a suicide-safer community

1. a suicide-safer community

2. WELCOME 01 Welcome

3. 02.1 Introduction to the River of Suicide

4. “Contributaries” of suicide (no thoughts of suicide) 02.2 Introduction to the River of Suicide

5. “Contributaries” of suicide (no thoughts of suicide) Thoughts of suicide 02.3 Introduction to the River of Suicide

6. “Contributaries” of suicide (no thoughts of suicide) Thoughts of suicide Suicidal behavior 02.4 Introduction to the River of Suicide

7. “Contributaries” of suicide (no thoughts of suicide) Thoughts of suicide Suicidal behavior Death or harm 02.5 Introduction to the River of Suicide

8. POSTVENTION For those who injure themselves and those who are affected 03.1 Types of Suicide Prevention Workbook Page 4

9. PREVENTION Important but unlikely to prevent all people from having thoughts of suicide POSTVENTION For those who injure themselves and those who are affected 03.2 Types of Suicide Prevention Workbook Page 4

10. PREVENTION Important but unlikely to prevent all people from having thoughts of suicide INTERVENTION Suicide first aid to prevent the risk of suicidal behavior POSTVENTION For those who injure themselves and those who are affected 03.3 Types of Suicide Prevention Workbook Page 4

11. Unreported suicides: 5% to 25% more suicides Non-fatal suicidal behaviors: 40 to 100 times greater than number of suicides Number of people affected: Each suicidal behavior may affect a few or a very large number [Region, Year] Pop. [Population] Reported suicides: [data] People with thoughts of suicide: [data] 04 Magnitude of the Problem Workbook Page 4

12. 03.3 Types of Suicide Prevention Workbook Page 4 PREVENTION Important but unlikely to prevent all people from having thoughts of suicide INTERVENTION Suicide first aid to prevent the risk of suicidal behavior POSTVENTION For those who injure themselves and those who are affected

13. ongoing quality control trainers worldwide all disciplines highly evaluated ASIST TRAINER over 1 million trained evolving since 1983 evidence based 5-day training for trainers detailed trainer manual one of several programs 05 LivingWorks Trainer Supports

14. Your Job 0 0 Clergy Counselor Nurse Physician Psychologist Social Worker Administrator Educator Other Police/Correctional Officer Volunteer Youth Worker 0 0 0 0 0 0 0 0 0 0 06 Your Job

15. 80% 80% 40% 40% YES YES Has anyone you know died by suicide? Other Acquaintance Close friend Family 0 0 0 0 Has anyone you know attempted suicide? Other Acquaintance Close friend Family 0 0 0 0 07 Personal Experiences

16. 80% 80% 40% 40% 1 2–5 6–20 >20 YES Have you ever been a helper to a person at risk of suicide? How many times? Professionally Personally 0 0 08 Helping Experiences

17. How prepared do you feel to help a person at risk of suicide? Well prepared Mostly prepared Partly prepared Not prepared 0 0 0 0 My feelings about suicide mostly come from… (Check all that apply) I have little or no feelings about suicide Lectures, workshops, etc. Books, newspapers, articles, etc. Media programs about suicide Internet Professional experience with suicidal persons Personal experience with suicidal persons 0 0 0 0 0 0 0 09 Learning Opportunities

18. Have you had thoughts of suicide?(Check all that apply) Never in my life Some time in my life Within the last year Within the last week 0 0 0 0 Have you ever deliberately injured yourself? Yes, with a clear wish to die by suicide Yes, though uncertain about dying Yes, but no wish to die No 0 0 0 0 10 Self Experiences

19. Who would you tell if you had thoughts of suicide? (Check all that apply) Caring person Friend Clergy Health worker Co-worker No one Family Other 0 0 0 0 0 0 0 0 You could also tell your workshop trainer(s): [trainers] 11 Who Would Help You?

20. 02.5 Introduction to the River of Suicide “Contributaries” of suicide (no thoughts of suicide) Thoughts of suicide Suicidal behavior Death or harm

21. 12.1 Structure of the Suicide Intervention Model Workbook Page 5

22. CONNECTING 12.2 Structure of the Suicide Intervention Model Workbook Page 5

23. UNDERSTANDING CONNECTING 12.3 Structure of the Suicide Intervention Model Workbook Page 5

24. UNDERSTANDING CONNECTING ASSISTING 12.4 Structure of the Suicide Intervention Model Workbook Page 5

25. HELP HELP HELP ACTIONS • Giving away possessions • Withdrawal (family, friends, school, work) • Loss of interest in hobbies • Abuse of alcohol, drugs • Reckless behavior • Extreme behavior changes • Impulsivity • Self-mutilation • FEELINGS • Desperate • Angry • Guilty • Worthless • Lonely • Sad • Hopeless • Helpless PHYSICAL • Lack of interest in appearance • Change/loss in sex interest • Disturbed sleep • Change/loss of appetite, weight • Physical health complaints THOUGHTS "All of my problems will end soon" "No one can do anything to help me now" "Now I know what they were going through" "I just can't take it any more" "I wish I were dead" "Everyone will be better off without me" "I won't be needing these things anymore" "I can't do anything right" "I just can't keep my thoughts straight anymore" STRESSFUL EVENTS with FEELINGS OF LOSS 13 Explore Invitations Workbook Page 7

