Suicide threat

I am doing a favor for a friend. Sorry for the length.

Her former boss has asked me to post this scenario and get some input from the pro's.

A management member in a nursing home environment, several buildings involved - I don't know if it is one campus or spread out over one or more cities - was approached by one of the nurses. She and he and one other friend participate in triathalons, etc - so she knows him outside of work, if that matters.

She told him she was thinking about committing suicide. I don't know a lot of details except he did encourage her to talk to a mental health professional. A few days later he was in the building where she worked and had further discussions with her. Apparently she went into more detail; talking about financial difficulties, that she went into some more detail about her plans. They were all going to do a mini triathalon in March and she plans on the suicide in September.

He wonders about what more to do - she is a friend, an employee and he is worried about safety issues with patients, staff, etc.

My first though was to require a fitness for duty evaluation and to recommend an EAP program. My next thought was for the safety of patients she cares for on a daily basis, thinking that she might be a danger. I thought it might make sense to have this nurse, her supervisor and this management guy sit down and evaluate her from a patient safety standpoint.

This manager does not have access to any staff mental health professionals, so I suggested a discussion with the local suicide hotline folks thinking they might be able to steer him a bit.

Well that's the long story - as you can tell, I need some input and will pass your comments along.

Thanks.

Comments

  • 8 Comments sorted by Votes Date Added
  • Tough one. Usually, suicides don't come with a "warning" or threat; that's why they're so devastating. That's not to say her talk is not serious, and shouldn't be taken so. All your friend can do is encourage her to seek help; if the employer has an EAP, alert them. I wouldn't think patient safety is at issue unless she's palming meds from them and storing up for the deed, then that is a problem. Your friend should talk with the HR Director and the Risk Manager at his facility. An 'intervention' may be in order; and from a patient safety perspective at minimum an audit of patient and pharmacy records. Ultimately, her choices are her own and if she refuses to seek help, not much else he can do but continue to listen and encourage. He should not, under any circumstances, begin to think or feel that he is responsible for her or her problems or her ultimate actions.


  • This scenario is so similar to a phone call I got yesterday. It's been weighing on my mind. I don't work w/ the lady but have known her a little more than casually for five or six years. She is planning to take herself out this summer so as not to ruin her family's Christmases forever.

    She also works in patient care. She's unwilling to hear any solution other than suicide. She says that's the only thought that calms her fears of everyday living and being alone. I feel helpless...and "responsible" to solve her problem.
  • Gosh, You are both in NV, could this be the same person? Also, I read that Tony Dungy's son James comitted suicide last night. He was 18. Such a tragedy.
  • Absolutely get this person in touch with a mental health professional. In South Dakota, we have community mental health centers (non-profits) that serve all areas. Do not assume just because she is giving notice that she will not do it. If I were the employer, I would make it mandatory for her to see someone and follow their recommendations for treatment.

    Good luck -- this is tough.
  • I don't diagree that there are legal ramifications and especially with privacy information in today's world. However, how would they be able to live with themselves if this happened and they didn't take some action.
    1. If available, get in touch with EAP and have them call the employee.
    2. Is there any family involved that they could talk with. Sounds as if the employee is "begging" for help or wouldn't be publicizing it.
    3. See if they can "talk the employee" into going to the appropriate doctor, even volunteer to go with them if necessary. (Can get leads from their insurance company if need to.)
    4. If employee doesn't do anything and is till discussing it, I would even consider calling the police or someone and have them taken off to a hospital for evaluation or help. Again, I don't know the full relationship... but GET HELP.

    E Wart
  • A troubling dilemma! I think E Wart offers some good suggestions, but I would add a few caveats.

    EAPs, unless they are operated by internal personnel, operate "passively"-- i.e., the individual must take the initiative to seek help, the EAP will normally not come looking for those in need of help. And it doesn't sound like she's likely to seek it on her own.

    She's a nurse-- so I would assume that she's working in a helathcare organization of some sort. If there are qualified shrinks on staff, your friend's boss might go to HR or whomever WILL have direct access to an on-staff shrink, and try to enlist the shrink to participate in an intervention. Or ask the shrink to be available if the boss can get her to go with him to see the shrink.

    Calling police or rescue should be the absolute last resort. Someone she told her suicide plans to would have to provide that info to authorities, and probably have to testify in court in a commitment hearing-- a very ugly way to go!

    Just on common sense, It seems to me that someone intent upon killing themselves would go to any length to keep their plans secret from EVERYONE, lest someone try to interfere and stop them. And so, I have to agree that her telling someone of her plans is in fact a "cry for help". Most likely, she is someone who feels she is powerless to improve her situation, and is trying with her threats of suicide to enlist someone else to take responsibility for her life-- to "rescue" her. That puts both her and the "enlistee" in a very bad situation.

    I fully agree that no one should allow themselves to be sucked into this by taking on themselves any feeling of responsibility for her actions, whatever they might be. Doing so will not be of any benefit to either party....and might actually be harmful to both. Sounds pretty grinchlike, I realize....but I believe some situations just call for a "tough love" approach, and I don't believe that any one of us mortals can successfully rescue another person from their own life situation. If I want my life to change, I need to be the one who takes action to change it, no one else can do it for me.


  • Odd, isn't it? She sounds like she's made concrete plans, which is one of the ways you can judge the lethality of her intent, but then seems very willing to divulge her plans to someone in management, which she has to know will trigger some kind of intervention. Actually, I think you've already outlined a fair course of action, although I think the primary concern should be the safety of her patients, and my future actions would hinge on that point. Is assisting a suicide a crime in your state? The reason I ask is because the fact that your friend's former boss had prior knowledge of the event might put him at legal risk.
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