Last Updated on June 29, 2020
The news and media reports have a significant impact on human behavior. The human services community is no different and clients who already have mental health challenges may actually be even more impacted by what they see on television. In recent months, the reports of gun violence have sadly become common place in our society. Often times our clients are influenced by this behavior and think it’s acceptable to make homicidal threats. It’s times like these when we as human service professionals need to reevaluate how we deal with client threats.
I recently had an encounter with a client who threatened to
get a gun and shoot everyone that did him wrong. I didn’t feel threatened due
to the working relationship with the client for several years (And after I
confirmed he didn’t have a gun). In hindsight I should have explained the seriousness
of these threats a little more than I did at the moment. Here are some general rules to follow when working with a client who is presenting threatening behaviors:
Take every threat
seriously: It’s critical to take every threat seriously no matter how minor
it may seem. We should take it seriously
even if we are 99% sure that the client has no means or capability to carry out
the threat. The one percent chance of
something happening is too much to risk.
Call emergency
services: Emergency services should
be contacted immediately upon receiving any kind of threat. In situations when you’re
in a client’s home, be sure to get out of the home and get to a safe place to
make the call. Emergency services can send out a trained clinician to assess
the situation. Many cities also offer the assistance of CIT police officers who are trained to work with the mentally
disabled. These offers often accompany
the clinician to perform the evaluation if there is any threat of a violent
confrontation. If it is determined that
the client is a legitimate danger to self or others, the clinician may request
a petition from a magistrate to have the client temporarily detained in a
psychiatric hospital. This process is often referred to as a TDO or Temporary Detention Order. In
cases that do not rise to the TDO level, a safety plan
is often put in place to prevent further escalation of the situation.
Contact CPS and APS as needed: Adult Protective Services (APS)
and/or Child Protective Services (CPS) may also be contacted to determine if more
services need to be implemented to prevent unsafe behaviors. CPS would also be
involved if there are children in the home that could be put in harm’s way. Of
course, case managers, emergency services clinicians as well as police officers
are considered mandated reporters and have are obligated to report these
events.
Document incident
according to agency policy: Of
course last but not least, document all events according to agency policy as
well as any local and state regulations. This will likely include internal
incident reports and progress notes in the client’s record. It is critical that all parties document the
behavior. This creates a “paper trail” of events that can hopefully make it
easier to prevent more catastrophic events in the future. It also provides
history that can be used for treatment and recognizing triggers that may lead
to the behaviors. Documentation provides
proof that all regulations and policies were followed, as this information
could potentially be used in court.
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