Tag Archives: sommers-flanagan

Suicide Assessment and Intervention

You Are One In A Million

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While I blog away, WordPress counts things. I don’t exactly understand how it works, but apparently my little blog just passed the 1.0 million visitor and 1.5 million views thresholds. Wow.

You may be wondering, what does passing that million-visitor pinnacle mean, and why is JSF sharing about his blogging achievements?

The answer to that important question is: All this means it’s time to celebrate!

In honor of this blogging achievement, I’m doing what bloggers are supposed to do. I’m honoring my million visitors by giving out five free books.

To “win” a book, all you have to do is post here, a nice, supportive, celebratory comment of at least 20 words about this blog. If you’re one of the first five to post a comment in response to this historic blog celebration, you should also email me your best mailing address. Then, if you’re quick at the blog commenting draw, in the next couple weeks, you will receive one shiny new copy of the exciting thriller titled, “Suicide Assessment and Treatment Planning: A Strengths-Based Approach” by John and Rita Sommers-Flanagan.

Thanks for following and reading my blog. Today’s news means, quite literally, that “You are one in a million!”

I very much appreciate your support. I hope you’ve enjoyed, or appreciated, or at least not hated my idiosyncratic and sometimes irreverent posts.

Best,

John S-F   

Clinical Interviewing

IS PATH WARM – An Acronym to Guide Suicide Risk Assessment

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Suicide Risk Factors, Acronyms, and the Evidence Base

[This is adapted from our forthcoming 5th edition of Clinical Interviewing]

In 2003, the American Association of Suicidology brought together a group of suicidologists to examine existing research and develop an evidence-based set of near-term signs or signals of immediate suicide intent and risk. These suicidologists came up with an acronym to help professionals and the public better anticipate and address heightened suicide risk. The acronym is: IS PATH WARM and it’s outlined below:

I = Ideation

S = Substance Use

P = Purposelessness

A = Anxiety

T = Trapped

H = Hopelessness

W = Withdrawal

A = Anger

R = Recklessness

M = Mood Change

        IS PATH WARM is typically referred to as evidence-based and, in fact, it was developed based on known risk factors and warning signs. Unfortunately, reminiscent of other acronyms used to help providers identify clients at high risk for suicide, in the only published study we could find that tested this acronym, IS PATH WARM failed to differentiate between genuine and simulated suicide notes (Lester, McSwain, & Gunn, 2011). Although this is hardly convincing evidence against the use of this acronym, it illustrates the inevitably humbling process of trying to predict or anticipate suicidal behavior. In conclusion, we encourage you to use the acronym in conjunction with the comprehensive and collaborative suicide assessment interviewing process described in our chapter in the Clinical Interviewing textbook. See: http://www.amazon.com/Clinical-Interviewing-2012-2013-John-Sommers-Flanagan/dp/1118390113/ref=sr_1_1?s=books&ie=UTF8&qid=1373655813&sr=1-1

After talking about IS PATH WARM in workshops over the past year or so, it seems important to emphasize that these “risk” factors are near-term risk factors. Other, very important longer-term risk factors, are not included. For example, previous attempts and clinical depression aren’t even on the list. And, although they include withdrawal, it seems that words like isolation or loneliness capture this dimension of risk at least as well.

The point of my criticism is to emphasize that even the best suicidologists on the planet struggle in their efforts to identify the most important immediate and longer-term suicide risk factors. This is primarily because suicide is nearly always unpredictable and one of the reasons that it’s unpredictable is because it occurs, on average in the U.S. in 13 people per 100,000. The other side of this dialectical coin is that, of course, we need to try to predict it and prevent it anyway.

You can check out more details about IS PATH WARM on many different internet sites, including a description of its origin provided by the American Association of Suicidology: http://www.suicidology.org/c/document_library/get_file?folderId=231&name=DLFE-598.pdf