Dr. Sommers-Flanagan’s suicide risk assessment is the true breakthrough in the field of suicide therapy. Its key strength lies on the surface – it is the shift from a solely medical approach towards sociologist approach meaning that more efforts are applied to determining and understanding various reasons and motives behind suicide ideations. It is rather problematic to name any weaknesses in this approach; I would rather speak of limitations rather than weaknesses, in this case. One possible limitation that might be pointed out in this respect is that Sommers-Flanagan’s suicide risk assessment relies on the premise that understanding the reasons and motivation is the clue to understanding the prevention strategy. Yet, unfortunately, this is not always the case. In this regard, there is a very curious book on this theme called Life at the Bottom: The Worldview That Makes the Underclass.

In this book, Theodore Dalrymple, a recognized British doctor and psychiatrist provides many examples of a situation when the reason lies on the surface and, yet, little can be done to save a person’s life because the specialist is helpless in terms of helping the patient in solving his or her problems that lie at the roots of the suicide ideation (e.g. an Indian girl that wants to commit suicide because her family says she has to marry her husband, while she wants to finish school and enter the University; if she refuses to, her family’s good name will be besmirched and so her mother will have to commit a suicide). However, contrast to other sources that I located on this theme, Sommers-Flanagan’s suicide risk assessment seems to be the most effective because all other approaches that I examined (those that he calls traditional medical model approaches) perceive suicide ideations as a deviation what is a misleading way to address the problem because it unreasonably narrows down the target population and creates unfavorable implications of suicide (suggesting that those who think about it have some mental problems).

If I were Dr. Sommers-Flanagan, my emotional response to Tommi’s revelations would be mixed and complicated. The first response would be, probably, a surprise mixed with puzzlement. Further on, however, I would do my best to differentiate my sentiments from the professional conduct that I am supposed to demonstrate: I would hide the former and rely entirely on the latter. One of my first steps, as his social worker, would be to develop an effective and consistent safety plan. To do it, I would want to have a detailed interview with Tommi after which we would make a list of those things that help him regain the positive reinforcement when he thinks about suicide. Moreover, we would make a list of those people who he can rely on in case of acute desperation. Other primitive aspects that this plan would include would be the list of professionals and emergency contact details. If we created a list for a longer perspective (e.g. a month), I would likewise create a plan of how to make his environment safe. This would relate not only to the physical subjects with which he can potentially hurt himself but likewise the abstract triggers that can make him feel worse all of a sudden.

The key assessment tool that I would rely on would be an interview because it is one of the most effective assessment instruments: it allows going into details and clarifying all the issues that seem to be vague or ambiguous. Additionally, it should help me to learn more about his cultural background so that I would better understand which cultural implications to consider. I think this method would work well, especially given that we would manage to build trustful relationships with time.