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1 Suicide Prevention Suicide Prevention Developed by: Developed by: Education, Training, and Dissemination core of the VISN 2 Center Education, Training, and Dissemination core of the VISN 2 Center of Excellence of Excellence Canandaigua VA Medical Center Center of Excellence, Bldg. 3 400 Fort Hill Avenue Canandaigua, NY 14424
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Suicide Prevention

Dec 31, 2015

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Suicide Prevention. Developed by: Education, Training, and Dissemination core of the VISN 2 Center of Excellence Canandaigua VA Medical Center Center of Excellence, Bldg. 3 400 Fort Hill Avenue Canandaigua, NY 14424. Suicide Prevention Introduction. Objectives: - PowerPoint PPT Presentation
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Page 1: Suicide Prevention

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Suicide PreventionSuicide Prevention

Developed by: Developed by: Education, Training, and Dissemination core of the VISN 2 Center of Education, Training, and Dissemination core of the VISN 2 Center of Excellence Excellence Canandaigua VA Medical CenterCenter of Excellence, Bldg. 3400 Fort Hill AvenueCanandaigua, NY 14424

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Suicide PreventionSuicide Prevention IntroductionIntroduction

Objectives:Objectives: The scope and importance of suicide preventionThe scope and importance of suicide prevention The negative impact of myths and misinformationThe negative impact of myths and misinformation How to identify a person at risk-signs symptomsHow to identify a person at risk-signs symptoms How to effectively communicate with a suicidal How to effectively communicate with a suicidal

personperson How to gain information to help the personHow to gain information to help the person How to refer a person for evaluation and How to refer a person for evaluation and

treatmenttreatment

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Suicide in the U.SSuicide in the U.S..

13.5 % of all Americans reported a history of suicidal 13.5 % of all Americans reported a history of suicidal ideation or thinkingideation or thinking

3.9 % actually made a suicide plan that included a 3.9 % actually made a suicide plan that included a definite time, place and methoddefinite time, place and method

4.6 % reported actual suicide attempts4.6 % reported actual suicide attempts 50 % of those who attempted suicide made a “serious” 50 % of those who attempted suicide made a “serious”

attempt attempt

Suicide PreventionSuicide Prevention Brief overviewBrief overview

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Suicide Suicide PreventionPrevention Brief overviewBrief overview

Suicide in the veteran populationSuicide in the veteran population

Male veterans are twice as likely as civilians of Male veterans are twice as likely as civilians of either gender to commit suicideeither gender to commit suicide

1000 suicides occur per year among veterans 1000 suicides occur per year among veterans receiving VA carereceiving VA care

5000 suicides occur per year among all living 5000 suicides occur per year among all living veteransveterans

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Suicide PreventionSuicide Prevention Brief overview Brief overview

What do the statistics mean?What do the statistics mean?

Veterans may be at higher risk for suicide. Veterans may be at higher risk for suicide. We need to do more to reduce risk.We need to do more to reduce risk. Suicides are preventable in most cases.Suicides are preventable in most cases.

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Suicide PreventionSuicide Prevention Program approachesProgram approaches

VA National InitiativesVA National Initiatives

ResearchResearch Best practices in identification and treatmentBest practices in identification and treatment Educating employees at every level Educating employees at every level Partnering with community based organizations and Partnering with community based organizations and

the armed forcesthe armed forces Veterans Suicide HotlineVeterans Suicide Hotline

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Suicide PreventionSuicide Prevention Myths and MisinformationMyths and Misinformation

Myth:Myth: Asking about suicide will plant the idea in a Asking about suicide will plant the idea in a person’s head.person’s head.

Reality:Reality: Asking a person about suicide does not Asking a person about suicide does not create suicidal thoughts any more than asking about create suicidal thoughts any more than asking about chest pain causes angina. The act of asking the chest pain causes angina. The act of asking the question simply gives the person permission to talk question simply gives the person permission to talk about his or her thoughts or feelings.about his or her thoughts or feelings.

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Suicide PreventionSuicide Prevention Myths and MisinformationMyths and Misinformation

Myth:Myth: There are talkers and there are doers.There are talkers and there are doers.

