Suicide Assessment and Intervention in Clinical Practice: Application of the 988 Lifeline Model

Available with English captions and subtitles in Spanish.

Gillian Murphy, PhD, presents as part of the 2023 Suicide-Focused Assessment and Treatment: An Update for Professionals course.

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Suicide Assessment in the Clinical Setting

In her talk, Murphy discusses the practical aspects of suicide assessment and prevention in a clinical setting. She describes the need for clinicians to receive training in the screening, assessment, and intervention of suicide. Murphy points out the importance of developing the ability to have open conversations and increased comfort in talking about suicide with patients who are at risk.

Watch now to learn more about:

  • Why some clinicians are unprepared to address suicide
  • How resources from the 988 Lifeline model can be applied to clinical practice
  • Why listening to a patient’s story is key to effective assessment

According to Murphy, too many mental health care professionals do not feel confident in assessing and having conversations with patients about suicide. Because of such discomfort, many patients cannot find the help they need.

“In my practice, I often get calls from individuals who say that they have reached out to three, four, or five clinicians before reaching me,” Murphy states. “As soon as these individuals mentioned either a history of suicide attempts or potential current suicidal ideation, that clinician did not accept them into their practice.”

Murphy, who previously worked for the National Suicide Prevention Lifeline, is currently a therapist in private practice. She often presents to groups of health care providers on how they can use the assessments and interventions of the Lifeline (now called the 988 Suicide and Crisis Lifeline) in their own practices.

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The 988 Crisis Lifeline is a network of over 200 crisis centers nationwide that are required to adhere to established clinical standards. These standards include how to assess an individual for suicide risk, how to ask effectively about an individual’s imminent risk for suicide, and how to provide the least invasive intervention for someone who is at high risk of suicide.

“The focus for crisis centers is on working with the individual to establish safety right now—to move away from a focus on ‘how do I talk to this person and try to predict outcomes’ to ‘how do I focus on talking to this person and engaging them in efforts on suicide prevention and immediate safety,’” Murphy explains.

She outlines how the 988 safety assessment model is divided into three distinct phases:

  • Connection
  • Central assessment phase
  • Follow up

Murphy says that when she talks with mental health professionals who are in private practice, she often focuses on step two of the model, in which the provider listens to the patient’s narrative, clarifies what the patient is saying, and plans for safety.

“The focus here is on allowing the person to tell their story, while also gathering information about the individual’s level of desire, their intent, their capability, and what buffers or safety measures are possibly in place,” she explains.

Resources

You may also find this information useful:

Learn more about the Current Status of Suicide-Focused Assessment and Treatment

About Gillian Murphy

Dr. Gillian Murphy is a licensed clinical social worker and psychotherapist. In her previous role as the assistant deputy director for the National Suicide Prevention Lifeline, now the 988 Suicide and Crisis Lifeline, she oversaw the development of national standards of excellence and clinical best practices in suicide prevention for phone, chat, and text-based services.

Now in private practice, Murphy works extensively with adults and teens at risk of suicide and non-suicidal self-injury.

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Mental Health Webinars

Suicide Assessment Workshop 2023