Risk Assessment Counselling - LGBT+ Counselling, Support & Awareness

Name of Client(required)

Date of Assessment(required)

Your Name:(required)

SUICIDE RISK ASSESSMENT:

Is there currently a suicide in progress?(required)

Yes – contact 999 immediately No carry on with the assessment

Q1 Does the client currently have any active thoughts?(required)

Yes – proceed to next question No = zero risk no need to continue with the suicide assessment enter n/a for remainder of section

Details of thoughts(required)

Q2 Does the client currently have a plan as to what they will do?(required)

Yes – medium risk – enter details and proceed to 111 assessment link below: No – risk remains low – GIVE VERBAL ADVICE TO CLIENT THAT IF THOUGHTS PERSIST, GET STRONG OR THEY MAY ACT ON THEM TO CONTACT 111/999 IMMEDIATELY

Details of plan(required)

If the answer to Q1 and Q2 above is yes, click here to complete an online assessment via 111: https://111.nhs.uk/

Detail here the outcome of the advice from the above 111 assessment:(required)

RELAY THIS INFORMATION TO CLIENT: Have they agreed/are undertaking action?(required)

Yes No – see next section

Based on the above, do you consider that the client is in danger, or a further risk to themselves or others?(required)

Yes – undertake the advice from the 111 assessment yourself, eg call an ambulance, etc No/Not applicable

Detail here the actions you have taken to mitigate risk of suicide(required)

SELF HARM RISK ASSESSMENT:

Q1 Does the client currently have any active thoughts?(required)

Yes – proceed to next question No = zero risk no need to continue with the self harm assessment enter n/a for remainder of section

Details of thoughts(required)

Q2 Does the client currently have a plan as to what they will do?(required)

Yes – medium risk – record plan and proceed to 111 assessment link below: No – risk remains low – GIVE VERBAL ADVICE TO CLIENT THAT IF THOUGHTS PERSIST, GET STRONG OR THEY MAY ACT ON THEM TO CONTACT CONTACT 111/999 IMMEDIATELY

Details of plan(required)

If the answer to Q1 and Q2 above is yes, click here to complete an online assessment via 111: https://111.nhs.uk/

Detail here the outcome of the advice from the above 111 assessment:(required)

RELAY THIS INFORMATION TO CLIENT: Have they agreed/are undertaking action?(required)

Yes No – see next section

Based on the above, do you consider that the client is in danger, or a further risk to themselves or others?(required)

Yes – undertake the advice from the 111 assessment yourself, eg call an ambulance, etc No/Not applicable

Detail here the actions you have taken to mitigate risk of self harm(required)

MEDICAL RISK ASSESSMENT:

Q1 Does the client currently have any medical issues?(required)

Yes – proceed to next question No = no need to continue with the assessment enter n/a for remainder of section

Details of above(required)

If the answer to Q1 is yes, click here to complete an online assessment via 111: https://111.nhs.uk/

Detail here the outcome of the advice from the above 111 assessment:(required)

RELAY THIS INFORMATION TO CLIENT: Have they agreed/are undertaking action?(required)

Yes No – see next section

Based on the above, do you consider that the client is in danger, or a further risk to themselves or others?(required)

Yes – undertake the advice from the 111 assessment yourself, eg call an ambulance, etc No/Not applicable

Detail here the actions you have taken to mitigate risk of medical problem(required)