Respond to two colleagues by proposing an intervention that would address the indicators identified. Explain the potential impact of social work interventions such as this on adolescents’ lives. How might Stephanie’s adolescent life have improved with this intervention? 

1JO- 

The first question I would have asked Stephanie when she was experiencing suicidal ideation as a teen is: Do you have a plan? It is critical that a worker not shy away from this difficult question (National Alliance on Mental Illness, n.d.) because it could mean the difference between life and death for an adolescent. I worked as a registered nurse on a behavioral health unit in the past and this was always one of the first questions we asked our patients. Part of my job was to assess patients in the emergency department before admission to the BHU. Unfortunately, however, most adolescents who complete a suicide attempt do not have a mental health diagnosis (Udoetuk et. al, 2019) so they are not in contact with a mental health professional.

I would have also asked Stephanie whether she had access to any lethal weapons such as guns or pills. Not having access to these items is a significant protective factor (Udoetuk et. al, 2019). My 19-year-old son shot himself in the head in December, and I will spend the rest of my life regretting the fact that I did not fight him harder to get the gun away from him that was his prized possession, given to him by his grandfather. My son’s suicide was an impulsive act, and he would still be here today if he had not had access to a loaded weapon. He had been working for months to get into the army, and died just days before that was set to happen. There is no possible way his act was pre-meditated. The gun was there, he had an impulse, and that was the end of the story.

My other son (30 years old) stabbed himself in the throat and laid in the snow and bled to death before someone found him the next morning. Even though the boys were not in contact, they somehow both chose the same night to go. In retrospect, all of the signs were there with my older son. He had frequent somatic complaints, sleep disturbances, anxiety, depression, and increased substance use, increased anger, and withdrawal from family (National Alliance on Mental Illness, n.d.; Udoetuk et. al, 2019). He was angry and withdrawn from me at the time of his death which is why I wasn’t there to save him. Another of my life’s biggest regrets. If Stephanie had shown these symptoms, I would have recommended a stay in a short term mental health facility, at the least, and then helped her come up with a long-term maintenance plan to help her deal with her issues.

Stephanie stated she is bipolar. Given the fact that many adolescents who complete a suicide attempt do not have an official mental health diagnosis, it does not mean they do not have an undiscovered underlying condition. I would have taken the steps necessary to ensure that all of Stephanie’s conditions were diagnosed so they could be properly treated. I believe both of my boys had ADHD; I have it and so does my daughter. I was only recently diagnosed at the age of 47 after it was too late to save my sons from its devastating effects. If I had known I had this, I would have researched it and realized it was hereditary. I believe ADHD caused my younger son’s death by impulsivity and I believe it caused my older son’s death because he was abusing substances in an attempt to self-medicate his symptoms.

2SO- 

Suicide represents a significant and concerning issue among youth, with alarming statistics indicating its prevalence. It's distressing that a substantial percentage of young individuals who experience suicidal thoughts or behaviors do not receive adequate treatment. Social workers, due to their presence in diverse settings like schools, shelters, and mental health agencies, play a pivotal role in identifying and treating suicidal youth. Over the past decade, attachment-based family therapy, integrated cognitive behavioral therapy, and dialectical behavior therapy have shown promise in reducing suicidal ideation and attempts in young people. This article aims to review the theoretical foundations, conceptual frameworks, and key intervention techniques of these three therapies, enabling clinicians to effectively integrate them into their work with suicidal youth and families. Throughout this review, practical implications for practice are interwoven.

As the school social worker during Stephanie's time of suicidal ideation, my approach would involve vigilant observation of her behavior for potential warning signs, underpinned by empathy and compassion. I would closely monitor indicators of emotional distress, such as isolation, mood fluctuations, and social withdrawal. If her academic performance were to suddenly deteriorate, I would consider it an essential cue to explore her emotional well-being further. Also, I would remain attentive to changes in her self-care routines and appearance, while also being attuned to expressions of hopelessness or negative thoughts.

 I would initiate open, non-judgmental conversations, creating a safe and supportive environment in which Stephanie could openly share her thoughts and experiences. By expressing genuine concern and seeking to understand any shifts in her behavior or mood, I would aim to uncover the underlying challenges she faces in coping with daily life. If she were to disclose feelings of hopelessness or thoughts of suicide, my top priority would be her safety, necessitating the involvement of appropriate professionals or support networks. My overarching goal would be to provide the necessary assistance and resources, ensuring Stephanie receives the comprehensive support required to navigate her difficulties and move toward a healthier and more stable well-being.