If you are a mental health practitioner and you offer online therapy, please be sure to follow standard informed consent protocol. Always obtain demographic information from your client including name, address and contact information. If your client resides in a different geographic region than you, look up community emergency and safety resources in your client’s geographic area. If your client indicates harm to self or others and you cannot make contact with your client or do not know your client’s exact location, contact your local police department and explain your situation. The police may intervene by tracing the client’s ISP.
If you offer online therapy consider utlizing an assessment tool such as the SAD PERSONS Scale.
You can triage your patient’s risk for suicide by utilizing the SAD PERSONS Scale.To use, assign one point for each positive risk factor, add your total points and review the recommended guidelines.
SAD PERSONS SCALE
[Important Suicide Risk Factors]
Sex [Assign one point only if male]
Age [Assign one point only if <19 yrs or >45 years old]
Depression
Previous attempts
Ethanol abuse [alcohol or substance abuse]
Rational thinking loss
Social supports lacking [lack of family, friends, etc]
Organized plan [lethal, affairs in order, note]
No spouse [divorced, widowed, separated, single, no children]
Sickness [chronic, debilitating and severe]
Scale Score:
0-2: Typically not an acute situation, but make sure to follow up with the client by phone and document referral sources.
3-4: Closer follow up recommended. Ask the client to sign a release form to allow you to communicate with their mental health provider or primary care doctor.
5-6: Discuss the option of hospitalization with the client. Ask the client to sign a medical release and speak with their doctor. Ask the client to make a verbal or written contract that says they will see their therapist or go to the emergency room prior to attempting to take their life.
7-10: This may be a situation where hospitalization may be necessary with or without the client’s consent. It is imperative in these situations to continue to validate the patient’s feelings and call in the support of the patient’s other providers and caretakers.
Adapted from:
Juhnke GA, Hovestadt AJ. Using the Sad Persons Scale to promote supervisee suicide assessment knowledge.The Clinical Supervisor 1995;13 (2):31-40.
Patterson W, et al. Sad Persons Scale. Psychosomatics 1983; 24:343.
