Over the past decade suicide mindset rates have significantly increased in the United States. A suicidal mindset is a serious problem and can happen to anyone. Suicidal mindsets do not always equate to mortalities, regardless these numbers have trended upwards spanning across varied age groups and greatly impacting middle aged adults, young adults and even teens. According to 2020 reports from the Substance Abuse and Mental Health Services Administration (SAMHSA), 12.2 million adults seriously thought about suicide, 3.2 million made a plan, and 1.2 million attempted suicide.

Many people who are considering suicide do not easily confide in others, and may be struggling through trauma, depression or intense stressors which they find are difficult to handle or manage. Professional support is always a great option to assist them during these times so encourage them to talk to someone. Whether you know someone or whether this is just for informational purposes consider the following to support someone who may be struggling with a suicidal mindset.

• Reach out to the Suicide and Crisis Lifeline, text or call, 988.
• Call 911 or transport them to the nearest hospital.
• Reach out for mental health services.
• Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

We can also learn to be vigilant of the possibility someone close to us may be struggling with a suicidal mindset.

Pay attention to their language and behavior

If a person is talking about suicide, take them seriously. Do not dismiss them or their concerns as a sign of weakness or immaturity; this could lead them to feel even more hopeless and helpless. Take notice of suspicious behaviors of someone who has expressed suicidal ideation, such as:

• Frequent changes in personality or mood.
• Increase in substance abuse.
• Withdrawal from friends and family.

Do not leave a person who has expressed suicidal feelings alone, even for a moment.

If you see a person whom you feel is “high risk,” and are worried they may engage in unsafe behaviors do not leave them alone; no matter how much it may seem like the person wants to be left alone and even if that person indicates that they do want to be left alone.

Get involved and use “active listening.”

Active listening is a skill that can be learned. It’s more than just hearing what the other person is saying, it involves paraphrasing and summarizing what they’re saying so you can truly understand their point of view.

If you’re having trouble figuring out how to use active listening effectively, try these tips:

• Listen intently with your eyes closed: this will help keep your focus on what they’re saying instead of getting distracted by other things around them (like their appearance).
• Paraphrase back after each sentence or thought without interrupting them: this will help them feel heard and understood by showing that you took in their entire thought process before responding with something like “I see.”
• Encourage them to talk about it and to express their feelings: If the person you are with wants to speak, listen without judgment and try to understand their point of view. Do not judge what they say or how they feel; instead, just be there for them and let them know that you care about them.

Conclusion

You can help someone with a suicidal mindset by listening carefully to them, being there for them, and showing that you care. Be sure to take action if you suspect a person might be at risk of suicide. If possible, find out what the person needs before making any decisions about what steps should be taken next. Let’s care for our loved ones and communities. Let’s learn and grow together and spread the word to everyone you know!

Progress notes…in the helping field we certainly do hear that term a lot. Therapists everywhere rely on progress notes to record and manage client records as service unfolds. Every session, from one to the next, reveals client challenges and progress. Documenting progress notes help monitor the details of these sessions, help collect clinical information, and highlight those challenges and/or progress seen in treatment, ultimately paving the direction of future treatment. Reality is that therapists will have multiple clients in a day, in which progress notes help keep information current, individualized, and organized.

Sometimes unknown, is the fact that there are different formats that can be used to structure progress notes. Three, best practice, progress note formats, may vary depending on your region, include the DAP (Data, Assessment, Plan), the SOAP (Subjective, Objective, Assessment, and Plan) and the BIRP (Behavior, Intervention, Response and Plan).

Regardless of which format is used the progress note should still capture key elements; 1) Important gathered information about presenting problem or behaviors, 2) Assessment inclusive of your professional opinion regarding how the session went or your interpretation, techniques and methods used during the session, and the responses received to the therapy as a whole, and 3) Addressing the next objectives.

As such, these various progress note formats are aimed to help professionals in the field monitor the progress of their clients in an efficient and effective fashion. It is a tool designed to help reduce time spent on documentation. It can also aid in facilitating communication with all other involved providers and yield valuable insight for collaboration purposes. Which is why it is also important to remember progress notes are a part of the client’s official record and subject to be shared/viewed by others.

Progress Note Documentation Method:

The progress note documentation method can be broken down into three or four sections dependent upon the format being used. Today, we are going to focus on the DAP format, we will look at the SOAP and BIRP formats at another time.

The DAP uses three boxes:

Data

The data section of the progress notes is the objective recollection of the session. This is where you capture information that was gathered, as well as, everything that was observed and heard during the session. This section should be used to capture information like behavior, dispositions, and responses. Though primarily objective, subjective recollection is at times seen when referencing observations of behaviors. For example: “Client appeared irritated when asked about a sensitive topic.” (subjective) versus “Client reacted to a sensitive topic by tapping their foot.” (objective) 

A good rule for this section is to ask yourself: What did I observe?

Assessment

In the assessment section of the progress note you’ll want to assess and interpret the data section and provide a subjective interpretation. Here you are documenting your professional opinion about how the sent went. Your assessment of the client’s progress and response to treatment. This is critical to understanding the client’s progress toward the goal and future treatment plan decisions.

Questions to consider may include: Is the client making efforts towards achieving goals? Is the client engaged in treatment? What does the data mean?

Plan

The plan is the section that connects one session to the next.  In this section you’ll want to identify what is to be worked on, by you and/or the client, from now into the next session. At times, a “homework assignment” may be given for the client to work on in-between sessions. In addition, next session objectives are identified. It is also at times helpful to set a date and time of the next session appointment.

A question to consider is: What will be worked on next?

SUICIDE PREVENTION AWARENESS MONTH

If you or someone you know is actively suicidal or in need of emergency attention, call The National Suicide Hotline at 1-800-273-TALK (8255) or call 911 immediately.

September is Suicide Prevention Awareness Month, a dedicated time to raise awareness to a social issue that is highly stigmatized, often ignored and overlooked, and at times considered a taboo topic. Though September is the recognized and dedicated month to this mental health condition let us be conscious enough to practice recognizing, supporting, and talking about this mental health issue, and those who are affected by it, regularly, increasing public awareness and creating a shift in public perception and support.

Suicide ranks high as a top cause of death in the U.S. It crosses many demographic populations including age, gender, religion, and sexual orientation. Though some groups are at a higher risk, it is important to be knowledgeable and aware of warning signs and risk factors so that help can be rendered when needed.

Recognizing warning signs is important, as it can assist in identifying someone who may be in need of help. Warning signs include, but are not limited to:

• Talking about or being preoccupied with death, dying, or killing oneself
• Talking about feeling hopeless and/or helpless
• Talking about being a burden to others
• Increased substance use
• Sleeping too much or too little
• Mood swings
• Withdrawing from family and friends, or isolating oneself
• Giving away of possessions
• Saying goodbye

Risk factors are also important as they identify whom may be more likely to affected. Risk factor considerations include, but are not limited to:

• Family history of suicide
• History of mental illness
• Substance use
• History of trauma or abuse
• Prolonged stress
• Gender identification and/or sexual preference

Suicide impacts more than just an individual, it also impacts family, friends and their community. Being aware of the resources available empowers us all to be able to do more for our loved ones.

In the event of a crisis immediately call 911 or the National Suicide Hotline at 1-800-273-TALK (8255). If a phone call is not an option reach out via text: Text NAMI to 741-741.  In a non-emergent event seek out the help of a trained mental health professional.

Let’s care for our loved ones and communities. Let’s learn and grow together. Share the information with those you know.