Mental Health/Suicidal Ideations or Attempts

  • Question:

    Given the information about the 26-year-old male applying for an unarmed security officer position, who has a family history of bipolar disorder, reported symptoms of depression, and experiences auditory hallucinations (hearing his deceased grandfather's voice), along with personality test elevations in psychotic experiences and thought disorders, what would be your recommendation regarding his suitability for the position?

    Answer:

    Based on the details provided, the individual's symptoms and history suggest potential psychosis in the making. His continued auditory hallucinations and the fact that he has not sought therapy raise significant concerns about his mental health stability. Although the position is unarmed, the presence of psychotic symptoms and his need for an antipsychotic medication, rather than just antidepressants, is a major red flag. Given these factors and the personality testing results showing poor suitability and psychotic tendencies, it would be prudent to recommend Non-Suitability (NS) for this candidate. Additionally, remember to comply with GINA guidelines by not mentioning the family history of bipolar disorder in the report.

  • Question:

    Given the applicant's history of psychiatric hospitalization at age 17 for self-harm, reported homicidal ideation, recent marijuana use, lack of current mental health treatment, and invalid PAI, should we consider him suitable or not suitable for the position?

    Answer:

    From a clinical perspective, the applicant may appear relatively stable, especially with the issues being from several years ago. However, from a risk management standpoint, it is important to consider the overall risk factors. His history of homicidal ideation, previous suicide attempt, psychiatric hospitalization, and continued use of marijuana despite its potential contribution to his self-harm are significant concerns. Additionally, his lack of current mental health monitoring and his invalid PAI raise further red flags. Considering these factors and the potential liability involved, it is prudent to recommend Non-Suitability (NS) for the position to mitigate risks for both the employer and FMRT.

  • Question:

    Given the applicant's history of passive suicidal ideation, recent mental health concerns, and her attempt to minimize this history during the evaluation, should she be considered suitable or not suitable for a deputy position?

    Answer:

    Based on the applicant's history, it is prudent to classify her as Not Suitable (NS) for the deputy position. The deceptive nature of her responses and the recent instance of passive suicidal ideation are significant concerns. Despite her current stability and professional qualifications, the pattern of suicidal ideation and the risk of it recurring under stress, especially in a high-stress role such as law enforcement, present a substantial risk. The potential for these issues to resurface, particularly with access to a department-issued firearm, poses too great a risk. Therefore, from a risk management perspective, it is in the best interest of the employer to pass on this applicant.

  • Question:

    Given an applicant's history of psychiatric hospitalization, recent suicidal ideation, PTSD from childhood sexual trauma, and a lack of clarity regarding the severity of these issues, should he be deemed Not Suitable (NS) for a law enforcement position, or could a Weak But Suitable (WS) suffice?

    Answer:

    Considering the significant red flags, including the psychiatric hospitalization with no records to clarify the severity, suicidal ideation within the past year, and unresolved PTSD from childhood sexual trauma, it would be prudent to lean towards Not Suitable (NS). Law enforcement requires high stability and minimal room for potential issues, especially regarding mental health. Your clinical instincts suggesting something is off should also be taken seriously, cementing the decision for NS.

  • Question: What is your recommendation for a 25-year-old female applicant applying for a telecommunicator position, given her history of recent marijuana use, past mental health issues, childhood trauma, and financial instability?

    Answer: Based on the applicant's profile, I recommend a finding of "Not Suitable" (NS). Here’s why:

    1. Substance Use:

      The applicant has a recent history of marijuana use, with the last instance occurring just two months ago, around the time she applied for this position. While she claims to have distanced herself from friends who continue to use marijuana, this recency and the fact that she used cocaine in the past raises significant concerns about her ability to maintain a drug-free lifestyle, especially in a high-stress job like this.

