Suicide prevention starts in the community! Many people trying their best and working together to prevent suicide helps make it more likely that folks struggling with mental health get what they need. I want to go over the different ways that we can work together to respond to someone with suicidal thoughts. Using things that we know are more likely to help (also known as evidence-based practices) is important because we have learned a lot by studying what does and doesn’t work to prevent suicide. For example, we now have more information and know not to use things like “no-suicide contracts,” since they do not prevent suicide behaviors, while, on the other hand, safety plans are effective.
Immediate vs. Long-Term Interventions
There are different types of things we can do when someone expresses thoughts of suicide. Some are meant to be used in the moments after discovering that someone is having such thoughts, while others are a specific treatment and are exclusively used in professional settings. Some of the immediate interventions can be learned and used by people in the community. Having more people trained to recognize signs that someone is having thoughts of suicide and able to intervene means that more people get better help to stay alive.
Why Proper Training Matters
The immediate interventions that are available to community members still require training by someone certified by whatever company maintains quality. This helps make sure that the interventions are provided in a similar manner each time. Consistency is important because we can only trust that the interventions are effective if they are used in the same way as when they were studied. If parts of the interventions are changed, we are no longer able to say that the intervention is likely to work. It’s similar to not knowing for sure which size to order for clothes or shoes when you haven’t shopped at a particular store or bought a certain style before.
Community Trainings That Save Lives
Some of the interventions in which anyone can be trained and use include Question, Persuade, Refer (QPR), Applied Suicide Intervention Skills Training (ASIST), and Suicide Alertness for Everyone: Tell, Ask, Listen, and Keep Safe (safeTALK). Links to find local trainings for each of these are included below. These trainings focus on developing the skills needed to identify signs that an individual might be considering suicide and learning how to appropriately ask about suicidal thoughts and intervene appropriately. There is also another option called Assessing and Managing Suicide Risk (AMSR) that people in direct caring roles, such as teachers, case managers, peer specialists, and more, can use to gain helpful skills.
Choosing Effective Suicide-Focused Treatments
When it comes to seeking treatment or recommending treatment for someone who has thoughts of suicide, it’s very important to make sure you’re spending your time and money wisely on something that you know is more likely to work. Especially when the stakes are so high!
What Evidence-Based Clinical Treatments Include
Most effective suicide focused treatments will involve asking questions in detail about the suicidal thoughts, including about how often they occur, how intense they are, and when they last happened. The answers to these questions help clinicians understand your problems better and be more equipped to respond helpfully. Most of these treatments will also include another intervention called a safety plan, which, when done well, can be a very helpful tool to keep people alive. These treatments will also begin with a focus on suicide, not another problem that might seem related, like general depression symptoms. The treatments do differ in terms of exactly which components will help individuals decrease thoughts of suicide.
Overview of Evidence-Based Therapies (CAMS, CBT-SP, DBT)
Collaborative Assessment and Management of Suicidality (CAMS) focuses treatment on identifying what is driving an individual to consider suicide, and targets those drivers individually, along with ongoing monitoring of symptoms. Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) focuses on identifying triggers, challenging thinking, and developing coping skills. Dialectical Behavioral Therapy (DBT) focuses on accepting reality as it is while, at the same time, working hard to change and learn skills to refrain from unhelpful behaviors, increase mindfulness and emotion regulation, and improve relationships. These are not the only treatments that are evidence-based, but these three (CAMS, CBT-SP, and DBT) are more likely to be available to you locally.
Trainings
Livingworks provides 
ASIST and SafeTALK trainings which can be found here https://findtraining.livingworks.net/events
QPR institute provides the QPR Gatekeeper training online here https://qprinstitute.com/individual-training
EDC Solutions provides AMSR training for direct care individuals in outpatient and inpatient settings and can be found at these links
References
https://zerosuicide.edc.org/resources/resource-database/suicide-care-training-options
About the AuthorHeather Smith (she/her), Psy. D. is a licensed clinical psychologist specializing in Dialectical Behavior Therapy and trauma treatment. She approaches treatment from a non-judgmental and compassionate stance and assists clients in making changes to help make life worth living. Heather is passionate about helping people heal by giving them the tools they need and encouraging them at every step. Click Here to learn more about Heathers’s experience and therapeutic style.