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About Suicide Prevention

PLEASE NOTE: If you are having thoughts of suicide, I urge you to call the hotline in your geographic area to speak with personnel trained in suicide first aid intervention. See hotlines below…

    HOTLINES…

In the United States:

National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

Internationally (click logo below for map of resources):

Recently, I heard there was going to be a class called safeTALK (sponsored by National Alliance on Mental Illness (NAMI) and the Mental Health Association). The acronym safeTALK stands for ‘Suicide Alertness For Everyone’/'Tell, Ask, Listen, KeepSafe’.

Having had direct contact with multiple people who were experiencing thoughts of suicide in the days before I learned of the class, I was pleased and grateful to have the opportunity to take such a well-regarded class about such an important topic. The class brochure came to my attention at a time when I was wishing I had more knowledge about this topic and how to facilitate getting people to the suicide first aid resources they needed.

A person with thoughts of suicide usually gives what are referred to as “invitations”, commonly known as signs or indicators. This is where the person is literally inviting help and tells someone (as clearly as possible either by his/her words, behaviors, or actions) that he/she is having thoughts of suicide. Invitations may not always be blatantly obvious and they are sometimes missed. An alert helper knows what to look for and is thus more likely to notice such “invitations”.

It would be impossible to include all of the information I would like to here. I am certain I will be writing more articles in the future about this topic. There was simply too much information covered to do it justice in one article. However, I thought I would take a moment to list an abbreviated sampling of examples of “invitations”. These are things to look for around you. Someone you know could be sending out signals that he/she is in need of help:

Actions: Withdrawal (family, friends, school, work); Giving away possessions; Extreme behavior changes

Thoughts (that may be expressed verbally): “No one can do anything to help me now”; “I wish I were dead”; “Everyone will be better off without me”

Feelings: Desperate; angry; guilty; worthless; lonely; hopeless

Physical: Lack of interest in appearance; disturbed sleep; physical health complaints

Now, I know many readers here may be thinking that much of what’s listed above could be a sign of other issues and not be “invitations” at all. For example, the “physical” section above may look familiar to chronic illness patients who are not having thoughts of suicide. I understand where you’re coming from if you’re thinking this. The important thing that I took out of learning the invitations above (and others) is that it really can be difficult to tell an “invitation” from, say, a chronic illness patient who is struggling with issues such as having the time/energy to focus on appearance as they might have previously. However, since these are a few of the key “invitations” that people with thoughts of suicide tend to display or say, I think it is well worth noting them.

If you notice potential “invitations”, it’s important to take them seriously and follow up as needed. (Again, I will have to elaborate on details in future posts but, by all means, refer anyone you are concerned about to a hotline if you believe the person is having thoughts of suicide). Some people think asking a person outright if he/she is having thoughts of suicide might “plant the seed in his/her head”. This is not true. If you have reason to believe someone is having thoughts of suicide, it is important not to set aside your concerns. If you believe someone may be having thoughts of suicide, there are two ways to ask them about it:

1) Are you thinking about suicide?
2) Are you thinking of killing yourself?

While these may seem very blunt ways of asking, this is not a time to beat around the bush. It is important to be direct with your questions (like above). If you are concerned enough about the person to ask the question in the first place, it is important to be direct. Again, bringing up the topic won’t “plant the seed in anyone’s head”. So, asking directly like this is an important means for determining whether the person is, in fact at risk for completing suicide. (Please note that I used the word “complete” rather than “commit”. Please refer to the American Foundation for Suicide Prevention’s “Recommendations for language” section. The safeTALK class taught us to use the word “complete” rather than “commit”).

See below:

The purpose of becoming a trained helper (by taking a class like safeTALK) is not to learn counseling techniques or to do a suicide intervention – as these techniques require much more training. The purpose of the class is to simply recognize a person’s invitations, ask them directly about suicide, and if their answer is yes, to connect that person with suicide thoughts to suicide first aid intervention caregivers. An example of a KeepSafe statement would be, “We need extra help. I want to connect you with someone who can help you KeepSafe”.

