In Paul’s case with suicide, both immediate and severe risks are present. He talks about wanting to make suicide again after his three previous attempts. He also mentioned to the doctor that if he had a gun, he could commit suicide – but he has sold it to pay his debts. Moreover, he feels hopeless and seems to have no reason to live according to his long silence on the doctor’s question about the things he has to live with.
Major depressive episodes, inability to get up after waking up, and starting drinking again after ten years of recovery from alcoholism constitute the warning signs in Paul’s circumstance. Significantly, the fact that he talks about being a burden to his daughter seems concerning. His feeling that he could not hit any lower in his life reflects his vulnerability and the sign that he seeks immediate psychological help. Moreover, his belief that he is worthless both as a father and as a person warns about his low self-esteem.
Notwithstanding the negative assessments mentioned above, some protective factors also exist. Most importantly, Paul has Alyssa, his daughter, and a close person who loves and supports him. Alyssa denies Paul’s statement that he was more of a burden to her than anything. Moreover, Paul also loves Alyssa and considers her somebody he has to live with, which might imply that he can stop thinking of committing suicide, at least for his daughter (Ellis & Bryan, 2020). Moreover, he has friends at Alcoholics Anonymous, who can be a significant source of support on his way back to everyday life.
I would rate the client’s level of lethality to lie between 5 and 6, which means that he can recuperate and leave suicidal inclinations. My recommended immediate intervention includes a safety plan, where I will send the patient home with a follow-up. I will take care of contacting social support, for example, his daughter and friends. In case his condition worsens again, I will consider hospitalization.
Reference
Ellis, T. E., & Bryan, H. (2020). Collaborative movement from “preventing suicide” to recovering desire to live. In Alternatives to Suicide (pp. 161-178). Academic Press.