Teaching Suicide Assessment: A Trauma Informed and Collaborative Model

Overview: This presentation outlines a conceptual model for teaching suicide assessment and intervention to social work students that centers client agency, the therapeutic relationship, and the impact of mental health systems on marginalized clients and communities.Proposal text: Social work students and new graduates frequently encounter clients experiencing suicidality, but often feel unprepared and distressed about suicide assessment and intervention (Almeida et al., 2017; Kourglantakis et al., 2018; Osteen et al, 2012; Quest & Nedegaard, 2018; Ruth et al., 2015; Sharpe et al., 2014). A 2006 survey of social workers indicated that all participants had worked with at least one suicidal client, but reported receiving little, if any training in suicide assessment (Feldman & Freedenhthal, 2006). A recent study indicated that social work instructors feel there is a need for updated social work curriculum for teaching suicide assessment and that they would benefit from increased opportunities to learn about teaching suicide assessment (Mirick, 2020). Current approaches to suicide assessment and intervention often violate clients’ autonomy and self-determination and can lead to contact with systems of surveillance and policing with potentially dangerous consequences, especially for people in marginalized and oppressed communities.

Given the focus of this year’s APM of “leading critical conversations,” We reviewed the literature for approaches to suicide assessment, cognizant of dynamics of power and systems that social workers and clients routinely navigate. Although there are a variety of theoretical frameworks and practice models for teaching suicide assessment, few aim to respond to the needs of oppressed and marginalized clients and communities (Kourgiantakis et al., 2020). Social work has long been complicit in systems of oppression, particularly collaboration with law enforcement regarding mental health crises, with grave consequences for clients of color (Jacobs et al., 2021). Social workers’ approaches to suicide assessment vary greatly (Regehr et al., 2016) and assessments have been shown to be influenced by a social worker’s own emotional state and level of post-traumatic stress (Regehr et al., 2015). Traditional models for suicide assessment emphasize risk management and control at the expense of understanding clients’ distress and supporting their active engagement in their healing (Felton et al., 2018). Our review highlights the need for a reflective and team-supported model of suicide assessment that centers a client’s agency and choices as well as critical attention to power as integral to collaborative practice with clients who are experiencing suicidality

In this paper, we will present a collaborative, trauma-informed, critical social work model of suicide assessment. The model involves reflection, curiosity and rapport-building, assessment of a client’s needs and desires, critical and ethical reflexivity, collaboration and development of plans, and the maintenance of connection. All of which are crucial components of teaching social work practice in BSW and MSW classrooms. This model embraces the value of the therapeutic relationship in assessment and intervention, viewing suicidal ideation and plans as vital communications about the client’s experience (Espeland et al., 2021). Furthermore, it supports social workers to respond authentically to expressions of suffering (White et al., 2017). We will share the strengths and challenges identified by piloting this model in MSW programs and in interdisciplinary practice settings. Finally, attendees will leave this session with a new conceptual model to inform teaching social work students about suicide assessment and intervention.