“All forms of help-seeking about suicide need to be encouraged. A decision to live is far more likely when a person at risk can make it in the company of a helper who is comfortable talking about suicide. The simple and yet profound first approach to any person at risk should be, ‘let’s talk’. That message regards the disclosure of thoughts of suicide as a potential ‘new beginning’. Help-seeking is supported by access to many kinds of resources that can provide help. Crisis line workers, persons aware of the danger of suicide and trained suicide interveners are some of the key resources needed to make help seeking credible”…

Source: Page 10 of the safeTALK Resource Book
© 2008 LivingWorks Education Incorporated

At this point I would like to pause to make it very clear that I am not trained in suicide first aid intervention such as the ASIST (Applied Suicide Intervention Skills Training) program. The safeTALK class I took essentially helps to bridge the gap between the community and suicide first aid resources (i.e. suicide prevention hotlines).

For an explanation of the difference between alertness training (like safeTALK) and skills intervention training (like ASIST), see below. This explanation comes from LivingWorks, the company that designed the two programs:

The safeTALK class that I took was very informative, helpful and powerful. If you are interested in looking into whether safeTALK training is available in your area, just Google it. When I Googled it, this list came up for New York State:

Alternatively, you might want to check with one of the organizations that sponsored the workshop I attended. Perhaps they can direct you to one in your area. I cannot recommend this class highly enough. Our instructor, Eric Weaver (Executive Director of Overcoming the Darkness) was informative, helpful, and encouraging. With the content of the material being so serious, he obviously took measures to ensure that careful language choices were made and that there was an appropriate tone for the classroom atmosphere. At the same time, I do not want to leave the impression that the class was a gloomy experience. On the contrary, everyone in the room was clearly highly motivated to get everything they could out of the class and it was a positive, empowering experience because the end goal of taking such a class is to help people gain access to the suicide first aid resources they need.

Having never taken a class quite like this, I didn’t know exactly what to expect. Early on, I became very comfortable thanks to the helpful instructor, great materials (videos) presented during the class, and the wonderful people who took the class with me.

Additional related resources:

24-hour crisis line in the USA:
— > Tel: 1-800-273-TALK (8255)

In Canada:

24-hour crisis line in Australia:
— > Tel: 13 11 14

Befrienders Worldwide (with Samaritans): Find helpline by country here…

Samaritans: Email helpline > HERE or phone (see below)
— > Tel: In the UK dial… 08457 90 90 90 (UK local rate) or +44 1603 611311 AND in the Republic of Ireland dial 1850 60 90 90.

This list of resources is not all-inclusive. Again, if you are in crisis and are having trouble locating a hotline in you area, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or please click here to search by geographical area:

Additional resources that may be of interest:

Tel: +1 (202) 237-2280

Washington D.C. and Newton, MA, USA
Tel: 877-GET-SPRC (877-438-7772)
TTY: 617-964-5448

120 Wall Street, 22nd Floor
New York, NY 10005
Tel (toll-free):1-888-333-AFSP (2377)
Phone: (212) 363-3500
Fax: (212) 363-6237


This post was written by Jeanne at http://chronichealing.com. Copyright © Jeanne — chronichealing.com. All rights reserved.


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Reading: About Suicide Prevention

24 comments

1 Jenny H.No Gravatar { 10.25.10 at 4:18 pm }

Hi Jeanne,
I’m very happy to read this post and the class you took seems very interesting. I was going to mention the Canadian site but see that you already included it. I know most of your readers are adults but I suspect some may be teens or teachers/parents. Because I’m a teacher and kids are my life I wanted to mention Kids Help Phone (Jeunesse, J’écoute in Quebec). It is a wonderful, anonymous resource for children and teens up to age 20. They have counsellors available for many issues including suicide (either kids dealing with thoughts of suicide or loss of a loved one to suicide).

The toll-free number is 1-800-668-6868 and you can also go to Kids Help Phone. Of course dialing 911 is also prudent if someone is having suicidal thoughts.

