How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 161
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The following are examples of forms that can be utilize for crisis evaluations:
Maureen Malloy, R.N. Behavioral Emergency Outreach Program.
LETHALITY ASSESSMENT WORK SHEET
LOW LETHALITY
HIGH LETHALITY.
Vague,
indeterminate
plan
Method
undecided
METHOD
AVAILABILITY
TIME
Clear thoughts,
philosophical
Some specifics
Method: pills,
cutting
Method: CO,
oven gas, car
Method
unavailable
Can acquire
easily
Some effort
required to
No time
specified
PLAN
Specified
vaguely, within
weeks
1 or 2 gestures
Day and time
chosen, within
a week
Hx of many
threats,
attempts
Chronic
lethal
attempt
Major
depression
depression
Several
concurrent
stressors
Major loss or
conflict
Severe
illness or
injury,
Recent Dx
Alone, at
home, no
help nearby
Terminal
illness, Recent
Dx
Long term
existence
of several
factors
Suicidal
careers
PREVIOUS
ATTEMPT
No Previous
attempts
DEPRESSION
Feeling low or
blue
Mild depression
RECENT
LOSSES
No specific
stress
1 minor conflict
or loss
HEALTH
Physically
healthy
Transitory
illness
Disability or
chronic health
problems
ISOLATION
Others
present and
supportive
Roommates/SO
there
Others close
by
COMORBIDITY
No presence
jf 0 predictors
listed below
1 predictor
present
More than 1
factor
prese