SUICIDE PLANS DON’T DETERMINE RISK
It may surprise many to consider that suicide plans do not determine intent to act on those plans. In fact, unlike the protocols of many organizations who quickly ask about a plan after they’ve asked someone if they’re having thoughts of suicide, in the evidence-based, certified ASIST workshop (Applied Suicide Intervention Skills Training,) we teach Caregivers to hold off on the question about a plan until much later on in the intervention. That’s not always possible. But often it is. So, why do we ask so early?
OUTDATED POLICIES AND PROCEDURES
Policies and procedures typically instruct staff to ask about a suicide plan directly after asking about thoughts of suicide. The main reason is they are usually trying to simplify processes, and assess the level of risk someone may be experiencing. However, determining risk this way is misguided. Allow me to explain why.
In this short video we explain the difference between what I call the “hostage-taker voice” (thoughts of suicide that are trying to pull someone down to death,) and a person’s “Life Voice” (that part of them that is fighting to keep themselves safe. Sometimes knowingly. Sometimes subconsciously.) When the volume of the hostage-taker is cranked up, it can be hard, if not impossible, to hear a Life Voice. And, that’s when we need to be most concerned. That’s when it’s most difficult for someone to find their reasons for living.
When a person’s Life Voice is louder it’s not as difficult for a person to understand why they may need help keeping themselves safe from thoughts of suicide. When the Life Voice is clear to see, hear, or sense, it is less likely a person will act on their thoughts of suicide.
Let’s say you meet someone who is having thoughts of suicide and has a suicide plan. We’ll call this individual “Person A”. Traditional protocols would put this individual fairly high on their risk list. But, let’s say they can still hear their Life Voice, are feeling empowered to stay safe, and are determined to keep themselves away from their suicide plan.
Now, let’s say you meet someone else. We’ll call this individual “Person B”. Person B is having thoughts of suicide, and doesn’t have a plan. Traditional protocols would put this individual lower on their risk list, and may even refuse service to this individual. But, let’s say Person B can’t find their Life Voice at all. And, they can’t find any reasons for living. How difficult do you think it will be for Person B to find a plan in the foreseeable future? Unfortunately, it’s not difficult at all. It could happen the moment they leave your office.
So, who are you most concerned about? Protocols may say Person A. But, most people already know in their gut it’s Person B who is at greater risk.
REWRITING POLICIES AND PROCEDURES
Any time thoughts of suicide are present we should be taking the time to create a safety plan with that person. Even if there is no suicide plan. Safety planning is about a lot more than uncovering a potential suicide plan and helping to guard against it. Safety planning is about conversation around substance use, potential support systems, strengths, short term changeable situations, mental health concerns, and more. If a person’s Life Voice is buried deep, and isn’t being heard right now, we’ll likely want to take more time with them than the person who has a plan but knows why they want to stay alive and how to make that happen.
ADDING ASIST TO YOUR HEALTH AND SAFETY STANDARDS
Whether for work, or in your personal life, ASIST training will equip you to know how to ask about suicide, when to ask about a plan, and what to do in-between. It will teach you a certified model developed by LivingWorks; the gold standard in suicide intervention training. It will teach you how to safety plan, and how to gauge whether a person’s Life Voice is actively speaking, and what to do when its not.
SUICIDE IS NOT BLACK AND WHITE. OUR POLICIES AND PROCEDURES SHOULDN’T BE EITHER.
Anyone who has lived with thoughts of suicide, or been bereaved by suicide, knows that this topic is anything but black and white. It’s time policies and procedures reflected this reality.
If you’d like to revisit your organization’s policies and procedures around suicide talk and suicide risk, attend an ASIST workshop. You can find them around the world through this link. Or, click here for a list of our upcoming workshops. We are suicide interventionists. We don’t just talk how this can be done. We live it.
We also help organizations revise their policies and procedures using evidence-based models. Connect with us here for more information on our services. Or click here to register for an upcoming workshop at our new Life Voice Workshop & Wellness Centre in Guelph.