. Sandra’s current counselor, in talking to her most recent prior counselor, learned that she has never attempted suicide actively but has often talked about wanting to die “if it happened.” She is not sure how she would do it because she is afraid. Sandra is an adult survivor of childhood sexual abuse. She is an active member of her church, and she does not think it would be “OK” to actually attempt suicide.

❏ Acute risk or ❏ Chronic risk

❏ Low risk ❏ Moderate risk ❏ High risk

Risk factors: ______________________________

Warning signs: _______________________________

Protective factors: _________________________________

Demographically relevant information:__________________________