Policy #38: Suicide Intervention Protocol

1. If a client or participant expresses suicidal imagery in their artwork, poetry, or other artistic creations, then it is important to address the imagery with the client. Be curious and invite an explanation or description from the client. Keep in mind the client’s history and current known risk factors. If the client’s discussion about the imagery suggests a potential risk, then ask about suicidal ideation and attempts. If a disclosure is made, then proceed to Step 2. If no disclosure is made, document concerns in the session notes and discuss the situation with the applicable supervisors and also take the artwork/concerns to the next supervision session.
2. If a client or participant discloses thoughts of suicide or reports a suicide attempt or rehearsal to a student or staff member of the Institution, a thorough suicide assessment should be conducted immediately in a one-to-one interview, using the Suicide Safety Plan located on the Institution’s LMS. In the event that a client discloses such information, the client should be invited to talk one-to-one with the student art therapist and/or the supervising clinician. Follow the steps on the Suicide Safety Plan.
3. If a disclosure is made when a Site Supervisor or Clinical Coordinator is present, then report the disclosure immediately to that person and follow their instructions before completing the Suicide Assessment Interview.
4. If the disclosure is made to a student of CiiAT and there is no supervisor on site, the student shall proceed and conduct the assessment. If the student determines the client is at LOW risk for suicide, then the student shall report the situation to the student’s Clinical Placement/Practicum Supervisor and/or the Clinical Placement/Practicum Coordinator immediately following the session. If the student is concerned that the client is at MODERATE or HIGH risk of suicide, then the student shall contact the student’s Clinical Placement/Practicum Supervisor and/or the Practicum Coordinator immediately (PRIOR to the end of session and release of the client). If the client is determined to be at IMMINENT risk for suicide, then the student shall phone the country’s emergency number and then proceed to contact the student’s Supervisor and/or the Coordinator as soon as possible.
5. If the student requires immediate assistance and a Supervisor or Coordinator is not available, then the student shall contact the Clinical Manager or Clinical Director. If the disclosure is made to a CiiAT staff member, Art Therapy Supervisor or Clinical Placement/Practicum Coordinator, then the student shall report to the Executive Director.
6. If the student intern or a CiiAT staff member, Supervisor or Clinical Placement/Practicum Coordinator requires immediate assistance with a client who is disclosing risk of suicide, and the Executive Director, Clinical Director, or Clinical Manager is not available, and the client is under 18 years old, then contact the agency necessary and insist that immediate assistance is necessary. Do not take a message. Request the Team Leader or a Mental Health Clinician. If the client is 18 years or older, then contact Mental Health and Addiction Services that exist in that country.
7. After the completion of a Suicide Assessment Interview, if the client is under 13 years old and at low, medium, high, or imminent risk of suicide, then inform the client that the parents will be contacted about the disclosure. If the client is 13-18 years old and is at medium, high, or imminent risk of suicide, then inform the youth that their parent/guardian will be contacted about the disclosure. If the youth is at low risk and is extremely concerned about notifying the parent, then inform the youth that confidentiality will be maintained unless risk increases.
8. Complete all necessary steps on the Suicide Safety Plan. Consult with the Clinical Placement/Practicum Supervisor and/or the Clinical Placement/Practicum Coordinator, if necessary.
9. Document the disclosure and steps taken in the intervention on the Suicide Safety Plan and in the session notes. Have this completed form signed by a CiiAT Director or the Clinical Manager. Submit the completed and signed form to the client’s file.