Assessing for suicide and homicide is not a fun thing to do. That being said, as a clinician, it is a vital part of the job. A huge part of being a clinician means keeping the client and those in their life safe. To do this, it is important for the clinician to ask the tough questions to find out if their client is suicidal or homicidal in order to take the necessary steps to keep the client and others safe.
Assessing for suicidal and homicidal ideation is important to do, even for little ones. But do you assess for suicidal and homicidal ideation in small children? This post will provide you with the answer.
When I am assessing for suicidal ideation, I generally ask my clients “have you felt that you have wanted to kill yourself or no longer want to be here?” I ask similarly for homicidal ideation (“have you felt that you wanted to kill someone else or no longer want them to be there?”). If they say yes, I check for a plan and accessibility to the plan.
That being said, it is common for little ones (ages 3-6) to not to want to talk about such difficult topics. I tend to get through to them by using these two tools.
One of the first things that I use is my “yes” and “no” sheet. I even laminated it because I use it so frequently! If a child does not verbally answer your questions about suicidal and homicidal ideation, it can be helpful to provide them with this above sheet so that you can get your answers, but they don’t need to feel incredibly vulnerable and say everything out loud.
The second thing that I use is my barometer sheet. This sheet is used even more frequently than my “yes”/”no” sheet, so you bet it is laminated! This barometer is great because it can help with assessing suicidal and homicidal ideation, but also with other aspects in therapy, such as how angry the child is, how scared they were in a certain situation, how much a certain coping skill helped, and so on and so forth. I generally use this scale with my older kids (ages 6 and up) in order to see where exactly their thinking is with suicidal and homicidal ideation.
There you have it! My two go to tools to assess suicidal and homicidal ideation in my little ones. Do you have a method that you like to use when assessing safety concerns in early childhood clients? Tell me about it in the comments below!
In the meantime, Play On!