Suicide Prevention Training
Lloyd B. Potter PhD, MPHDirector
Suicide Prevention Resource Center
November 2, 2006 Adelaide
TopicsTopics
A community approach to prevention
Training as one aspect of prevention
Gatekeeper training Rationale and Logic
Common gatekeeper programs
Issues for gatekeeper programs
Society
Community
Family/Peers
Spheres of influence on risk for suicidal behavior
Individual
NAMI New Hampshire - FrameworksNAMI New Hampshire - Frameworks
Gatekeepers Schools/Education Mental Health and
Substance Abuse Providers Emergency Medical Services Emergency Departments Law Enforcement Dispatch
Cultural CompetenceJudiciarySocial Service AgenciesTeens/StudentsPrimary Care ProvidersCommunity CoordinatorFuneral DirectorsClergy
PROTOCOLS DEVELOPED FOR:
www.NAMINH.org
Programs for the Prevention of Suicide Among Adolescents and Young Adults
School gatekeeper training
Community gatekeeper training
General suicide education
Screening programs
Peer support programs
CDC. Youth Suicide Prevention Programs: A Resource Guide. 1992.
Programs for the Prevention of Suicide Among Programs for the Prevention of Suicide Among Adolescents and Young Adults (continued)Adolescents and Young Adults (continued)
Crisis Centers and hotlines
Restriction of access to lethal means
Intervention after a suicide
CDC. Youth Suicide Prevention Programs: A Resource Guide. 1992.
SPRC Training InstituteSPRC Training Institute
Strategic Planning for Suicide Prevention
Assessing and Managing Suicide Risk (3 versions)
First Responder Curriculum (forthcoming)
Online workshops Locating, Understanding, and Presenting Youth Suicide Data
Planning and Evaluation for Youth Suicide Prevention
Youth Suicide Prevention: An Introduction to Gatekeeping
3 more forthcoming
Training for clergy (planned)
Rationale for Gatekeeper TrainingRationale for Gatekeeper Training
Suicide does not usually occur spontaneously. There often is time to intervene.
Gatekeeping is a process in which caring individuals recognize the potential for risk behaviors in others and take action to insure that people at-risk receive the help they need.
GatekeeperGatekeeper
Gatekeepers must have: command of the basic facts about suicide and of
suicidal behavior
the personal confidence and specific skills needed to recognize and respond to a person who may be at-risk of suicide
the ability to appropriately interact, support, and assist family and friends in the aftermath of an attempted or completed suicide
Program Logic ModelProgram Logic ModelTrain Gatekeeper TrainersTrain Gatekeeper Trainers
Inputs Activities Outputs OutcomesResources•money
•staff
•volunteers
•facilities
•equipment &supplies
Constraints•laws
•regulations
•funding
Services•train trainers to train gatekeepers
Products• number trainers trained
Results• trainers train gatekeepers
• more persons at risk identified
• more referrals for MH care
• MH care results in reduced-risk
• fewer suicide attempts and completions
Program Logic ModelProgram Logic ModelTrain GatekeepersTrain Gatekeepers
Inputs Activities Outputs OutcomesResources•money
•staff
•volunteers
•facilities
•equipment &supplies
Constraints•laws
•regulations
•funding
Services•train gatekeepers
Products• number trained
Results• more persons at risk identified
• more referrals for MH care
• MH care results in reduced-risk
• fewer suicide attempts and completions
Valid program outcomesValid program outcomes
Evaluation to include measurable results:
Direct suicide factors-decrease in suicides & attempts
Suicide ideation
Related suicide factors- decrease in depression, stress & anger
Protective factors- increase in personal control, self- esteem, social support & problem solving
Eggert L, Thompson E, Reducing Suicide Potential Among High Risk Youths: Tests of School-based Prevention Program
Gatekeeper TrainingGatekeeper Training
For school personnel: Livingworks/ASSIST
Project SOAR (Suicide, Options, Awareness, Relief)
QPR (Question, Persuade, Refer)
Reconnecting Youth
For students: Yellow Ribbon (uses QPR)
Natural Helpers Peer Navigators/New Mexico
SOS (Signs of Suicide )
SuicideTALK: An exploration in suicide awareness (1.5–2 hours) provides a structure in which session members can safely explore some of the most challenging attitudinal issues about suicide, and encourages every member to find a part that they can play in preventing suicide.
safeTALK: suicide alertness for everyone (2.5–3 hours or full day 7 hours) ability to recognize a person with thoughts of suicide and know how to connect them with a person trained in suicide first aid intervention.
Applied Suicide Intervention Skills Training (ASIST) (14 hours) For caregivers who want to feel more comfortable, confident and competent in helping to prevent the immediate risk of suicide.
Training for Trainers (T4T) (Five days) Prepares local resource persons to be trainers of the ASIST workshop.
Source: www.livingworks.org
LivingWorks ProgramsLivingWorks Programs
As a QPR-trained Gatekeeper you will learn to: recognize the warning signs of suicide
know how to offer hope
know how to get help and save a life
WHAT YOU CAN DO… •Become a Certified QPR Gatekeeper Instructor. On site training and through a self-study program. •To locate a Certified QPR Gatekeeper Instructor in your area. •Learn QPR through out web-enabled interactive CD-ROM program.
Source: www.qprinstitute.com
QPRQPR
QPR CornerstonesQPR Cornerstones
The four cornerstones of the theory upon which the QPR approach is derived are these: Those who most need help in a suicidal crisis are the least
likely to ask for it.
The person most likely to prevent you from dying by suicide is someone you already know.
Prior to making a suicide attempt, those in a suicidal crisis are likely to send warning signs of their distress and suicidal intent to those around them.
When we solve the problems people kill themselves to solve, the reasons for suicide disappear.
Source: www.qprinstitute.com
YELLOW RIBBON INT'L SUICIDE PREVENTION PROGRAM
Promote and Raise awareness of suicide prevention in a community
Provide outreach to those at risk of suicide Educate people to be Gatekeepers, such as school staff (certified and classified), parents, peers, elders and the community to recognize suicidal behaviors in youth and adults.
Respond effectively and knowledgably in a suicidal crisis
Offer support to friends and family of suicide victims.
Source: www.yellowribon.org
Maine Gatekeeper Training ProgramMaine Gatekeeper Training Program
Free materials
Background about risk and protective factors
Responding to a person at risk:1. Show You Care
2. Ask About Suicide
3. Get Help
Support of family members
Building school readiness
Responding to a completed suicide
Source: www.state.me.us/suicide
Gatekeeper training issuesGatekeeper training issues
Intensity, content, learning objectives
Skill building practice / role playing
Pre-post measures for persons trained
Expectations and record keeping for and about gatekeepers
Gatekeeper training issuesGatekeeper training issues
Exposure of gatekeepers to at-risk individuals
Subjective assessment of risk dependent on exposure to gatekeeper
Difficulty causally tying gatekeeper actions to therapeutic follow-through or prevention of suicidal behavior
Limitations in scope of Limitations in scope of programsprograms
Inadequate links to mental health services
Programs for alcohol and drug abuse, HIV and other risk factors rarely make formal ties with suicide prevention
Reach youth not enrolled in school
(CDC Youth Suicide Prevention Programs: A Resource Guide,1992)