Transcript College Suicide:

Paul Quinnett, PhD
President and CEO
The QPR Institute
So long as suicide remains a
mystery, we have no responsibility
to prevent it. But once we begin to
understand suicide, we must act
boldly in good faith to save lives.
The QPR Institute Staff and Faculty
Suicidal behaviors are not rare…
Suicide is understandable…
Suicide makes sense to the suicidal person….
If suicide is to be prevented, how will it be
done?
AWARENESS
TRAINING
EDUCATION
ACTION
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Increase our sense of shared responsibility
for the prevention of suicide
Improve our collective competence to prevent
suicide attempts and completions
Leadership must agree that suicide is a
serious problem and that it is preventable
Orientation goals:
 What is QPR?
 Why is it important?
 How does it work?
 What is the evidence base?
 Who is using it?
 How long does it take to learn?
 What are the end goals?
 What training is available?
◦ stands for Question, Persuade and Refer,
an emergency mental health intervention
that
teaches lay and professional Gatekeepers
to recognize and respond positively to
someone exhibiting suicide warning signs
and behaviors.
QPR Gatekeeper Training for Suicide Prevention © 1996
As measured by independent university
researchers… QPR training increases:
1. Knowledge about suicide
2. Gatekeeper self-efficacy
3. Knowledge of suicide prevention resources
4. Gatekeeper skills
5. Diffusion of gatekeeper training information
These are minimum measureable outcomes…
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Each letter in QPR represents an idea and an
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QPR intentionally rhymes with CPR – another
universal emergency intervention
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QPR is easy to remember
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action step
Asking Questions, Persuading people to act
and making a Referral are established adult
skills
“Out of clutter, find simplicity”
Albert Einstein
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Is a simple, direct, behavioral intervention
designed to produce a predetermined
outcome: a referral for professional help
Is designed to produce a helpful dialogue
between someone at risk for suicide and a
trained Gatekeeper
Teaches Gatekeepers to take bold, positive
action to access professional care
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QPR is theory-based
Recognizes that even socially isolated suicidal
individuals have contact with potential
rescuers
QPR reaches out to at-risk people within their
own environments and does not require
suicidal people to ask for help.
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Assumption: passive systems don’t work
-Those most at risk for suicide:
- tend not to self-refer for help
- tend to be treatment resistant
- often abuse drugs and/or alcohol
- dissimulate their level of despair
- go undetected
- go untreated (and remain at risk for
suicide)
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Most suicidal people send warning signs
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Warning signs can be taught
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Gatekeepers can be trained to a) recognize suicide
warning signs and, b) intervene with someone they
know
Gatekeepers must be fully supported by policy,
procedure, and professionals in their community
The person most likely to prevent you from taking
your own life is someone you already know
1.
2.
3.
4.
4 necessary links…
Early recognition of warning signs
Early application of QPR
Early referral to professional care
Early assessment and treatment
Knowledge + Practice = Action
QPR PREVENTION STRATEGY
AWARENESS
Suicidal
Thoughts
Perceived
Insoluble
Problem
SURVEILLANCE
Suicidal
Warning Signs
DETECTION
Suicide
Attempt
Suicide
injury or
death
INTERVENTION
OPPORTUNITIES
Question
Persuade
Treat
Refer
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Strangers don’t prevent suicide, people you
already know do…
Friends, family members, co-workers, and
professionals with a duty to public safety
have the greatest opportunity to recognize,
detect, and refer….
The more people trained the better the odds
an at-risk person will be detected before a
suicide attempt is made
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Effective QPR depends on the recognition of
suicidal communications and warning signs,
risk factors and quick, compassionate,
positive action. Just as tightness in the chest,
radial left arm pain and sweating are warning
signs of a pending heart attack, so are clinical
depression, statements of hopelessness and
giving away prized possessions warning signs
of a pending suicide attempt.
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The more people trained the more lives are
saved.
Experiencing an out-of-hospital cardiac
arrest?
To survive, where do you want to be?
In one American county your odds of survival
are 56%; in most others it is less than 5%.
Learn why one county in America leads the
world in preventing death by cardiac arrest:
Google “Cardiac Arrest Seattle.”
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Train as many people as possible to
recognize symptoms of distress and direct
and indirect suicide warning signs and to take
quick action to intervene
QPR training gives people the knowledge,
skills, and – most importantly – the
permission and courage to reach out to those
in distress….
Just one story…
A few months after participating in a QPR Gatekeeper Training,
a gentleman who participates on our pastoral support team
received a call from a woman indicating she was suicidal, had
a plan and means, and was ready to 'do it now'.
He remembered QPR, and supported this woman, talking to her
about her value and purpose. She indicated she was willing to
have someone come to help her, so while they were talking,
he asked a colleague to dial 9-1-1.
The police arrived at the woman's home while he was still on
the line with her. They took her in for assessment and
care. The woman is now on her way to recovery. She is so
thankful to the man who helped her through her crisis, and is
doing very well.
