During my time working at a mental health hospital for adolescents, I worked with many families supporting a child struggling with a mental health diagnosis and too often I was asked how to keep a child safe and guarantee their safety after a recent hospital stay. As much as I wanted to give them ‘The Answer’, to provide them with solid direction ensuring their child’s uncompromised safety, I was unable. Sadly, there isn’t an answer that guarantees anyone’s safety regarding preventing them from acting on their suicidal urges. However, there are precautions. I can recall many conversations where I shared simple and effective guidance on interventions to greatly decrease incidences of a loved one’s success in engaging in self-harm. In this blog post, I will share with you an intervention called the House Survey, an intervention I shared with many parents to assist in creating and upholding a safe environment for their child.

While working at the hospital, I was required to meet with families and patients to discuss safety as part of a successful discharge. The basics of my speech encompassed recommendations instructing support persons to secure obvious means of self-harm, to include locking up all medications, firearms and sharps. My time at the hospital highlighted, that while securing these few items were effective, I had only identified a fraction of potentially dangerous items in the home. Considering this, I started sharing the details of a wonderful intervention called the House Survey. The objective of the House Survey is to spotlight as many means and methods of self-harm as possible specific to the individual patient as well the individual home. Additionally, biproducts of participating in the House Survey fosters teamwork and communication between patients and those supporting them.

The House Survey is comprised of a single and simple question, “Have you thought about hurting yourself in this room?”. The question is non-suggestive and unassuming. Through this inquiry, the patient’s perspective is at the forefront. The patient is able to share with support persons the narratives surrounding thoughts and urges relative to in home spaces. Specific to each patient and each home, it is important for support persons to understand the potential dangers relative to the patient. For example, I once had a child explain to his mother how the glass in the picture frames that displayed suspended moments of happiness throughout their lives, were triggers for his cutting behaviors. The mother was horrified and saddened. She had not considered her child’s urges to cut included breaking the glass out of pictures, frames that had captured him at some of the highest points of his life. The House Survey is a means of information helping support persons pinpoint potential dangers we may have never considered. And, if the question is “How do I keep my child safe?”, then the long answer is “Knowledge.”

The survey is carried out with the patient and a support person walking through each room of the house. The support person will ask the question, to which the patient will disclose thoughts, feelings and behaviors associated with self-harm in each room. It is important support persons keep the non-suggestive and non-assuming nature of the question as means of reducing inception of further self-harming thoughts. Support persons should also couple the questing with the request of relinquishing any hidden self-harming implements without consequence.

Regarding sustained safety, the House Survey is a form of information gathering. The survey provides support persons with insight into the thought process of a loved one’s self-harming urges. Such knowledge makes it easier to secure the means specific to the methods and significantly reducing acting on self-harm urges when thoughts are present.

SocInq understands the demands and nuances of supporting a loved one struggling with suicidal thoughts and urges.  We can help.  Contact us for a Care Coordination session and we will help you complete a home survey with your loved one.