    2. Mental Health and Trauma:

      The applicant has a complex history of mental health issues, including childhood trauma marked by sexual abuse, foster care placements, self-harm, and a psychiatric hospitalization during her teenage years. Although she reports that her mood has stabilized since leaving her unhealthy home environment and has not had mental health problems or treatment in recent years, the severity of her past issues, including a diagnosis of bipolar disorder, cannot be overlooked.

    3. Financial Instability:

      The applicant's financial history is also concerning. She was homeless for about a year from 2022 to 2023, although she stayed with friends rather than living on the street. Financial instability can contribute to stress and may impact her ability to perform consistently in a demanding role.

    4. Incomplete Employment History:

      The applicant did not fill out her F3 form correctly, which raises questions about her attention to detail and transparency. Her employment history is patchy, with her longest job being just under two years. This lack of stability is another red flag, particularly in a position that requires reliability and resilience.

    Given these factors, and considering the intense work environment at the Communications Center, the applicant is at a high risk of failure in this role. Her past trauma, mental health history, and recent substance use are significant risk factors that outweigh her positive interview presentation. Therefore, I strongly recommend an NS finding

  • Question: Should a 33-year-old male applicant be deemed suitable for the position of detention officer, despite his history of suicidal ideation and recent mental health developments?

    Answer: The applicant should be considered Not Suitable (NS) for the position. Although the agency prefers a positive outcome, his mental health history presents significant risk factors that are too substantial to overlook, particularly for a role that involves high-stress situations and access to firearms.

    Relevant Details:

    • The applicant has a documented history of suicidal ideation, including a severe incident in 2017 where he put a gun to his head during a moment of distress related to job stress in the Marines. This incident is a major red flag, especially since it occurred in response to a challenging work environment—a situation he could easily encounter again in law enforcement.

    • He has been in ongoing mental health therapy since the 2017 incident, which initially seemed promising. However, therapy notes from just three months ago revealed that he had a "fantasy" about publicly killing himself to gain attention and notoriety. Although his therapist rated his risk as low and he denied any intent to act, the recentness of these thoughts raises significant concerns.

    • While the applicant has taken proactive steps to manage his mental health, including self-presenting to the emergency department in 2017 and continuing therapy, the potential for a recurrence of suicidal ideation under stress remains a critical issue. His military experience and desire for a long-term career in law enforcement are positive attributes, but they do not outweigh the risks associated with his mental health history.

    • Given that the applicant would be placed in situations that are likely to be stressful and would have access to a department-issued firearm, these risks cannot be taken lightly. The fact that his suicidal thoughts occurred as recently as three months ago makes it impossible to confidently recommend him as suitable for the role.

    • Although the decision could be deferred until hospital records are received to confirm whether the 2017 incident was a voluntary or involuntary commitment (IVC), it is advisable to proceed with the NS recommendation now. This is due to the likelihood that the agency may move forward with hiring before all documentation is obtained. If the records later show an IVC, this information can be communicated to the agency accordingly. Ultimately, while the decision may not align with the agency's wishes, it is in their best interest to prioritize safety and the well-being of both the applicant and the community.

  • Question: How should a police applicant's significant underreporting of her psychiatric history during evaluation be handled, given that her psychiatric hospitalizations occurred over 20 years ago during childhood, and her current functioning appears stable?

    Answer: The applicant should be considered Weak But Suitable (WBS) rather than Not Suitable (NS). While her underreporting is concerning, the incidents in question occurred when she was a young teenager, and more than 20 years have passed since her psychiatric hospitalizations. Given this significant time gap and her current stable functioning, it is more reasonable to issue a WBS report.

    In your report, consider splitting the mental health section into two distinct paragraphs:

    1. Psychiatric History: Detail her psychiatric hospitalizations, clarify that this was not an Involuntary Commitment (IVC) (if applicable), and note the absence of suicidality or auditory hallucinations in the past 19-21 years.

    2. Current Functioning: Emphasize her post-partum recovery, her current stability, and coping mechanisms, and note that she is no longer on medication or under mental health care.

    This approach ensures the reader understands her past psychiatric history without it being indicative of her present functioning, and it acknowledges the discrepancies while focusing on her current mental health stability.

