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Suicide and Suicidal Ideation

An important issue that is currently growing in its recognition and understanding by


society, is the issue of suicide and suicidal ideation. This diagnosis has existed for the entirety of
the existence of the human race, however only lately are people really making an effort to
understand and help people with these diagnoses. This support from other people and the
education aspect are highly important to the success and recovery of people with this diagnosis.
It is the main focus of therapeutic recreation to find ways to help people cope and succeed for
almost any disability or diagnosis.
Diagnosis
In order to spread the education of this diagnosis, it is vital to know what the meaning
actually is. As defined by the textbook, Recreational Therapy Handbook of Practice: ICF-Based
Diagnosis and Treatment, Suicide is the act of killing oneself and suicidal ideation is the
perseveration of thought of killing oneself (Porter, 139). Suicide is something that we as
professionals wouldnt really be able to treat, because at that point it is beyond our ability to
help. What we really want to do is watch for signs of suicidal ideation, because that is where the
process starts. It is important to catch this diagnosis early on, and it isnt always something that is
easily recognizable in a client.
Luckily, through the study of this diagnosis there have been signs and warnings
discovered that will help with diagnosing a client with suicidal ideation. In an article written by
the American Foundation for Suicide Prevention (AFSP), Risk Factors and Warning Signs, it is
said that Something to look out for when concerned that a person may be suicidal is a change in
behaviors or the presence of entirely new behaviorsMost people who take their lives exhibit
one or more warning signs, either through what they say or what they do (AFSP). So, in our
field of work this is something we can pay attention for. When you have a client, it is important
to get to know more about them, especially when it comes to this diagnosis. The more

comfortable a client is with their recreational therapist, they may be more willing to share
personal information. Some information you want to listen for is health factors, environmental
factors, and historical factors. Examples of these are depression, loss or grief, and previous
suicide attempts.
Another important aspect to this is the population of clients you are working with. As
stated in the Recreational Therapy Handbook of Practice, Suicideis most prevalent in
adolescents and the elderly (139). This means that one thing to pay attention to in the population
is the clients age. Another important factor into people who are more likely to commit suicide, is
how the population is viewed by society. Race, gender, and sexual orientation were taken into
account for the research reported in the article Suicide Ideation and Bullying Among US
Adolescents: Examining the Intersections of Sexual Orientation, Gender, and Race/Ethnicity,
their results showed that White and Hispanic gay and bisexual males, White lesbian and
bisexual females, and Hispanic bisexual females were more likely to be bullied than were White
heterosexual adolescents (Mueller, 2015). Meaning that there are many aspects you need to
consider when working with a population, and know who is possibly more at risk.
Overall, when working with the clients with these diagnoses you need to be
understanding. One approach to this is called Acceptance and Commitment Therapy (ACT), the
article by Murrell says that The goal of ACT interventions is to increase psychological
flexibility. Psychological flexibility is an individuals ability to fully connect with the present
moment and to behave in ways consistent with ones identified values (Murrell, 2014). This
however is only one approach, and there are endless ways to help the client. So long as you
express your care for the client and try your hardest to help them, that is what matters most.
Body Functions
Code and Name: b1265 Optimism

Optimism deals with the point of view and outward or inward emotions when it comes to
their view on life or specific situations. Such as if they hopeful or cheerful, or if they are
despairing. This category falls under the mental functions section.
This code is relevant to the diagnosis of suicide and suicidal ideation, because usually
when a client has little optimism about their life, they might not believe that there is any other
way to deal with how they feel. With the uncertainty of what comes with the future a client may
lose hope which leads to lack of optimism.
Code and Name: b1301 Motivation
Motivation is what drives a person to carry out an action or goal, and this also includes
developing the incentive to act. This is covered under the mental functions category.
This code is relevant to this diagnosis, because often the clients who are diagnosed with
this may also be experiencing mood disorders such as depression. With depression comes a lack
of motivation to get out and accomplish things, either because they arent as enjoyable anymore
or the client may not see the point in trying.

Code and Name: b1522 Range of Emotion


Range of emotion is how well a client is able to fully experience emotions, when the
range is inhibited that means that they might feel as many possible emotions or experience them
as intensely as is average.
Range of emotion is relevant to this diagnosis because of many clients also experiencing
mood disorders such as depression, and with that the client might not be able to fully express all
the emotions they would normally be able to. With this may come miscommunication and
misunderstandings between the client and the recreational therapist.
Activities and Participation
Code and Name: d240 Handling Stress and Other Psychological Demands
Basically this code deals with the clients ability to cope with different stressors and
aspects of life. This code is listed under the general tasks and demands category.

This code is very relevant to this diagnosis because it is one of the main causes of this
diagnosis. When a person may not be able to deal with what life is dealing them, things may
begin to seem hopeless and suicide might seem like the only option to the client. I used the broad
code because these subsections show up frequently in clients, sometimes multiple at a time.
Code and Name: d5702 Maintaining Ones Health
This encompasses how well a person is taking care of themselves, and focuses in on the
health aspect of it. Health is a broad term and can cover many different parts of daily life. This
code is listed under the category of self-care.
This code may not be entirely obvious to everyone, but it is applicable. This applies to
this diagnosis because self-harm is common among people with suicidal ideation and that is not
taking care of themselves and is harmful. Also, when it comes to other disorders that may show
up as well as suicidal ideation, sometimes basic health needs are not taken care of, such as
illnesses and diet.
Code and Name: d9205 Socializing
This code deals with how well a client is able to interact with the people around them and
ability to make connections.
People with this diagnosis may not know how to reach out to the people around them to
get help, or may not have people already there to help them should they need it. Also, the client
may not want to socialize as much as they use to because they dont want to hurt the people
around them, or out of fear that the people may not understand what they are feeling.
Environmental Factors
Code and Name: e325 Acquaintances, Peers, Colleagues, Neighbors, and Community Members
This code is under the support and relationships category. This deals with how physically
and emotionally supportive this population is with the client.
With this diagnosis many of these people are adolescents, and with this comes a lot of
pressure from their peer group. If the client doesnt have emotional support from their peers they
may feel isolated and alone, and feel like they have no one to turn to for help.

Code and Name: e465 Social Norms, Practices, and Ideologies


This code falls after under the attitudes category. It deals with the attitude of society on
what is considered normal and what isnt, usually based on what is most common within
society.
This code is relevant to the diagnosis because often there is a lot of pressure from society
to act or look a certain way. Our client may have been seen as outside of the social norm, which
can lead to less self-worth and the feeling of isolation. In many cases there is also a lot of
judgement and hate when it comes to social norms, and with hate comes a lot of stress and
negative emotions.

References
Mueller, A. S., James, W., Abrutyn, S., & Levin, M. L. (2015). RESEARCH AND PRACTICE.
Suicide Ideation and Bullying Among US Adolescents: Examining the Intersections of
Sexual Orientation, Gender, and Race/Ethnicity. American Journal Of Public Health,
105(5), 980-985.
Murrell, A. R., Al-Jabari, R., Moyer, D., Novamo, E., & Connally, M. E. (2014). An acceptance
and commitment therapy approach to adolescent suicide. International Journal Of
Behavioral Consultation & Therapy, 9(3), 41-46.
Porter, H. R., & Burlingame, J. (2006). Recreational Therapy Handbook of Practice: ICF- Based
Diagnosis and Treatment. Enumclaw, WA: Idyll Arbor.

Risk Factors and Warning Signs - AFSP. (n.d.). Retrieved February 26, 2016, from
http://afsp.org/about-suicide/risk-factors-and-warning-signs/

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