QPR Training Notes:

Suicide prevention:
Terms: Suicide, attempt, ideation
Facts:
High school suicide deaths (1 in 13 attempt, 1 in 6 consider) 33 do in one
year, IN
One classroom 1 boy and 2 girls have attempted
4:1 attempts to deaths for older people, younger is 100:1
Reasoning abilities, means to be able to complete it
Firearms most common method in united states- almost half
Suffocation is second
Poisoning and other methods fall behind
-restricting means can reduce the number of suicides, statistically
IS PATH WARM?
Ideation
Substance abuse
Purposelessness
Anxiety
Trapped
Hopelessness
Withdrawal
Anger
Recklessness
Mood Changes
?
High risk factor for suicide: previous suicide attempt
Untreated major depressive disorder, one of leading contributors
Hopelessness: most common psychological state
After a suicide: a toolkit for schools, good resource for if your school
experiences a student suicide
National Suicide prevention lifeline (18002738255)
Question, Persuade, Refer
Evidence based training program for teachers and professionals
-Not intended to be treatment or counseling
-Offers hope through positive action

-Young person in crisis that gets help and does not complete suicide will most
likely not be suicidal again, suicide attempt does not define a person
-Most suicidal people mention their intent the week before the act
-Most young people do not tell an adult
-Clues and signs:
Strongest predictors: previous attempt, current talk or plan, strong wish to
die or death, depression, substance use, recent attempt by friend or family
member
-Verbal cues: ice decided to kill myself, Im going to commit suicide, Im
going to end it all, I wish I were dead
-Indirect verbal: I cant go on, I want out, family will be better off without me,
I wont be around much longer, who cares if Im dead anyway
-Behavioral: past attempt, getting gun or pills, giving away good possessions,
impulsivity, risk taking, unexplained anger aggression irritability, self
destructive acts, truancy, running away, perfectionism
Situational: expelled, family problems, loss of relationship, death of friend or
family member, diagnosis of serious illness or terminal illness, financial
problems, sudden loss of freedom/fear of punishment, feeling embarrassed
or humiliated, victim of assault or bullying
-Youth related: change in interaction with family and friends, recent
disappointment or rejection, increased apathy, sudden decline or
improvement in academic performance, physical symptoms- eating, sleep,
headaches, stomach, menstrual
Asking the question:
If they are reluctant, be persistent
Talk to person alone in private setting
Allow person to talk freely
Give yourself plenty of time
If in doubt, dont wait and just ask
Have resources handy, QPR card, community resources, know your schools
protocol
How you ask the question is less important than that you ask it
Less direct:
Have you been unhappy lately?
Have you been very unhappy lately?
Have you been so unhappy lately that you've been thinking about ending
your life?
Do you ever wish you could go to sleep and never wake up?
Direct:
At times, 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?

Ways not to ask:
Youre not thinking about suicide are you?
Youre just kidding about killing yourself, right?
Persuade:
Listen to problem and give tem full attention
Suicide is the solution to a perceived, insoluble problem, suicide is not the
problem
Do not rush to judgment
Offer hope in any form
Then ask:
Will you go with me to talk to you school counselor?
Would you like me to tell your school counselor that you would like to talk to
him or her?
Are you willing to talk to your counselor within the next ten to fifteen
minutes?
If they say yes. will you promise not to kill yourself between now and the
time you talk to your school counselor?
Continue to monitor them closely until they are with the counselor
If you are unable or unwilling to talk to counselor, I want you to know that I
care enough about you that I will let them know
Note: counselor or administrator must be informed if you believe you are
seeing suicidal clues or warning signs from a student
Refer:
Suicidal young people often believe they cant be helped, so they may have
to do more
Best referral involves taking person directly to counselor
Next best is when student wants you to talk to counselor first
Third best is to make sure student is safe, under adult observation, and tell
counselor warning signs you have observed
-schools will have protocol or designated place to send students who are in
this kind of trouble, emergency people, place, etc. have all of these ahead of
time
follow up after referring, call home, talk to student, show them that you care
Instilling hope:
Say- I want you to live, im on your side
Communicate: with counselor and administration
Get others involved: ask person who might help, family friends, teachers,
etc.
Join the team- offer to work with school personnel and others involved

Follow up- phone call, card, whatever you can do to help them feel cared
about
Suicide risk screener:
Depression screening: over past two weeks have you felt down, depressed,
or hopeless?
Over past two weeks have you felt little pleasure or interest in doing things?
Most depressed people are not suicidal, but most suicidal people are
depressed
Wish you were dead or go to sleep and not wake uo?
Thoughts of killing yourself
Ever attempted to kill yourself
If yes, today, within 30 days, within one to six months, greater than 6?
Injury, were you feeling suicidal when injury occurred?