I also wanted to talk about the actions invitation you mentioned. The giving away of possessions one is something that can easily be overlooked. One of my students last year has a parental history of mental illness and with whom I felt strong bond (my mother suffers from clinical depression and has most of my life so I know how hard it is on a kid). He confided many things in me but never talked about suicidal thoughts…still I always made sure to touch base with him (and still do via email). One day he gave me a CD of his favourite band and told me it was to listen to in my car. I thought it was a sweet gesture but was totally terrified when my behaviour tech at the school told me that can be a sign…an “invitation” as you said. I worried all weekend and I believe he was even absent on the following Monday. But nothing happened he was and is still with us. But it made me realize that you should always follow your gut if something seems out of the ordinary. Talk to the person no matter how scared you are to hear the answer.

Thank you again for sharing this. While nobody in my life has completed suicide, I’ve known many people in my life who have been depressed and had suicidal thoughts. My husband’s friend completed suicide a few year ago and the brother of a former student as well. Seeing the sadness in the families eyes and knowing the guilt they feel is something that nobody should have to experience.
.-= Jenny H.´s last blog ..8 weeks =-.

2 JeanneNo Gravatar { 10.25.10 at 5:58 pm }

Hi Jenny,

Yes, the class really was interesting. It was very worthwhile and I would highly recommend it to everyone. The class is geared to everyone (ages 15+).

While most of my readers are adults, you are right that there are other readers who are teens. There are parents of patients who read it too; I have had a few recent blog comments from parents of endometriosis patients who are each 13 years old, for example. I have no doubt there are other teachers besides you reading my blog too. So, I appreciate very much you including this hotline information for Quebec!

I am glad that the student you mentioned is safe. You are right that the giving away of possessions “invitation” can be missed. When people are alert to such invitations, it can make it easier for them to pick up on subtler signs like this. Yes, I agree it’s important to follow your gut. When something doesn’t feel right, it’s important not to brush it aside.

Like you said, it is imperative to talk with the person no matter how scared you might be regarding what their answer might be to the question, “are you having thoughts of suicide?” While it’s understandable to feel some degree of fear at tackling such a serious subject, it is so important to put the question out there (directly) when there are invitations. If the person answers that, “yes”, they are having thoughts of suicide… then the task at hand it to get him/her to suicide first aid resources (i.e. suicide prevention hotlines).

We learned in class that 1 in every 20 people are having thoughts of suicide at any given time! So whether we realize it or not, each of us is surrounded by people having thoughts of suicide.

According to the American Association of Suicidology:

In 2007 (the latest year for which we have national statistics), there were 34,598 suicides in the U.S. (94.8 suicides per day; 1 suicide every 15.2 minutes).

That is a horrific number of deaths by suicide. (By the way, Jenny, the only reason I am quoting this U.S. statistic is that I am unsure of what the numbers are worldwide). I think this number shows the point, though, that the number of suicides is very high. Also, suicides are suspected to be under-reported. So, the numbers are most likely really higher than that.

I am sorry to hear about your husband’s friend and about the brother of a former student. Some of the people who took the class I took are suicide survivors. (To clarify terminology, suicide survivors are not people who have attempted suicide. Suicide survivors are those who have been left behind when a loved one has completed suicide). I cannot imagine the grieving process that suicide survivors go through. It is incredibly unfortunate.

Suicide prevention is so important. The instructor of the class I took made an analogy between safeTALK classes and CPR classes. What I took out of the class is that the vision for the future is to have classes like safeTALK become as common as CPR classes. One of the things we got from the class was a sticker that says, “suicide” in one “talk bubble” and “you can talk to me” in another “talk bubble”. I’m not sure if that logo is copyrighted so I didn’t post it on my blog but it’s a noticeable logo.

My instructor had such a sticker on his laptop. That way, wherever he goes that sticker is visible on his laptop and people know he’s a safe person to approach about the topic of suicide. The vision is that someday a logo like this will be a common sight… such as the red cross symbol. People will recognize the symbol as more and more people have it. In this way, more people in need of suicide first aid resources can be connected with them.

