Fear and emotion. Those are the words that often come to mind when talking about suicide and/or a mental health crisis. Although few people are neutral on the subject, baseline knowledge about suicide and its causes is low. As a result, the factual information concerning the subject of suicide is typically threatened by dangerous myths and misconceptions. These two entities can not only isolate people considering suicide from their family and community, but also lead to more hopelessness, a leading cause in death by suicide.

In hopes of making the subject of mental health and suicide less of a taboo we have established QPR training. The ultimate goal of QPR is to prevent suicide attempts and completions, and to find relief for those suffering from suicide ideation. To achieve that goal, we start with QPR training. We want to help people break their unconscious bias and enable them to speak freely about this topic.

So, let's dive in and explore a basic summary of what QPR is. (This is meant to provide information and should not be considered a formal training session.) QPR stands for Question, Persuade, and Refer. This is to be used as a life-saving technique, just like CPR. QPR is not intended to be a form of counseling or treatment, but rather offers hope through positive action. There are many myths surrounding the topic of suicide and it is important to debunk those myths. Some of the most common myths are: no one can stop a suicide, it’s inevitable, confronting someone about suicide will only make them angry and increase their risk, only experts can prevent suicides, suicidal people keep their plans to themselves, and many more. Although many people think the above myths to be true, suicide is actually one of the most preventable kinds of death, and almost any positive action may save a life.

The first thing to know in order to save a life are the suicide clues and warning signs. The more clues observed, the higher the risk, and all signs should be taken seriously. Verbal clues can come in a variety of ways, both direct and indirect. Talk such as “I wish I was dead.” or “I just want out.”, are quick clues as to how a person might be experiencing suicidal thoughts. But sometimes we don't get the verbal clues and have to rely on a person’s behavior. Behavioral signs/clues include previous mental health crisis, acquiring a gun or pills, putting personal affairs in order, giving away possessions, sudden interest/disinterest in religion, mood swings, etc. When we don't have verbal clues, it is important to watch for those behaviors to appear. Another type of warning sign is situational clues. These could be things like being fired or expelled, an unwanted move, loss of a relationship, death of a loved one, diagnosis of illness, financial loss, etc. The risk factor list is long and growing. Just remember, suicide occurs in contexts and knowing the context can help better understand the why behind someone’s thinking that suicide is a solution.

QUESTION
This can be the most intimidating part of QPR. If you have never asked someone if they are contemplating suicide, it can be a big hurdle to cross. So just remember if you are in doubt, don't wait. Ask the question. Be persistent and talk to the person alone, in a private setting, so they are more comfortable being vulnerable. Asking questions opens up dialogue which is the first step. Allow the person to speak freely and give yourself time. This is something that shouldn't be rushed. Taking the direct or indirect approach of asking is up to you and the situation. But the biggest thing to remember is never pass judgement on a person thinking about suicide. They are already feeling big emotions; they don't need to feel added shame or judgment that could be coming from you.  

PERSUADE
Now that you have asked the question, it is time to persuade them to stay alive. The number one thing when it comes to persuasion is to be an active listener. Give them your full attention. Nobody is going to open up if they feel like someone is not listening or has something else to do or somewhere else to be. Offer hope. Remember, suicide is not the problem. Suicide is often perceived as the only the solution to an insoluble problem. Once you have listened and built a relationship of trust then ask “Will you go get help with me?” Your willingness to listen and help will make the biggest difference.

REFER
Thankfully, our world has made huge strides in making mental health help readily available. Getting to a counselor, therapist, religious leader, etc. is something that can be done quite easily. There are even 24/7 hotlines and online help. The best referral involves taking the person directly to someone who can help. That way we know they are getting help. If it is not something that can be done in that moment, the next best option is to get a commitment from them to accept help, then make the arrangements to get that help. Remember, referral is key! Any willingness to accept help at some point, even if in the future, is a good outcome.
When faced with a potential suicide, please remember QPR. Almost any effort to show someone their worth, why you want them to live, will be met with agreement and relief. Most people just want someone to care. They want their pain/suffering to end, not their life. Don't hesitate to get involved or take the lead. All these steps provide hope and hope helps prevent suicide. You are providing that hope. Question. Persuade. Refer.

Reference: QPR Institute
Resources for help: Call/Text 988; chat online at www.988lifeline.org