Reality:Reality: Most people who die by suicide Most people who die by suicide have communicated some intent. Someone have communicated some intent. Someone who talks about suicide gives the guide who talks about suicide gives the guide and/or clinician an opportunity to intervene and/or clinician an opportunity to intervene before suicidal behaviors occur.before suicidal behaviors occur.

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Suicide PreventionSuicide Prevention Myths and MisinformationMyths and Misinformation

Myth:Myth: If somebody really wants to die by If somebody really wants to die by suicide, there is nothing you can do about it.suicide, there is nothing you can do about it.

Reality:Reality: Most suicidal ideas are associated Most suicidal ideas are associated with the presence of underlying treatable with the presence of underlying treatable disorders. Providing a safe environment for disorders. Providing a safe environment for treatment of the underlying cause can save treatment of the underlying cause can save a life. The acute risk for suicide is often a life. The acute risk for suicide is often time-limited. If you can help the person time-limited. If you can help the person survive the immediate crisis and overcome survive the immediate crisis and overcome the strong intent to die by suicide, you have the strong intent to die by suicide, you have gone a long way toward promoting a gone a long way toward promoting a positive outcome.positive outcome.

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Suicide PreventionSuicide Prevention Myths and MisinformationMyths and Misinformation

Myth:Myth: He/she really wouldn't commit suicide He/she really wouldn't commit suicide because…because…

he just made plans for a vacationhe just made plans for a vacation she has young children at homeshe has young children at home he made a verbal or written promisehe made a verbal or written promise she knows how dearly her family loves hershe knows how dearly her family loves her

Reality:Reality: The intent to die can override any rational The intent to die can override any rational thinking. “No Harm” or “No Suicide” contracts have thinking. “No Harm” or “No Suicide” contracts have been shown to be ineffective from a clinical and been shown to be ineffective from a clinical and management perspective. A person experiencing management perspective. A person experiencing suicidal ideation or intent must be taken seriously suicidal ideation or intent must be taken seriously and referred to a clinical provider who can further and referred to a clinical provider who can further evaluate their condition and provide treatment as evaluate their condition and provide treatment as appropriate.appropriate.

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Operation S. A. V. E. will help you act with Operation S. A. V. E. will help you act with care and compassion if you encounter a care and compassion if you encounter a person who is suicidal. person who is suicidal.

The acronym “SAVE” summarizes the steps The acronym “SAVE” summarizes the steps needed to take an active and valuable needed to take an active and valuable

role in suicide prevention.role in suicide prevention. SSigns of suicidal thinkingigns of suicidal thinking AAsk questionssk questions VValidate the person’s experiencealidate the person’s experience EEncourage treatment and ncourage treatment and EExpedite xpedite

getting helpgetting help

Suicide PreventionSuicide Prevention Operation S.A.V.E.Operation S.A.V.E.

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Suicide PreventionSuicide PreventionOperation S.A.V.E.Operation S.A.V.E.

Importance of identificationImportance of identification

Suicidal individuals are not always easy to Suicidal individuals are not always easy to identify. identify.

There is no single profile to guide recognition. There is no single profile to guide recognition. There are a number of warning signs and There are a number of warning signs and

symptoms. symptoms. Some of the signs of suicidality are obvious, Some of the signs of suicidality are obvious,

but others are not.but others are not. Signs and symptoms do not always mean the Signs and symptoms do not always mean the

person is suicidal but: person is suicidal but: When you recognize signs, it is important to When you recognize signs, it is important to

ask the person how they are doing because ask the person how they are doing because they may mean that they are in trouble.they may mean that they are in trouble.