I will have to look into whether or not that logo is copyrighted because I would like to post it on my blog to help get that logo seen by more and more people.

I truly believe that if more and more people are trained on suicide alertness that more people will be connected with the suicide first aid resources they need to be safe.

Thank you for your thoughtful comment!

Jeanne

3 Jenny H.No Gravatar { 10.25.10 at 6:22 pm }

It’s my pleasure, Jeanne. I suspect that the rates are very similar in Canada and other countries. Sadly, Quebec is well known for having a high suicide rate…the highest in Canada…especially among young men. It is on the decline but one statistic I found was that in 2007 it was 14 out of every 100,000 residents. This was down from 22 out of 100,000 in 1999. It is suspected that awareness is a big part of that decline. Ad campaigns for mental illness, depression in particular, are commonplace here. I think that understanding mental illness as an illness makes people more comfortable discussing it. I believe that the same will be true for suicide.

Also, just to clarify, Kids Help Phone is nationwide not just the province of Quebec. I believe Americans can call as well.

.-= Jenny H.´s last blog ..8 weeks =-.

4 Jenny H.No Gravatar { 10.25.10 at 6:23 pm }

I forgot to link my source sorry:

CBC News: Quebec suicide rate slides

.-= Jenny H.´s last blog ..8 weeks =-.

5 EndochickNo Gravatar { 10.25.10 at 8:23 pm }

Jeanne –

Suicide is a hard subject to write about. You are a valuable resource to your readers who are either struggle with suicidal thoughts or know a loved one who is. Thank you for taking time out of your life to educate yourself on this topic and on ways to help people experiencing suicidal feelings.
.-= Endochick´s last blog ..Update- Research =-.

6 JeanneNo Gravatar { 10.25.10 at 9:10 pm }

Jenny,

I looked at the CBC link you sent and was stunned by this part:

“Suicide remains the No. 1 cause of death among men between the ages of 20 and 40 in Quebec”. Wow. That is really sad.

The article did also say, “However, the number is on the decline by about four per cent per year, according to the public health institute”. (As you mentioned, the suicide rates are going down in Quebec and suicide awareness is one of the factors they are attributing the decline to).

According to The American Association of Suicidology:

“Mental health diagnoses are generally associated with a higher rate of suicide. Psychological autopsy studies reflect that more than 90% of completed suicides had one or more mental disorders”.

When this topic came up in class, the way it was worded was:

“Suicide’s correlation to mental health is evident, as it has been determined that 90% of all people who die by suicide have a diagnosable psychiatric disorder at the time of their death”.

When someone in the class asked how that number is determined, the instructor indicated that psychological autopsies are behind this number.

I have seen this number from many sources. The wording may differ slightly from one source to another but the number always remains the same.

The instructor emphasized the word diagnosable as opposed to diagnosed. The psychological autopsies can ascertain whether the person had a mental illness even if they were never diagnosed properly prior to their death.

I absolutely agree with you that the more comfortable people become discussing the topic of suicide, the more people will get directed to the suicide first aid resources they need.

Another thing I noticed in the link you posted was that mention was made of the awareness campaigns of the 1980s about drunk driving and how those campaigns helped with that. (I was Co-President of the Students Against Driving Drunk chapter at my high school and I remember the DWI campaigns they referred to since I graduated from high school in 1987).

I absolutely think increased awareness about suicide can help.

In the class I took, the instructor mentioned that DWI and child abuse used to be viewed as a “private thing” but that now people step in and take keys away from someone who is drunk or intervene if they see that a child is being abused.

Suicide needs not to be viewed as a “private thing”. People need to be able to recognize “invitations” and take appropriate action… to ask the person directly if they are having thoughts of suicide and to, if the answer is yes, get them connected to suicide first aid resources.

I didn’t realize that the Kids Help Phone resource served such a large area. Thank you for clarifying.

Thank you, Jenny, for the additional information and for caring enough to take the time to share it.