  • Key Question:
    For an applicant with a long-standing history of self-harm, episodic depression, and additional personal trauma who has been reportedly stable for a year, how should her suitability for a detention officer position be assessed, particularly in light of limited PAI data and potential Axis II indicators?

    Answer:
    Considering the applicant’s prolonged history of self-harm and the challenges of overcoming such a deeply ingrained behavior, there are valid concerns about her resilience and coping mechanisms if future stressors arise. Although she reports current stability and has not engaged in self-harm for over a year, the risk remains that she may revert to maladaptive coping behaviors, especially under the stress of a role in law enforcement. This field demands high emotional resilience, especially for a position like detention officer, where exposure to potentially triggering or high-stress situations is common.

    The lack of a fully valid PAI is also a factor, as critical items on this test help assess current psychological stability and potential areas of concern. In the absence of these records, the strong clinical intuition of possible Axis II traits—likely reflective of long-term, ingrained coping styles or personality features—suggests a cautious approach. These characteristics, such as emotional instability and past patterns of impulsive behavior, may compromise her ability to perform effectively in a law enforcement setting.

    Given these observations, the recommendation leans towards marking the applicant as "Not Suitable" (NS), emphasizing the clinical concerns regarding her potential for emotional decompensation under stress. However, if the agency still wishes to consider her, they should be made fully aware of these red flags.

  • Key Question:
    How should the suitability of an 18-year-old applicant with a history of severe psychological distress, including past hospitalizations for self-harm, attempted suicide, and other challenges, be assessed for a 911 dispatcher position, especially given the lack of verified treatment records?

    Answer:
    Based on the information presented, there are significant concerns regarding the applicant’s emotional stability and resilience to handle the demands of a 911 dispatcher role. The following points outline why the applicant may be "Not Suitable" (NS) for the position:

    1. Emotional Stability: The constellation of issues, including past hospitalizations, ongoing untreated psychological distress, and a history of maladaptive behaviors, strongly suggests a lack of the emotional stability required to handle the consistent exposure to trauma inherent in a 911 dispatcher role.

    2. Risk of Relapse: Without verified evidence of therapeutic progress, there is a high risk that exposure to distressing calls could trigger a relapse into previously reported self-harming behaviors or other maladaptive coping mechanisms.

    3. Recency of Issues: Given the relative recency of her intense psychological struggles, it is likely that she would face difficulty setting aside her personal challenges to maintain the composure and empathy needed to support individuals in crisis effectively.

    Limitations to Evaluation:
    It is critical to note that the absence of verified records from the applicant’s treatment providers limits the ability to confirm her reported stability or therapeutic progress. This lack of documentation significantly impacts the evaluation and should be explicitly referenced in the report under "Limits to Evaluation" and "Medical/Mental Health" sections.

    Language Adjustments:
    Ensure the report uses accessible, non-clinical terms for the audience, such as "intense psychological distress" and "problems with worrying" instead of diagnostic terms. Reference family challenges generically as "considerable hardships within the home" to comply with GINA and protect sensitive family details.

    Summary:
    While the applicant has expressed interest in the role and may perceive herself as stable, the unresolved concerns, absence of corroborating treatment records, and recency of significant psychological challenges make her a high-risk candidate for this position.

  • Question: An applicant for a 911 call-taker position has a history of mental health concerns, including Depression and PTSD. She has a strong cognitive profile, scoring 99 on the Wonderlic, holds a bachelor’s degree in criminal justice, and has prior experience as a crime scene investigator. However, she has a history of self-harm and suicidal ideation, with the most recent episode in 2022, which led to voluntary hospitalization. While she minimized the circumstances of her hospitalization, medical records indicate she ingested 15 Wellbutrin pills. She was in treatment and on medication until two to three months ago, but medical releases have not been obtained yet. Given her history, should she be considered Weak but Suitable (WBS) or Not Suitable (NS), and what additional factors should be considered?

