Suicide Intervention Handbook

by Richard F. Ramsay MSW, Brian A. Tanney, William A. Lang

The 152-page, extensively revised, tenth edition of the Suicide Intervention HandbookTM is a basic primer on all aspects of suicide prevention with an emphasis on suicide intervention. Among the authors are the designers of the Applied Suicide Intervention Skills Training (ASIST) the most widely used training vehicle on suicide intervention in the world. Written in an easy-to-read, non-technical style, the content is state-of-the-art on intervening to help people at risk of suicide. It is for family, friends, police officers, counsellors, teachers, physicians, nurses, mental health workers anyone who wishes to make a difference. It should be on the shelf of every helper and in the homes of everyone in the community. The Handbook is ideal for a wide range of education opportunities from general courses and seminars on helping practices to focused content on suicide intervention in technical training forums for mental health professionals. The handbook explores caregiver attitudes, provides tools for recognizing and estimating risk, outlines the steps and processes involved in doing an intervention and provides 25 pages of intervention illustrations. This content is bordered by an opening and closing chapter which places intervention into the entire suicide prevention picture. The last chapter provides many options for getting involved with suicide prevention. Several chapters are followed by extensive supplemental materials. Each chapter concludes with an intriguing true and/or false quiz. This handbook is primarily an introduction to suicide intervention. While we believe you will find the handbook helpful, it alone will not prepare you to be a suicide intervention caregiver, regardless of prior training. As a simple way of explaining that more is involved, this handbook is also part of the participant materials for the two-day, Applied Suicide Intervention Skills Training (ASIST). In ASIST, this handbook primarily serves as a refresher for what is learned first hand. If you want to feel ready, willing and able to be a suicide intervention caregiver, plan to attend an ASIST or similar workshop.

Genres: Psychology

151 pages, Paperback

First published January 1, 2004

Reviews

[Tinea · Rating 4 out of 5]

I read this to gain skills for mental health support work, to apply better self-care, and to understand what happens when you talk about suicide with a trained responder; what are the next steps, what words/actions triggers what reaction, and how does that process go. This organization offers workshops called ASIST, which are basically suicide prevention first aid courses. I would love to take one.

This book takes the viewpoint that any verbal acknowledgment of suicidal thoughts is an invitation for help. Talking about suicide is a sign of internal ambivalence. While a person may have clear reasons they want to die, they often hesitate to go through with it because they also have reasons to live. The job of the suicide prevention first responder is to look out for verbal and emotional cues that someone is suicidal, and then help explore with them that person's reasons to live, whatever it is that is keeping them from having already done it. The next step is to create an immediate safety plan that delays suicidal action until that person can access further resources.

The steps in a suicide intervention, as outlined in the book, and summarized in my own words, are:
1. Explore. Notice and verbally ask about verbal and emotional clues that someone is really struggling in their life. Trust your intuition but also actively look for signs that people are responding suicidally to their stresses. Focus on how someone is feeling rather than your own assessment of how bad an event/stress is.
2. Ask. Straight up ask if someone is thinking about suicide or planning to kill themself. You won't put the idea in their head if they're not already thinking about it, and dancing around the question keeps it taboo and prevents someone from opening up to you.
3. Listen. Specifically, ask about and listen attentively to both the reasons for dying and the reasons for living. People often gotta dump out the former before they can begin to explore and give any merit to the latter. Be sure to hear both.
4. Review risk factors. Anyone who is talking about suicide needs first aid. The shape of that first aid may be determined by several risk factors that sound alarms that someone may be closer to taking their own life:
--Prepared: They have a current suicide plan, possibly including how, when, and where. (Disable the plan)
--Desperate: They talk about unbearable physical or emotional pain, which makes escaping it urgent. (Ease the pain)
--Alone: The person feels alone. (Connect to resources)
--Familiar: They have tried suicide before or are otherwise familiar with it. (Protect against the danger and/or support past survival skills)
--Vulnerable: They have a mental health issue, especially depression or schizophrenia. The book didn't highlight this, but PTSD often contributes to suicide as well, for example in soldiers and rape survivors. (Link to health worker)
5. Contract a safe plan. Create a safe plan that includes the suicidal person agreeing to postpone suicide for a certain period of time, during which they will connect with further resources. Be specific about how this will happen.
6. Follow-up on everything you agree to do.

Safe plans may include calling a suicide hotline, going to the emergency room, seeing a therapist, or simply agreeing to get in touch if they consider suicide again, depending on how urgent the care needed appears. It may include removing guns, pills, or other things necessary to physically disable a plan, and potentially staying with that person until you can pass them on to further help. The idea is to get that person to agree to what they need to do to prevent them from immediately harming themself. If the suicidal thoughts are not serious or urgent, that may just mean opening lines of communication for them to talk again if the feelings become more overwhelming. Having a talk that specifically mentions suicide is one way to allow it to happen again.