Distress Map: Evolving distress has generic patterns that can provide a template for collecting individualised information. Understanding how people sink into DESPAIR is key.
Key Concept
O Assessment has a dual role, explore distress and capture hope
o Integrate multisource perspective on psychache
o Establish distress patterns and imminence of action
Key Principles
Gain Knowledge:
What are the different aspects of a comprehensive assessment?
What are the signs and symptoms of relevant mental illnesses?
What are the warning signs and fixed and fluid risk factors for suicide?
What is acute risk, chronic risk and acute on chronic risk?
Develop Understanding:
What are risk assessments trying to achieve?
What are the problems and how to avoid them?
How does distress evolve and why is it important to understand its evolution?
Why is it important to break down the drivers of distress into bite size chunks?
Where and when to call in more support?
Refresh Skills:
How to transform internal distress discourse into external distress dialogue?
How to develop common understanding of distress?
How to make reliable judgement calls on intent, motivation and immediacy?
How to engage family and friends in the assessment process?
How to gain an understanding of the balance between reasons for living and dying?
We must accept finite disappointment, but never lose infinite hope.
Martin Luther King, Jr.
There is a difference between giving directions and giving direction.
Simon Sinek
Enquire - Identify - Estimate
How to assess, collate and process the available information?
How to ground risk threshold?
Why useDESPAIR?
# Replicates usual assessment process - limited additional training requirement
# Enhanced rigour in enquiry and exploration through structure
# Minimal increase in assessment time
Why useDESPAIR?
# Crosscheck identifies gaps in history
# Follows logical sequence of how distress evolves in the suicidal mind
# Replicates normal conversation and lays the foundation for deep empathy
Why useDESPAIR?
# Balance facts and feelings
# Act of mapping and rating forces clinician to give due consideration to all the collated information
# Rating provides a degree of reliability and guidance for clear and imminent risk
Why useDESPAIR?
# Protect against creep, crash, crawl
# Stop undue influences and help navigate rational vs rationalising
# Conversation aid to modify dynamic risk factors and explain decisions