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Suicide PreventionSuicide Prevention SSigns of suicidal thinkingigns of suicidal thinking

Signs and Symptoms:Signs and Symptoms:

Threatening to hurt or kill selfThreatening to hurt or kill self Looking for ways to kill selfLooking for ways to kill self Seeking access to pills, weapons or other Seeking access to pills, weapons or other

meansmeans Talking or writing about death, dying or Talking or writing about death, dying or

suicidesuicide HopelessnessHopelessness Rage, anger Rage, anger Seeking revengeSeeking revenge Acting reckless or engaging in risky activitiesActing reckless or engaging in risky activities

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Suicide PreventionSuicide Prevention SSigns of suicidal thinkingigns of suicidal thinking

Feeling trappedFeeling trapped Increasing drug or alcohol abuseIncreasing drug or alcohol abuse Withdrawing from friends, family and societyWithdrawing from friends, family and society Anxiety, agitationAnxiety, agitation Dramatic changes in moodDramatic changes in mood No reason for living, no sense of purpose in No reason for living, no sense of purpose in

lifelife Difficulty sleeping or sleeping all the timeDifficulty sleeping or sleeping all the time Giving away possessions Giving away possessions Increase or decrease in spirituality Increase or decrease in spirituality

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Suicide PreventionSuicide PreventionAAsk questionssk questions

To effectively determine if a person is suicidal, To effectively determine if a person is suicidal, one needs to interact in a manner that one needs to interact in a manner that communicates concern and understanding. As communicates concern and understanding. As well, one needs to know how to manage well, one needs to know how to manage personal discomfort (i.e., anxiety, fear, personal discomfort (i.e., anxiety, fear, frustration, personal, cultural or religious values) frustration, personal, cultural or religious values) in order to directly address the issue. in order to directly address the issue.

Know how to ask the most important Know how to ask the most important questionquestion

The most difficultThe most difficult S. A. V. E. S. A. V. E. step is asking the step is asking the most important question of allmost important question of all – –

““Are you thinking of killing yourself.”Are you thinking of killing yourself.”

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Suicide PreventionAsk questions

How DO I ask the question?How DO I ask the question?

DO ask the question after you have enough DO ask the question after you have enough information to reasonably believe the person information to reasonably believe the person is suicidal. is suicidal.

DO ask the question in such a way that is DO ask the question in such a way that is natural and flows with the conversation.natural and flows with the conversation.

DON’T ask the question as though you are looking DON’T ask the question as though you are looking for a “no” answer. “You aren’t thinking of for a “no” answer. “You aren’t thinking of killing yourself are you?”killing yourself are you?”

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Suicide PreventionSuicide Prevention AAsk questionssk questions

Things to consider when you talk with the Things to consider when you talk with the person:person:

Remain calmRemain calmListen more than you speakListen more than you speakMaintain eye contactMaintain eye contactAct with confidenceAct with confidenceDo not argueDo not argueUse open body languageUse open body languageLimit questions to gathering information Limit questions to gathering information casuallycasuallyUse supportive and encouraging Use supportive and encouraging commentscommentsBe as honest and “up front” as possibleBe as honest and “up front” as possible

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Suicide PreventionSuicide Prevention VValidate the veteran’s alidate the veteran’s

experienceexperienceValidation means:Validation means:

Show the person that you are following what Show the person that you are following what they are sayingthey are saying

Accept their situation for what it isAccept their situation for what it is You are not passing judgment You are not passing judgment Let them know that their situation is serious Let them know that their situation is serious

and deserving of attentionand deserving of attention Acknowledge their feelingsAcknowledge their feelings Let him or her know you are there to helpLet him or her know you are there to help

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Suicide PreventionSuicide Prevention EEncourage treatment and ncourage treatment and EExpedite xpedite

getting help getting help For the cooperative person:For the cooperative person:

Tips for Tips for encouragingencouraging treatment: treatment:

1.1. Explain that there are trained professionals Explain that there are trained professionals availableavailableto help them. to help them.

2.2. Explain that treatment works.Explain that treatment works.3.3. Explain that getting help for this kind of problem Explain that getting help for this kind of problem

is nois nodifferent than seeing a specialist for other medicaldifferent than seeing a specialist for other medicalproblems.problems.

4.4. Tell them that getting treatment is his or herTell them that getting treatment is his or herright.right.

5.5. If they tell you that they have had treatmentIf they tell you that they have had treatmentbefore and it has not worked, try asking:  “What ifbefore and it has not worked, try asking:  “What ifthisthis is the time it is the time it doesdoes work?” work?”