26. UNDERSTANDING CONNECTING ASSISTING invitations? suicide? explore ask 12.5 Structure of the Suicide Intervention Model Workbook Page 5

27. CURRENT SUICIDE PLAN (RESOURCES) PRIOR SUICIDAL BEHAVIOR PAIN MENTAL HEALTH ALONE PREPARED FAMILIAR DESPERATE VULNERABLE 14 River and Risk Alerts

28. Review Risk RISK ALERT suicide Are you having thoughts of suicide?……………… YES 15.1 Review Risk Workbook Page 10

29. Review Risk RISK ALERT suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current suicide plan How? How prepared? How soon?……………………… prepared YES 15.2 Review Risk Workbook Page 10

30. Review Risk RISK ALERT suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current suicide plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES 15.3 Review Risk Workbook Page 10

31. Review Risk RISK ALERT suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current suicide plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES 15.4 Review Risk Workbook Page 10

32. Review Risk RISK ALERT suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current suicide plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior suicidal behavior Have you ever attempted suicide before?……………. familiar YES 15.5 Review Risk Workbook Page 10

33. Review Risk RISK ALERT suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current suicide plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior suicidal behavior Have you ever attempted suicide before?……………. familiar YES + Mental health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 15.6 Review Risk Workbook Page 10

34. CURRENT SUICIDE PLAN (RESOURCES) PRIOR SUICIDAL BEHAVIOR PAIN MENTAL HEALTH ALONE PREPARED FAMILIAR DESPERATE VULNERABLE 14 River and Risk Alerts

35. UNDERSTANDING reasons? risk? listen review CONNECTING ASSISTING invitations? suicide? explore ask 12.6 Structure of the Suicide Intervention Model Workbook Page 5

36. Review Risk Contract Safeplan RISK ALERT suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.1 Contract Safeplan Workbook Page 11

37. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.2 Contract Safeplan Workbook Page 11

38. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.3 Contract Safeplan Workbook Page 11

39. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES CURRENT FACTORS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.4 Contract Safeplan Workbook Page 11

40. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs CURRENT FACTORS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.5 Contract Safeplan Workbook Page 11

41. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs • Link to resources CURRENT FACTORS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.6 Contract Safeplan Workbook Page 11

42. INFORMAL RESOURCES FORMAL RESOURCES family and friends 24-HOUR 24-HOUR emergency health workers advisers LONGER-TERM LONGER-TERM personal connections community LIFE-LONG LIFE-LONG 16.7 Resources

43. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs • Link to resources CURRENT FACTORS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.6 Contract Safeplan Workbook Page 11

44. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs • Link to resources CURRENT FACTORS RISK SPECIFIC SAFEPLANS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.9 Contract Safeplan Workbook Page 11

45. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs • Link to resources CURRENT FACTORS RISK SPECIFIC SAFEPLANS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES • Disable the suicide plan Pain Do you have pain that at times feels unbearable?…… desperate YES Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.10 Contract Safeplan Workbook Page 11

46. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs • Link to resources CURRENT FACTORS RISK SPECIFIC SAFEPLANS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES • Disable the suicide plan Pain Do you have pain that at times feels unbearable?…… desperate YES • Ease the pain Resources Do you feel you have few, if any, resources?………… alone YES BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.11 Contract Safeplan Workbook Page 11

47. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs • Link to resources CURRENT FACTORS RISK SPECIFIC SAFEPLANS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES • Disable the suicide plan Pain Do you have pain that at times feels unbearable?…… desperate YES • Ease the pain Resources Do you feel you have few, if any, resources?………… alone YES • Link to resources BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.12 Contract Safeplan Workbook Page 11

48. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs • Link to resources CURRENT FACTORS RISK SPECIFIC SAFEPLANS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES • Disable the suicide plan Pain Do you have pain that at times feels unbearable?…… desperate YES • Ease the pain Resources Do you feel you have few, if any, resources?………… alone YES • Link to resources BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES • Protect against the danger/ support past survival skills + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES 16.13 Contract Safeplan Workbook Page 11

49. Review Risk Contract Safeplan RISK ALERT ALL SAFEPLANS • Keep safe • Safety contact(s) suicide Are you having thoughts of suicide?……………… YES • Safe/no use of alcohol/drugs • Link to resources CURRENT FACTORS RISK SPECIFIC SAFEPLANS Current Suicide Plan How? How prepared? How soon?……………………… prepared YES • Disable the suicide plan Pain Do you have pain that at times feels unbearable?…… desperate YES • Ease the pain Resources Do you feel you have few, if any, resources?………… alone YES • Link to resources BACKGROUND FACTORS + Prior Suicidal Behavior Have you ever attempted suicide before?……………. familiar YES • Protect against the danger/ support past survival skills + Mental Health Are you receiving or have you received mental health care?……………………………………… vulnerable YES • Link to health worker 16.14 Contract Safeplan Workbook Page 11

50. INFORMAL RESOURCES FORMAL RESOURCES family and friends 24-HOUR 24-HOUR emergency health workers advisers LONGER-TERM LONGER-TERM personal connections community LIFE-LONG LIFE-LONG 16.7 Resources