Post online training small group practice session and roleplays

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QPR

• Post online training small group practice
  session and role-plays

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QPR

• Question, Persuade, Refer

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QPR Suicide Clues And Warning SignsThe more
clues and signs observed, the greater the risk.
Take all signs seriously.
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Small Group Questions

• What do you know, or think you know, about
  suicide?
• Who completes suicide?
• What are some of the risk factors?
• What are some of the protective factors?

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Your experience with the training?

• Comments?
• Observations?
• Things you would like to discuss?
• Action steps, if any, you have taken since
  completing training?
• Did you talk with others about the training?
• Personal impact on you?

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Suicide Risk and Protective Factors

• This list and discussion of Suicide Risk and
  Protective Factors was taken from U.S. Public
  Health Service, The Surgeon Generals Call To
  Action To Prevent Suicide. Washington, DC 1999

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Risk Factors

• Previous suicide attempts
• Mental disorders particularly mood disorders
  such as depression and bipolar disorder
• Co-occurring mental and alcohol and substance
  abuse disorders
• Family history of suicide
• Hopelessness

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More Risk Factors

• Impulsive and/or aggressive tendencies
• Barriers to accessing mental health and/or
  substance abuse treatment
• Relational, social, work, or financial loss
• Physical illness
• Easy access to lethal methods, especially guns

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More Risk Factors

• Unwillingness to seek help because of stigma
  attached to mental and substance abuse disorders
  and/or suicidal thoughts
• Influence of significant people family members,
  celebrities, peers who have died by suicide
  both through direct personal contact or
  inappropriate media representations
• Cultural and religious beliefs for instance,
  the belief that suicide is a noble resolution of
  a personal dilemma
• Local epidemics of suicide that have a contagious
  influence
• Isolation, a feeling of being cut off from other
  people

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Protective Factors

• Effective and appropriate clinical care for
  mental, physical, and substance abuse disorders
• Easy access to a variety of clinical
  interventions and support for help seeking
• Restricted access to highly lethal methods of
  suicide
• Family and community support
• Support from ongoing medical, mental health and
  substance abuse care relationships
• Learned skills in problem solving, conflict
  resolution, and nonviolent handling of disputes
• Cultural and religious beliefs that discourage
  suicide and support self-preservation instincts

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QPR Tips for Asking the Suicide Question

• If in doubt, dont wait, ask the question
• If the person is reluctant, be persistent
• Talk to the person alone in a private setting
• Allow the person to talk freely
• Give yourself plenty of time
• Have your resources handy QPR Card, phone
  numbers, counselors name and any other
  information that might help
• Remember How you ask the question is less
  important than that you ask it

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Q QUESTION

• Less Direct Approach
• Have you been unhappy lately? Have you been
  very unhappy lately? Have you been so very
  unhappy lately that youve been thinking about
  ending your life?
• Do you ever wish you could go to sleep and never
  wake up?

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Q QUESTION

• Direct Approach
• You know, when people are as upset as you seem
  to be, they sometimes wish they were dead. Im
  wondering if youre feeling that way, too?
• You look pretty miserable, I wonder if youre
  thinking about suicide?
• Are you thinking about killing yourself?
• NOTE If you cannot ask the question, find
  someone who can.

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How NOT to ask the suicide question
Q QUESTION

• Youre not thinking of killing yourself, are
  you?
• You wouldnt do anything stupid would you?
• Suicide is a dumb idea. Surely youre not
  thinking about suicide?

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P PERSUADE
HOW TO PERSUADE SOMEONE TO STAY ALIVE

• Listen to the problem and give them your full
  attention
• Remember, suicide is not the problem, only the
  solution to a perceived insoluble problem
• Do not rush to judgment
• Offer hope in any form

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P PERSUADE

• Then Ask
• Will you go with me to get help?
• Will you let me help you get help?
• Will you promise me not to kill yourself until
  weve found some help?
• YOUR WILLINGNESS TO LISTEN AND TO HELP CAN
  REKINDLE HOPE, AND MAKE ALL THE DIFFERENCE.

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R REFER

• Suicidal people often believe they cannot be
  helped, so you may have to do more.
• The best referral involves taking the person
  directly to someone who can help.
• The next best referral is getting a commitment
  from them to accept help, then making the
  arrangements to get that help.
• The third best referral is to give referral
  information and try to get a good faith
  commitment not to complete or attempt suicide.
  Any willingness to accept help at some time, even
  if in the future, is a good outcome.

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Wrap up

• REMEMBER
• Since almost all efforts to persuade someone to
  live instead of attempt suicide will be met with
  agreement and relief, dont hesitate to get
  involved or take the lead.