Stan is a 48 year-old Caucasian male police officer. He has been referred to you by employee assistance following several major life changes. First, he has just been demoted at work due to insubordination and job performance issues over the previous seven months. The performance issues included showing up for work intoxicated. Second, he has just separated from his wife of fifteen years and has had to move back in with his parents because he can not afford to pay child support while maintaining his own residence. His wife has threatened to move to another state with their only son and has filed a restraining order against him because he has made threats of violence against her if she moves with his only son. Stan presents to you with a flat affect, poor hygiene, slumped posture, lack of interest in work or pleasure, and states, “I just want to go to sleep and never wake up/”
What risk factors for suicide and violence can you identify for this client based on the information given? What assessment considerations would you address to determine if Stan is suicidal. Are there any other safety issues that need to be addressed? If so, what are they?
Risk factors for suicide and violence
Based on information given, the risk factors for suicide and violence are poor hygiene, separation from wife, financial constraints, flat affect, demotion, threat of violence, and lacking pleasure or interest in work (Bilsen, 2018). Stan has been demoted at work on account of job performance problems and insubordination. His financial struggles made it impossible for him to maintain his residence and pay child support at the same time. So the 48-year-old moves back home to stay with his parents. Separating from his spouse after 15 years also puts him at risk of suicide. Stan also threatens to harm his wife if she relocates to another state with their only son.
The vital aspects that need to be considered when assessing Stan to ascertain if he is suicidal include history of suicide ideation, feelings of worthlessness, hopelessness or vulnerability, sleep problems, suicide attempts in the past, changes in appetite, access to weapons, and a history of substance abuse (CDC, 2019). It is imperative that suicide thoughts are addressed before determining if the Caucasian male can actually commit suicide. His statement that he wishes to never wake up again after falling asleep indicates hopelessness and worthlessness (Sadock, Sadock, & Ruiz, 2015). As a police officer, Stan can access a firearm and kill himself with it. Substance abuse is a major issue that even led to his demotion at work.
The safety concerns that should be addressed include alcohol abuse, restraining orders, moving back to stay with his parents, and accessibility to firearms. Stan can cause violence and harm the people around him due to intoxication (CDC, 2019). He may also harm himself or his partner because of the anger and frustration caused by the restraining order filed by the latter.
Bilsen, J. (2018). Suicide and youth: Risk factors. Frontiers in Psychiatry, 9: 540.
CDC. (2019, September 3). Risk and protective factors. Retrieved from https://www.cdc.gov/violenceprevention/suicide/riskprotectivefactors.html
Sadock, B., Sadock, V. & Ruiz, P. (2015). Kaplan and sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). New York: Wolters-Kluwe