Gatekeeper TrainingA Community Approach

to Youth Suicide PreventionPresented by Lucia R. Martin, M.Ed., NBCT

Resource School CounselorAnne Arundel County Public Schools

History

• Annual county-developed gatekeeper training• Trauma Response Teams• Cluster suicides – Spring 2009• Garrett Lee Smith Youth Suicide Prevention

Grant award – Levels 1 and 2– Identification of QPR Gatekeeper Training– ASIST

• Formation of Youth Suicide Awareness Committee

Youth Suicide Awareness Committee

QPR training

Lifelines

Youth Suicide Awareness Conference

Trauma Response Process

ID Card Lessons

High School mini-grants

Gatekeeper training research resultsIncreased knowledge

Increased recognition of sources of stressIncreased confidence and competence in

helping someone in crisisIncreased likelihood to intervene

Increased likelihood to call a resourceSatisfaction with the training

For every 13 gatekeepers trained, there was one referral made

Knowledge and skills are retained over time

QPR Works!

Why QPR?

• Evidence-based, one of few allowed in the grant

• Cost, amount of time for training• Accessible to a broad range of experience• Online support/resources for trainers• Several different formats available (for

community, agencies, youth, educators)

QPR Training

• 60 Trainers trained November 2009 and September 2010• Parents trained at Parent Involvement Conference, YSA

Awareness Conference• All Student Services personnel trained Winter/Spring

2010• All coaches/assistants trained Fall/Spring 2010 - 11• All secondary schools trained SY 2010 – 2011• All elementary schools trained SY 2011 – 2012• Parents, community partners, faith-based community,

etc. trained 2010 - 2012

QPR

Ask A Question, Save A Life

In School Settings

QPRQuestion, Persuade,

Refer

In School Settings

QPR

• QPR is not intended to be a form of counseling or treatment.• QPR is intended to offer hope through positive action.

In School

QPR Myths And Facts About Suicide• Myth Suicidal young people keep their plans to themselves.• Fact Most suicidal people communicate their intent sometime

during the week preceding their attempt.• Myth Those who talk about suicide don’t do it.• Fact People who talk about suicide may try, or even

complete, an act of self-destruction.• Myth Once a person decides to complete suicide, there is

nothing anyone can do to stop them.• Fact Suicide is the most preventable kind of death, and almost

any positive action may save a life.

How can I help? Ask the Question...

In School

QPR Myths And Facts About Suicide

• Myth If a suicidal youth tells a friend, the friend will access help.

• Fact Most young people do not tell an adult.

In School

Good Friends Don’t Keep Deadly Secrets!

QPR

Suicide Clues And Warning Signs

The more clues and signs observed,

the greater the risk.

Take all signs seriously.

In School

QPR•Strongest Predictors

•Verbal clues

•Indirect or “coded” clues

•Behavioral clues

•Situational clues

•Other youth-related clues

In School

QPR Tips for Asking the Suicide Question

• If the young person is reluctant, be persistent• Talk to the person alone in a private setting• Allow the person to talk freely• Give yourself plenty of time• If in doubt, don’t wait, ask the question• Have your resources handy: QPR Card, community

resources phone numbers and know your school protocol for handling suicide risk

•

Remember: How you ask the question is less important than that

you ask it

In School

QQUESTION

Direct Approach:• “You know, when people are as upset as

you seem to be, they sometimes wish they were dead. I’m wondering if you’re feeling that way, too?”

• “You look pretty miserable, I wonder if you’re thinking about suicide?”

• “Are you thinking about killing yourself?”

NOTE: If you can not ask the question, find someone who can.

QQUESTION

HOW TO ASK THE SUICIDE QUESTION

Less Direct Approach:

• “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 wakeup?”

WAYS NOT TO ASK THE QUESTION

“You’re not thinking about suicide are you?”

OR

“You’re just kidding about killing yourself, right?”Asking in this way encourages a negative response from

the young person you are talking with. It may also implythat you are frightened by the intensity of their feelings.

Similarly, be aware of your own non-verbal clues.

PPERSUADE

FOR QPR IN SCHOOL SETTINGS

• Listen to the problem and give them your full attention

• Remember, suicide is the solution to a perceived insoluble problem. Suicide is not the problem.

• Do not rush to judgment• Offer hope in any form

PPERSUADE CONT.

THEN ASK:

• “Will you go with me to talk with your school counselor, school psychologist, school social worker, school nurse?”

• “Would you like me to tell your school counselor school psychologist, school social worker, school nurse that you would like to talk to him or her?”

PPERSUADE CONT.

• “If you are unable or unwilling to talk to your counselor, school psychologist, school social worker, school nurse, I want you to know that I care enough about you that I will let them know.”

NOTE: The school counselor, school psychologist, school social worker or school nurse and/or administrator must be informed if you believe you are seeing suicidal clues or warning signs from a student.

*Here, we discuss our regulations, processes with school staff.

RREFER FOR QPR IN SCHOOL SETTINGS

• Suicidal young people often believe they cannot be helped, so you may have to do more.

• The best “referral” involves taking the person directly to see the school counselor, school psychologist, etc.

• The next best “referral” is when the student wants you to talk to the counselor first. (The young person should be monitored closely in the interim.)

• The third best option is to make sure the student is safe, is under observation by an adult, and then you tell the school counselor, school psychologist, etc. the warning signs you have observed.

NOTE:

You are not being disloyal or violating a trust when you share of a young person’s suicidality with a school

counselor or administrative staff.

You are being disloyal if you do not!

REMEMBER

Since almost all efforts to persuade a young

person to live instead of attempt suicide

will be met with agreement and relief,

don’t hesitate to get involved.

Challenges

• Time for training:– Trainers in each secondary school (35)– Resource student services personnel– Support from executive staff

• Cost of booklets– Grant funds– Out of the Darkness Walk

• Communication

Youth Suicide Awareness Committee

Lifelines

•Evidence-based curriculum•Reviewed by committee including community members, educators, students, parents•4 lessons, uses ASIST, but we are using QPR language•Part of mandatory (graduation requirement) Health curriculum

Youth Suicide Awareness Committee

• Conference held May 6, 2010• 280 school system and community agency

participants• National presenters on cluster suicide• Breakout sessions

Youth Suicide Awareness Committee

Trauma Response Process

• Each secondary school has a school-based Trauma Team made up of student services personnel assigned to the school.– Training provided to school-based personnel

• Feeder system teams made up of a school psych or sw, school counselor, ppw, and school nurse (personnel not assigned to that feeder)

• Elementary cluster teams with POC assigned by central office

• Trauma planners

Youth Suicide Awareness Committee

ID Cards•State mandated for all secondary students

•Lessons developed by Central Office

Youth Suicide Awareness Committee

High School Mini-Grants

• Stemmed from STAR week• $2000 per high school• Must include QPR and Substance Abuse• Must involve at least one community partner

Questions? Comments?

• Lucia Martin, M.Ed., NBCTResource CounselorAnne Arundel County Public Schools