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Suicide PreventionSuicide Prevention EEncourage treatment and ncourage treatment and EExpedite xpedite

getting helpgetting helpTips for Tips for expediting expediting a referral: a referral:

1.1. Assist the person in getting to a care facility by Assist the person in getting to a care facility by personally taking them or arranging for personally taking them or arranging for transportation.transportation.

2.2. Call the VA Suicide Hotline number with the Call the VA Suicide Hotline number with the veteran to get a referral started. 1-800-273-veteran to get a referral started. 1-800-273-TALK – push “1”.TALK – push “1”.

3.3. Call the local facility Suicide Prevention Call the local facility Suicide Prevention Coordinator – you make access this person Coordinator – you make access this person from the information desk at any VA.from the information desk at any VA.

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Suicide PreventionSuicide Prevention EEncourage treatment and ncourage treatment and EExpedite xpedite

getting helpgetting helpFor uncooperative people or those in immediate crisis:For uncooperative people or those in immediate crisis:

As you encourage the person to seek help, someAs you encourage the person to seek help, somesituations may involve people who are hostile andsituations may involve people who are hostile andaggressive.aggressive.

Here are some useful safety guidelines for workingHere are some useful safety guidelines for workingwith seriously and acutely distressed people:with seriously and acutely distressed people:  [These rules are both for the person’s safety and yours.][These rules are both for the person’s safety and yours.]

If you are not in face-to-face contact but are speaking If you are not in face-to-face contact but are speaking overoverthe phone with a person who expresses intent to the phone with a person who expresses intent to harm selfharm selfor others -or others - call 911 for assistance.call 911 for assistance.

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Suicide PreventionSuicide Prevention EEncourage treatment and ncourage treatment and EExpedite xpedite

getting helpgetting help

Any time a person has a weapon or object that Any time a person has a weapon or object that can be used as a weapon –can be used as a weapon – call for helpcall for help..

If a person tells you that they have overdosed If a person tells you that they have overdosed

on pills or other drugs or there are signs of on pills or other drugs or there are signs of physical injury – physical injury – call for help.call for help.

In addition to In addition to calling for helpcalling for help, if you are , if you are confronted with a hostile or armed person, confronted with a hostile or armed person, leave the area and attempt to isolate the leave the area and attempt to isolate the person. If the person leaves your area, attempt person. If the person leaves your area, attempt to observe his or her direction of movement to observe his or her direction of movement from a safe distance and report your from a safe distance and report your observations as soon as authorities arrive on observations as soon as authorities arrive on scene. scene.

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Suicide PreventionSuicide PreventionOperation Operation S. A.V. E.S. A.V. E.

SUMMARYSUMMARY

Operation Operation S. A. V. E.S. A. V. E. can save lives by helping you can save lives by helping you become aware of:become aware of:

SSigns of suicidal behavior and giving you the skills igns of suicidal behavior and giving you the skills to: to:

AAsk questions sk questions

VValidate the person’s experience and to alidate the person’s experience and to

EEncourage treatment and ncourage treatment and EExpedite getting helpxpedite getting help

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Suicide PreventionSuicide Prevention Operation Operation S. A.V. E.S. A.V. E.

By participating in this training you have By participating in this training you have learned:learned:

The scope of the problem of suicides among The scope of the problem of suicides among the veteran populationthe veteran population

The importance of suicide preventionThe importance of suicide prevention The negative impact of myths and The negative impact of myths and

misinformationmisinformation How to identify a person who may be at riskHow to identify a person who may be at risk Some of the signs and symptoms of suicidal Some of the signs and symptoms of suicidal

thinkingthinking How to effectively communicate with a How to effectively communicate with a

suicidal personsuicidal person How to gain information to help the personHow to gain information to help the person How to refer someone for evaluation and How to refer someone for evaluation and

treatmenttreatment

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Suicide PreventionSuicide Prevention Operation Operation S. A.V. E.S. A.V. E.

There are plenty of resources available to There are plenty of resources available to someone who is suicidal but we need someone who is suicidal but we need youyou to topartner with us in identifying the suicidal personpartner with us in identifying the suicidal personand getting them into treatment.and getting them into treatment.

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