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One of the training participants approached me immediately after the
training and said that she needed to go home immediately to talk to
her brother, who lives with her. She said that he has been exhibiting
multiple warning signs for suicide that were just taught in the QPR
class, but she never recognized them as such.
She and I talked about this and prayed together, and then she went
home to her brother. After she walked in the door, he just
happened to tell her that he was feeling suicidal. Because of the
QPR training she had just participated in, she knew exactly what to
do. She talked to her brother, and they called the Access & Crisis
Line together.
The folks at the crisis line referred them to help. He subsequently
went to a psychiatrist for assessment, and began therapy. Had this
woman not participated in the QPR Gatekeeper Training, she
wouldn't have known what to do. But, I'm happy to report now that
the turn-around has been drastic! He is now involved in supportive
groups, and the church.
QPR Gatekeepers are:
- Are alert to the possibility of suicide
- Recognize suicide risk and protective factors
- Recognize symptoms of distress and
depression
- Recognize suicide warning signs
- Know what to say, when to say it, and
what to do
QPR Training is safe and effective
 15 university published studies
 Only gatekeeper training program listed in
SAMHSA’s National Registry of Evidence
Based Practices and Policies
 AFSP/SPRC Best Practice Registry
 Used by 500+ colleges and universities
 More than one million gatekeepers trained
 20,000 gatekeepers/month trained in 2012
 No adverse outcomes reported since 1996
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Classroom training: 60-90 minutes, or longer
Online training takes 60-90 minutes, or longer if
downloadable guided practice session is used
Post training discussions with others typically
follow, as each person trained shares what they
learned with average of five people
Sharing QPR training and materials with coworkers, friends, and family members is a key
outcome of the training experience.
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QPR training is not designed to produce
therapists, but to provide ordinary people
with enough of those skills that have been
shown to produce significant behavior
changes via brief interventions, including the
value of imparting hope, empathic and active
listening, and behavioral steps to immediately
reduce risk factors and enhance protective
factors.
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Detection of suicidal persons
Active intervention
Alleviation of immediate risk factors
Enhancement of protective factors
Accompanied referral
Access to treatment
Accurate diagnosis
Aggressive treatment
“Ask the question, save a life.”
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Only taught by well-trained Certified QPR
Instructors licensed by the QPR Institute
Multi-media, lecture, and interactive
Practice session included
Video hosted by actress and author, Carrie
Fisher
Includes official printed QPR booklet/card
Customized referral/crisis response by QPR
instructor or hosting organization
Annual 30-minute review recommended
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Interactive, self-paced, multimedia training
Hosted by actress and author, Carrie Fisher
Unlimited user access (3 years), exam and
certificate
Free mental health screening for learner or
family member
Printable materials (QPR booklet/card)
On demand review and/or annual review
Immediate crisis service access
Customized referral/crisis response by
hosting organization
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It is not known to what degree intervention
on this “last professional contact” might
prevent suicide
Older adults have the highest rates of “last
contact” and, therefore, provide the greatest
opportunity for intervention
Alternative approaches are needed for
identifying those who make no contact
Primary Care Providers have most frequent
“last contacts” with those who die by suicide
 Luoma, Martin and Pearson, Am. J. Psychiatry, 2002
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“Most people who complete suicide had
contact with a health professional within a
year of death, and 40 percent of these
contacts were within one month of their
death. Many people die by overdose on the
prescription medications provided them at
these visits.”
Since most suicides are premeditated, are these
missed opportunities? Professionals need advanced
training in suicide risk detection, assessment,
treatment, and management.
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Options: Classroom, online, or blended online
+ classroom training
T4T training for Advanced Trainers
Basic QPR enhanced, enriched, and practicespecific online and blended courses for:
mental health and chemical dependency
professionals, nurses, physicians, PAs, NPs,
EMT/firefighters, law enforcement and
correctional professionals.
Training creates a “culture of safety”
Creating a “culture of
community safety”
Leadership
Policy
Procedures
Culture
4 Training matches level of duty
4 Where possible training is
Mental Health/Chemical
mandatory
Dependency Professionals
QPRT Training – 8-10 hrs
4 Professional competency
4 must be demonstrated
Primary Care Providers,
First responders &
School Counselors,
Corrections, Clergy
Triage training 6-10 hrs
Every willing citizen/student completes
basic QPR gatekeeper training
We must train hundreds to
save one, thousands to save
hundreds, and millions to
save thousands… and only
faith, hope, and technology
can get us there….
QPR Gatekeeper Training for Suicide Prevention
is the most widely taught basic suicide
prevention program in the United States.
Advanced training for professionals is the next
order of business in the suicide prevention
movement
Independent researchers have shown online
QPR training is equally effective to classroom
training and the same results are achieved.
Saving lives through excellence
in education
Ask a question, save a life
Preventing suicide…
It’s what people do
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Visit your local or state suicide prevention
leadership websites
Join in the cause
Visit the QPR Institute at
www.qprinstitute.com
Free e-book, Suicide: the Forever Decision is
also free as a download.
Search your smart phone apps under QPR for
free crisis support downloads or our book