    Answer: The applicant’s history of self-harm and suicidal ideation raises significant concerns, particularly given her recent hospitalization and lack of full transparency regarding its circumstances. However, she has engaged in treatment and does not currently present with overt distress or problematic test results. The fact that the position does not involve carrying a firearm also weighs in her favor.

    Weak but Suitable (WBS) determination may be reasonable if additional treatment records confirm she discontinued therapy and medication under appropriate clinical guidance rather than against medical advice. If these records are unavailable, the key concern becomes whether her PTSD symptoms stem from trauma that could be re-triggered by exposure to emergency calls. If the nature of her PTSD could impair her ability to handle distressing calls, a Not Suitable (NS) determination would be more appropriate.

    Next Steps:

    • Follow up on medical records to confirm whether treatment ended appropriately.

    • Assess PTSD etiology—determine if the applicant’s trauma history aligns with the stressors of a 911 call-taker role.

    • If in doubt about her ability to manage exposure to trauma-related content, err on the side of NS for risk mitigation.

  • Question: The applicant for a detention officer position has a history of suicidal ideation (SI) and non-suicidal self-injury (NSSI), peaking in high school with reported stability since 2019. She had minimal mental health treatment, including brief therapy in high school and short-term Prozac use. Additional concerns include a high school suspension for bringing knives to school, frequent marijuana use during adolescence, and a recent resignation from a telecommunications job due to performance issues. She also experienced a predatory, abusive relationship at age 14. Despite these red flags, she presented as confident and stable in the evaluation. Given her history and presentation, is she suitable for the position at this time?

    Answer: While the applicant reports several years of stability and presented well in the evaluation, multiple risk factors remain unresolved, making her unsuitable for the role at this time. The history of SI and NSSI, combined with limited mental health treatment as an adult, raises concerns about her ability to effectively manage future stressors. The suspension for bringing knives to school and past substance use suggest prior impulsivity, and her recent job performance issues highlight potential concerns with reliability and attention to detail. Additionally, her history of victimization in an abusive relationship increases the risk of vulnerability in a correctional setting, where staff must maintain strong personal boundaries. While she has shown improvement, her lack of sustained professional and psychological stability presents a risk to both herself and the agency. A more extended period of demonstrated stability and mental health engagement would be necessary before reconsidering suitability for this high-stakes role.

  • Question:

    When assessing a PEP candidate with chronic suicidal ideation, questionable integrity, and multiple moderate risk factors, but no single domain that is clearly "Not Suitable," how should we determine overall suitability for placement?

    Clinical Summary & Answer:

    Summary:
    The candidate is in their late 20s and applying for a Detention Officer position. Their mental health history includes chronic depression, anxiety, and ADHD. Although they have not had suicidal ideation in the past 1.5 years, they reported years of intermittent ideation with loosely formed plans, raising concerns about how they cope during stress. Their psychiatric medications have been stable, and their psychiatrist reports no problems.

    Substance use is a secondary concern—they occasionally binge drink and were evasive about the amount they consume before driving. There are also patterns of thrill-seeking behavior (multiple speeding tickets), lack of integrity (admitted to extensive cheating in academic settings with no remorse), and negative attitudes toward gender diversity and law enforcement norms. CPI results indicated high risk across multiple domains.

    Consult Response:
    While the candidate does not exhibit a single domain of clear "Not Suitable," the combination of chronic suicidal ideation and marked lack of integrity raises serious red flags. The persistence of suicidal thoughts over years—even if currently dormant—suggests a maladaptive coping mechanism likely to resurface during future stressors. Additionally, the candidate's open admission of dishonesty without remorse speaks to potential psychopathic tendencies and a disregard for responsibility—especially concerning in a detention setting where integrity is crucial for safety and accountability.

    Given the cumulative risk profile, including chronic mental health challenges and significant character concerns, the recommendation is Not Suitable. These factors suggest elevated risk to the safety of others and potential for misconduct on the job, despite intellectual strengths and educational attainment.