Duty to report suicide threat. If staff have reasonable cause to believe there is a need to release personal information without a written release in order to prevent a suicide from occurring, they should consult with their office director if available or senior staff person and then take appropriate action. Staff will document in the Task Notes in QE2 the action taken. The office director will review and approve documentation.

Suicide Threats/Warning Signs

People who are in danger of suicide often display warning signs.You may be in a good position to recognize these signs. Look for changes in behavior, personality, or mood.These signs/statements need to be taken seriously:

• Talking, reading, or writing about suicide or death.
• Talking about feeling worthless, or helpless.
• Saying things like, “I’m going to kill myself,” “I wish I was dead”, or “I shouldn’t have been born.”
• Less verbal cues, including “What’s the point of living?” “Soon you won’t have to worry about me” and “Who would care if I’m dead anyway?”
• Visiting or calling people to say goodbye.
• Giving things away or returning borrowed items.
• Uncharacteristically isolating themselves from others.
• Self destructive or reckless behavior
• Significant change in behavior including a sudden and unexplained improvement in mood after being depressed or withdrawn
• A sense of hopelessness about their current situation.

Appropriate Action When Warning Signs are Present

1. Specifically ask the individual if he/she is suicidal or having feeling of suicide. Probe their response to get a sense of the depth of the suicidal feeling. Inquire about any previous attempts at suicide.
2. Offer your support in obtaining help from:

   • A psychiatrist or other mental health professional.
   • Family doctor
   • Clergy or spiritual leader
   • Parents or appropriate family members, especially if the individual is a minor.

3. Offer the resources of a suicide hotline or crisis line. Initiate a three way phone call if your have that telephone feature.

   • 1-800-Suicide (1-800-784-2433) – National Hopeline Network (24/7 crisis counseling and referral)
   • 1-800-273-TALK (1-800-273-8255) – National Suicide Prevention Lifeline (24/7 crisis counseling and referral)
   • TTY1-800-799-4TTY (4889) – TTY USA National Suicide Hotline
   • 1-800-448-3000 - Girls & Boy Town National Hotline
   • 1-402-441-7940 – Community Mental Health Center of Lancaster County (24/7 crisis line and referral)

4. Consult with your office director if available or senior staff person.
5. Seek advice from any geographic emergency intervention resources.
6. If you believe a person is a danger to him/herself or others, call 911 for local law enforcement.
7. Report action taken to the office director if the office director has not already been involved.
8. Fill out a Suicide Call form and give to Office Director. Document the action taken in the Task Notes of the QE2 record. Office directors are to review and approve the documentation in the Task Notes.

Suicide Call Form