Mental Health Risk Assessment and Suicide Precautions

What is a mental health risk assessment?

A risk assessment is a type of mental health exam. Risk assessments are done when patients do or say something that makes their family or our staff think they might be planning to hurt themselves or others. A risk assessment helps keep everyone else safe.  

During this exam, the mental health provider or team talks with your child to learn more about them and their situation. This helps us know whether your child is at risk for self-harm or for hurting others.  

A risk assessment helps our staff: 

• Make sure your child is safe right now 
• Identify anything that puts your child at risk for self-harm or hurting someone else
• Plan steps to help keep your child and others safe when risk is present
• Decide if your child and family need more help or extra mental health support
• Determine the best place for your child to get more mental health care, if needed 

Types of questions asked during a risk assessment

During a risk assessment, your child is asked about their thoughts, feelings, and behaviors. Staff will ask about thoughts or plans of hurting themselves or others.

Some questions might be asked more than once or by more than one person. Repeating questions and listening carefully to the answers gives us important details about what your child and family need. 

Why a risk assessment is needed

Most children, teens, and young adults who hurt themselves or someone else show warning signs before they act. These signs may include making comments or doing things that others might think they did not mean. 

You might think that your child did not really mean what they said, or that St. Jude staff did not understand the situation. You could be right, but we will still do a risk assessment to be safe.

The assessment is an important part of keeping your child and others as safe as possible. We also want to make sure you and your child get all the help you need. 

What to expect from a risk assessment

A risk assessment can take several hours, depending on your child’s needs. Your child will not be left alone during this time. Staff will also take some items (e.g., extra cords, sharp objects, etc.) out of the room to enhance safety. We might need to talk to health care providers in Memphis or your home community. We might also need to talk to your insurance company to find services they pay for in your home community.

St. Jude staff works as quickly as possible to make sure your child is safe, stays safe, and gets all the help that is needed.  

If the risk assessment shows that your child is not at risk right now: 

• We might make a safety plan with your family. 
• We might help you and your child find more help, such as counseling. This could be in your home community or with a St. Jude psychologist, psychiatrist, or social worker you already know. 
• Your child might not need any more help beyond coping skills and support resources for emotional and mental health. 

If the risk assessment shows that your child is at risk:

• We might arrange for your child to go to a hospital or clinic for mental health care. This is because St. Jude does not have a mental health care unit for children and teens who need help quickly. You might be able to take your child to the mental health hospital or clinic, or they might go in an ambulance. Our staff wants to make sure your child is safe while going to the hospital or clinic. 
• If your child cannot leave St. Jude because of their medical condition, they might be admitted as an inpatient to St. Jude. Our staff will watch your child at all times until they are no longer at risk or until they can go to a mental health hospital or clinic. 

Suicide precautions

St. Jude staff members aim to keep you, your child, and our staff safe. We take certain actions if we believe children might hurt themselves or others. These actions are called “suicide precautions.” 

We will tell you if we use suicide precautions for your child. We will also give you written information on suicide precautions. 

When we use suicide precautions

Suicide precautions are used when patients answer routine screening questions in a way that identifies a potential for self-harm or harm to others. Suicide precautions also are used when patients:

• Do something to show they might hurt themselves or someone else 
• Say they have thoughts of hurting themselves or someone else 
• Have plans to hurt themselves or someone else 
• Are at high risk of accidentally hurting themselves or others 
• Show more signs of hurting themselves than they have in the past, such as pulling out their IV lines or disconnecting medical equipment 

Examples of suicide precautions

Steps we will take to keep your child and others safe may include:  

• Check your child’s room for any objects that could be dangerous.
• Take unsafe objects out of the room. These might include pens, pencils, scissors, wire hangers, plastic bags, and medical items with cords. 
• Ask you to take certain objects from your child, including personal items. These might include lighters, pocketknives, belts, medicines, nail files, and anything with wires. We can help you check for other objects that could be dangerous. 
• Ask about the objects you have with you. We will ask you to remove anything your child could use for self-harm or to hurt someone else. You may take the object home, or we can help you put it where your child cannot get it. 
• Always have a “sitter” with your child to keep them safe. The sitter might be a nurse, a patient care assistant, or someone else who works with St. Jude. They will be with your child at all times, even in the restroom. We understand this might make your child uncomfortable, but we need to make sure your child is safe. You can expect the sitter to be professional, respectful, and understanding. 
• Bring your child’s meals in paper dishes and cups. We might ask your child to order food they can eat without a fork, knife, or spoon. Or we might allow your child to use a plastic spoon. We will take this away as soon as your child has finished eating. 
• Watch your child take any medicines we give them. 

We will do a formal review of your child’s safety and risk at least once a day. We will also tell you when it is safe to bring certain items back to your child or their room. 

Why we use suicide precautions

Suicide precautions are used to ensure we keep our patients safe. If the mental health clinician who did the risk assessment decides that suicide precautions must remain in place, it means they are necessary for your child’s safety, other people’s safety, or both. 

Most children, teens, and young adults who hurt themselves or someone else show warning signs. We take these signs seriously because we have found they could result in harm to your child or to others. 

We know that you can watch your child closely, but using a sitter allows you to eat, sleep, care for yourself, and focus on being your child’s caregiver.

How long we use suicide precautions 

We are always working to keep your child safe. The precautions will end when the mental health clinician decides that your child is safe without precautions. Or they will end when your child goes somewhere else for care. 

More information about risk assessment and suicide precautions

If you have questions or concerns, please contact the person or people on your child’s care team who reviewed your child’s safety and risk level. We want you and your child to understand how we assess risk, why we use suicide precautions, and how these actions help keep your child and others safe. 

You may also call the St. Jude Psychology Clinic at 901-595-3581 and ask to speak to the “Doc of the Day.”