Jeanne

7 JeanneNo Gravatar { 10.25.10 at 9:21 pm }

Endochick,

It is a hard subject to write about but I think everyone who takes the time to talk, read, learn, and write about it will bring about more awareness… and that awareness is very important. I know that you have written about this topic and that you really care about getting people who are in need of help connected to the suicide first aid resources they need. Thank you for what you have done to reach out to people on this important topic (and for taking the time to comment when I know you are extremely busy with graduate school).

Jeanne

8 SaraNo Gravatar { 10.26.10 at 12:12 pm }

Jeanne,

I am so pleased to see this post. You covered so many important ways to help someone who is considering suicide. I’m really glad that you were told to ask someone directly if they had intentions of completing suicide. In addition, I think knowing about the “invitations” is critical.

It seems to me that when someone is really depressed and starts to give invitations, it’s almost a knee-jerk reaction to NOT bring up suicide for the very reason you mentioned in your post — that it might encourage someone.

As someone who considered suicide at one point in my life, I feel the opposite. I think it can be almost a relief to have someone put things “on the table” so to speak. It removes some of the secret nature of suicide.

I’m pleased that you attended this workshop and shared these wonderful ideas about handling the subject of suicide.

Very informative post…thanks:~)
.-= Sara´s last blog ..Story Photo- Cover Picture =-.

9 JeanneNo Gravatar { 10.26.10 at 11:54 pm }

Sara,

Thank you so much for your thoughtful comment.

Yes, “invitations” were stressed in the class as being important signs to look for regarding suicide alertness.

I agree with you that people sometimes pull back… and go out of their way not to talk about suicide at the very times when talking about it may well be most needed!

The notion that talking about suicide “plants the seed” is a myth… and it was emphasized in class that talking about suicide does not “plant the seed”.

Thank you for sharing your own personal story here. By sharing your story, you are helping open up this topic for more discussion and that is a helpful thing!

As you indicated, it can actually be a relief to someone having thoughts of suicide to have someone to talk with about it.

Thank you again for your helpful comment. I appreciate your candor and I truly believe that the more people talk openly about this subject, the more people can be directed to needed suicide first aid resources.

Jeanne

10 AnnieNo Gravatar { 10.27.10 at 11:43 pm }

Thank you for an informative post. I’m quite worried about my brother’s mental state right now and it’s good know about these resources.

BTW – I just purchased the DVD I’m giving away for the contest on my blog and I did remember to go to Amazon via your website!

11 JeanneNo Gravatar { 10.28.10 at 1:51 am }

Annie,

I’m sorry to hear that you’re worried about your brother. I know your family has been through some terrible losses and adversity! Hopefully your brother is getting the support and/or treatment he needs (you obviously know his situation far better than I do) to help him cope with his situation. If you have concerns about whether your brother might be having thoughts of suicide, please ask him directly about it (as indicated in the post). If it is possible to do this in person (where you can make eye contact), all the better. If I remember correctly, he does not live near you. So, I know this may not be possible. Yes, please keep those hotlines handy in case you need them for your brother.

Thank you very much for making a purchase using my Amazon blog ads. Your support is greatly appreciated. We are still waiting to hear feedback regarding my husband’s 11th interview with the same company. So, the Amazon referral is especially appreciated at this time.

Jeanne

12 AmandaNo Gravatar { 10.28.10 at 6:18 am }

Jeanne,

This is, as always, an amazing post written with so much awareness and compassion and I hope that it helps as many people as possible. That being said, even if it only helps one single person, it will be worth more than anything!

I can only imagine your gratitude for such a course as I know how passionate you are about suicide awareness and prevention.

It might be worth putting a highly visible link on your sidebar to this particular post as you have so many resources mentioned here, it would be a real shame to lose it to the masses of information available here (not that the masses of information are a bad thing, I don’t think I worded that correctly, but I think this is a topic that needs a big, visible, eyecatching effect to grab people as soon as they visit.)
.-= Amanda´s last blog ..Changes changes and more changes… =-.

