Academy Hour INTERVENTION, Mental Health Training …...SUICIDE PREVENTION, INTERVENTION,...

SUICIDEPREVENTION,

INTERVENTION,POSTVENTIONAc

adem

y H

our

Amy Morgan, MSC

Mental H

ealth Training

CAUSES OFSUICIDAL THOUGHTS

RESPONDING TO SIGNSOF SUICIDE

PREVENTION

INTERVENTION

POSTVENTION

Poll Question

■ Have you ever known someone who died by suicide,or who attempted suicide?– ATTEMPTED but lived– DIED by suicide– NONE of the above

CAUSES OFSUICIDAL THOUGHTS

Activity: Life Stressors

■ Life stressors

■ Money

■ Relatives/Family

■ Job

■ Divorce


■ Relationship problems

■ Money

■ Job Stress

■ Kids

■ Moving

■ Job Loss

■ Death of a loved one

■ Other stressors


■ Keep carrying the books?

■ Put them away properly, one by one?

■ When heavy enough, for a longperiod of time.. The inclination is tojust DROP all the books.

Imagine…

This is for my mom, my dad and “brother.” This is my last words. I hope you are not grieving of my death. I amsorry for my pain I have put upon you. Mom I love you. I am sorry.”

Poll Question

■ Do you feel confident that you would know what to do tosave this child’s life or help him stop thinking of suicideas a solution?– YES– NO

What is suicide?

■ Want pain to end

■ See no solutions

■ See no hope

Reasons for Suicide

■ Pain ■ Loss

Reasons for Suicide

■ Pain ■ Loss

■ Adults 85 years of age and older

Not going to improve Not going to improve

RESPONDING TO SIGNSOF SUICIDE

Would you know what to do?...

Prevention vs. Intervention

■ Prevention:– Staying well so you don’t have to try to recover

■ Prevention:– Prevention of the elements that lead to thoughts of suicide– Teaching the tools for coping– Recognizing signs of self-destruction

Prevention vs. Intervention

■ Intervention:– Recognizing the signs of suicidal ideation and stepping in to

prevent follow-through– Assisting someone in finding resources to help them deal with

or resolve whatever is causing their suicidal thoughts– Implementing a safe plan with the individual

Postvention

■ Prevention of a new cycle– Care offered to friends & family left behind after a suicide– Watching for same signs as the Prevention phase– Those left behind are at risk

PREVENTIONBefore thoughts of suicide begin

“She seemed fine.”

PreventionStay healthy & well

Prevention ■ Talking about suicide■ Untreated depression■ Giving away possessions■ Saying goodbye■ Suicide notes■ Alcohol & drugs■ Sudden calmness■ Reckless behavior■ Researching suicide methods

Look for warning signs

Prevention ■ Buying suicide materials■ Creating/updating a will■ Social withdrawal or isolation■ Talking about being a burden■ Feeling hopeless■ Preoccupation with death■ Previous suicide attempt

Look for warning signs

What to do

■ Ask / listen to what the problems and stressors are

■ Help find resources– Counseling– Job search– Family assistance– Support network / friends

■ 800-273-8255 (National Suicide Prevention Lifeline)

INTERVENTIONSaving the life of someone contemplating suicide

“I just need to know there’s hope.”

People hide whatthey don’t wantyou to know orsee.

Interventionallows someoneto talk about theirsuicidal thoughtswithout judgment.

What is anintervention?

Definition:

Interference so as to modify aprocess or situation

What is anintervention?

Thoughts of Suicide

Suicidal Behavior

Death or Harm

“Contributaries” of Suicide(no thoughts of suicide)

Credit: Applied Suicide Intervention Skills Training (ASIST)

How does aninterventionwork?


Understanding

Connecting Assisting

Phase 1:Connecting


ConnectingPractice….“Are you thinking about suicide?”

Phase 1:Connecting


ConnectingFriend: “I’m just going to end all ofthis and fix all my problems.”

You: “ .”

Poll Question

■ What would be your immediate reaction to a friend who is sayingthey are contemplating suicide?