13 JeanneNo Gravatar { 10.28.10 at 1:10 pm }

Amanda,

I really am thankful to have had the opportunity to take the safeTALK class. It was very informative.

Regarding placing a visible link to this post on my sidebar, I took your advice and did just that. I decided to use the same photo I had used in this post; I placed it in the sidebar with the various suicide prevention hotlines and resource graphics/links. I expect that I will be writing more about suicide prevention in the future. There was too much information covered in the class to fit it into a single post. The link for this post has now been shared 86 times on Facebook and my friend Jasmine (who knows that I am no longer on Twitter) was kind enough to post the link on Twitter last night.

This post has been getting a great deal of traffic. I think it’s crucial to make people aware of the suicide first aid resources that are available.

Jeanne

14 Jannie FunsterNo Gravatar { 10.28.10 at 5:57 pm }

Hi Dear Jeanne,

I am so glad you are a courageous person who follows what you know will help people.

That you took it upon yourself to take the safeTALK class shows what an awesome person you are and how much you value what you offer here on your blog.

I found this post very very freeing in these 2 lines…

1) Are you thinking about suicide?
2) Are you thinking of killing yourself?

And hearing Sara reiterate how those questions are good to be asked and heard, made it crystal clear to me how to approach a friend or relative if ever I sense they could be thinking of completing suicide. Wow, sometimes the simplest route is the best. Most times, actually.

I like the link in your sidebar.

Ooo, and I see I am in the sidebar Healing Posse too. Thanks!! That means a lot to me!

xoxo
.-= Jannie Funster´s last blog ..Let Us Be Good To Each Other — a poem for my friend =-.

15 Jannie FunsterNo Gravatar { 10.28.10 at 6:00 pm }

(I mean the “On Suicide Prevention” button in your sidebar).

xoxo and such.
.-= Jannie Funster´s last blog ..Let Us Be Good To Each Other — a poem for my friend =-.

16 JeanneNo Gravatar { 10.28.10 at 7:34 pm }

Jannie,

I really do think this part is key:

1) Are you thinking about suicide?
2) Are you thinking of killing yourself?

It was made very clear in the class that it is not a time to beat around the bush (when you think someone may be having thoughts of suicide).

As you mentioned, Sara’s words (see previous blog comment) show a real life example of where this direct approach is best. I think it really is freeing to know that it’s OK to come out and ask these very direct questions. Yes, I think a simple, direct approach like this is best. That’s what we were taught in the class. There’s no room for interpretation or ambiguity.

I must give credit to Amanda for the idea to put the “On Suicide Prevention” button in my sidebar. She suggested that in an earlier comment.

Yes, Jannie. You are in the Healing Posse. ;)

Jeanne
xoxo

17 Jannie FunsterNo Gravatar { 10.28.10 at 11:39 pm }

Thanks, Jeanne.

I agree with Amanda that even if this post helps just one person, the time, caring and concern for people in crisis is absolutely priceless. Thanks again for this. YOU rock, and a such a true friend to so many, and to the world.

xo
.-= Jannie Funster´s last blog ..Politics — in 55 words =-.

18 JeanneNo Gravatar { 10.28.10 at 11:47 pm }

Jannie,

Thank you. YOU rock and your very devoted group of loyal readers and friends is a testament to that. I am very fortunate to have you as a friend!

Jeanne
xoxo

19 DianeNo Gravatar { 10.30.10 at 6:53 pm }

The husband of one of my closest friends completed suicide yesterday. I am devastated. I wish the info in this wonderful post could have saved his life.

20 JeanneNo Gravatar { 10.30.10 at 9:13 pm }

Diane,

I am so, so sorry to hear about your friend’s husband. I hope that she has a strong support network. Hopefully her community has some type of support group for suicide survivors. I’m so terribly sorry to hear about this.

I just added a banner for 12th Annual National Survivors of Suicide Day in my sidebar. There are many organizations that offer support to suicide survivors.

Take care,

Jeanne

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