1. Remind them of all the good things they have going on intheir life;

2. Tell them to stop talking like that because they’re worryingyou;

3. Tell them to start telling you all the reasons they want to endtheir life;

4. I have absolutely no idea what to do.

Phase 1:Connecting


ConnectingFriend: “I’m just going to end all ofthis and fix all my problems.”

You: “ .”

Phase 1:Connecting


ConnectingAccept what the person issaying, without judgment, andlet them know you’re here tohelp.

Phase 1:Connecting


Connecting“I can see you really seem tobe having a hard time.”“Tell me what’s bothering youthe most.”“That does sound verydifficult.”“What else?” “Tell me more.”

Phase 1:Connecting


ConnectingIt’s not about you, or youropinions.Build trust.Create a sense of trust andopenness for sharing.Goal: Save the person’s life.

Phase 1:Connecting


Listen for red flags / risk factors

1st question: Are you havingthoughts of suicide?

?■ Review Risk

■ ARE YOU HAVING THOUGHTS OF SUICIDE?…… suicide

RISKALERT

Phase 1:Connecting


Ask questions about currentfactors that may contribute totheir suicidal thoughts.

“Do you have a plan?”

?■ Review Risk


RISKALERT

CURRENT FACTORS

preparedCurrent Suicide PlanHow? How prepared? How soon?…………………….

desperatePainDo you have pain that at times feels unbearable?…..

aloneResourcesDo you feel you have few, if any, resources?………...

“Do you have pain that attimes feels unbearable?”

“Do you feel you have few, ifany, resources?”

Phase 1:Connecting


Ask questions about backgroundfactors that may contribute totheir suicidal thoughts.

“Have you ever attemptedsuicide before?”

?■ Review Risk


RISKALERT

CURRENT FACTORS




BACKGROUND FACTORS

vulnerable

+ Mental HealthAre you receiving or have you receivedmental health care?………………………………………

familiar+ Prior Suicidal BehaviorHave you ever attempted suicide before?…………….

“Are you receiving or have youreceived mental health care?”

Poll Question

■ How good of a listener do you think you are when youdisagree with what a person is telling you?

1. Terrible – I just want to stop them and correct them;2. Average – I can keep from interrupting, but not

necessarily take in what they’re saying.3. Amazing – I love to listen to what other people have to

say, even if I don’t agree with what they’re telling me.

Phase 2:Understanding


Understanding

Ask them to tell you all about allof the stressors.

Listen without judgment oropinion, and without trying toturn them to more positivethinking.

Poll Question

■ You’re trying to listen to your friend tell you all the thingsthat have been going wrong, and you know you can helpwith 2 he’s just mentioned. What do you do?

1. Hooray! I can fix these.. I quickly tell my friend thesolutions.

2. I make a mental note of potential resources to bring uplater.

3. I do nothing; I’m supposed to just listen.



Understanding

Connecting



Understanding

Listen for cues about reasons forliving.

Listen for ambivalence.


“Survivors often regret theirdecision in midair, if not before.”

“I instantly realized thateverything in my life that I’dthought was unfixable was totallyfixable – except for having justjumped.”

Who can dieby suicide?

How can THIS person bethinking of suicide?

Anyone is at risk.

What is astressor?

Remember: What isstressful to one personmay not be to another.And what you considerstressful may not be tosomeone else, and viceversa.

Caregiverattitudesmatter

The caregiver is the only one who hasclarity and focus. Those thinking ofsuicide can only focus on the thingsthat are causing them to feelhopeless.

Phase 3:Assisting


Assisting

Phas

e 3:

Ass

istin

g


?■ Review Risk


RISKALERT

CURRENT FACTORS

BACKGROUND FACTORS




vulnerable



++Contract Safeplan

• Safety contact(s)• Keep safe

• Safe/no use of alcohol/drugs• Link to resources

ALL SAFEPLANS

Phas

e 3:

Ass

istin

g


?■ Review Risk


RISKALERT

CURRENT FACTORS

BACKGROUND FACTORS




vulnerable



+• Link to health worker

• Protect against the danger/support past survival skills

+• Disable the suicide plan

• Ease the pain

• Link to resources

RISK SPECIFIC SAFEPLANS

Contract Safeplan

• Safety contact(s)• Keep safe

• Safe/no use of alcohol/drugs• Link to resources

ALL SAFEPLANS


family &friends

advisers healthworkers

emergency

personalconnections community

24-hour

Longer-term

Life-long

Informal Resources Formal Resources

800-273-8255

Phase 3:Assisting


Phase 3:Assisting



Connectinginvitations?suicide?

exploreask

Understandingreasons?risk?

listenreview Assisting

safeplan?commitments?

contractfollow-up

Patiently listen TO the death side ofambivalence; help the person at risk

talk about their reasons for dying

Persistently listen FOR the life sideof ambivalence; search for reasonsfor living or reinforce them when theperson at risk discovers them

DEATH LIFE


Poll Question

■ At this point, how confident do you now feel that youcould recognize someone who is having thoughts ofsuicide, and help them to live?– MUCH MORE CONFIDENT– JUST AS CONFIDENT– STILL NOT CONFIDENT

POSTVENTIONHelping someone who’s lost someone to suicide

I don’t understand, and I’m hurting.

Poll Question■ How many of you respond to suicides as part of your job

and sometimes talk with the family & friends leftbehind?

1. I respond to suicides and talk with family & friends;2. I respond to suicides but do not talk with the family &

friends;3. I do not respond to suicides.

Responding to a suicide

■ Family just lost a loved one■ Cause of death is irrelevant■ They are shocked, traumatized, confused, grieving, and have questions

Questions of the survivors

■ Does suicide run in the family?■ Suicide is a learned behavior.

– Families pass on behavior and emotional environments– Families can teach poor coping skills, self-destructive behavior– Depression and anxiety are contributors

Life Stressors

■ Relationship problems

■ Money

■ Job Stress

■ Kids

■ Moving

■ Job Loss

■ Death of a loved one

■ Other stressors

Postvention = Prevention

■ Listen for signs of wanting to die

■ Start the Connecting Phase with the family members

■ Assess the level of risk, and ask about factors that may contribute tofuture thoughts of suicide

Resources■ Offer resources for the family members

■ 9-1-1

■ Emergency room

■ Physician

■ Family members

■ Friends

■ Clergy

■ Counselor

Expectations

■ Talk about what they can expect

■ A significant loss

■ A traumatic event

■ May need to seek help later

■ Ask them to think about who they might call at the time.

Resources

■ Who are your resources?■ Think to yourself of who you would call. Do you have

their number ready?

Applied Suicide Intervention Skills Training (2-day)https://www.livingworks.net/programs/asist/

THANK YOU!Amy Morgan, MSC

Academy Houremail: [email protected]

Phone: 405-326-4116

www.AcademyHour.com

SUICIDE PREVENTION,INTERVENTION,POSTVENTION

Acad

emy

Hou

r

Amy Morgan, MSC

Mental H

ealth Training

2017

Suicide is the 10th leading cause ofdeath in the U.S….

2015 statistics


Acad

emy

Hou

r

Amy Morgan, MSC

Mental H

ealth Training

2017

Each year 44,193 Americans die bysuicide…

2015 statistics


Acad

emy

Hou

r

Amy Morgan, MSC

Mental H

ealth Training

2017

On average there are 121 suicidesevery day…

2015 statistics


Acad

emy

Hou

r

Amy Morgan, MSC

Mental H

ealth Training

2017

Firearms as a method account foralmost 50% of all suicides…

2015 statistics


Acad

emy

Hou

r

Amy Morgan, MSC

Mental H

ealth Training

2017

White males accounted for 7 of 10suicides in 2015…

2015 statistics


Acad

emy

Hou

r

Amy Morgan, MSC

Mental H

ealth Training

2017

Over 1 million people die by suicide,worldwide, each year…

2015 statistics


Acad

emy

Hou

r

Amy Morgan, MSC

Mental H

ealth Training

2017

75% of global suicide occurred in low-and middle-income countries in 2012.

Academy Hour INTERVENTION, Mental Health Training …...SUICIDE PREVENTION, INTERVENTION,...

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