The District of Columbia Department of Mental Health regularly conducts a free three-hour training entitled “SafeTALK: Suicide Alertness for Everyone”. Although open to anyone over the age of 15, the majority of attendees tend to be employees of the Department of Behavioral Health who needed to earn continuing education credits. This author recently attended one of them.
This workshop is part of a suite of suicide prevention programs modeled on the CPR training program which equips people to respond knowledgeably to crises. Developed by a Canadian company called LivingWorks, the complete suite of programs includes:
• Suicide Assist: Learn Suicide Intervention Skills
• SafeTALK: Learn Suicide Alertness Skills
• SuicideTALK: Bring Suicide Awareness to Your Community
• SuicideCare: Upgrade Skills for Working with Persons at Risk of Suicide After the Initial Suicide Crisis
SafeTALK is a well-crafted program that varies videos, role-playing, lecture and discussion in order to fully engage the student on how to “move beyond common tendencies to miss, dismiss or avoid” signs of suicide and how to identify those with suicidal thoughts. After attending this training, students are not expected to actually counsel or advise anyone on a professional level but only to provide that person with references to a trained provider or an appropriate care facility.
According to SafeTALK, most people who have suicidal thoughts often have ambivalent feelings about actually following through and may frequently spend a long time just considering the act. The hints they may often drop for others are missed or go unacknowledged because the listener is in denial or doesn’t know how to respond. So one key takeaway from this workshop is that any hint of suicide needs to be taken with the utmost seriousness.
Due to the stigma surrounding suicide and mental health, most people don’t feel comfortable discussing suicide or asking somebody directly whether they are thinking of killing themselves. One of SafeTALK’s core tenets is that this must change – that the only way to gain the trust of a person with suicidal thoughts or urges is to demonstrate that you are at ease, non-judgmental, and will not panic or become uncomfortable if they do take the risk of opening up to you.
This idea was hard to accept for many in the audience who felt, as clinicians, that a more indirect approach in order to establish trust and avoid the risk of offending was better. One student asked if it wouldn’t be preferable to ask whether the potentially suicidal person was “thinking of harming themselves”. The instructor responded that a person with suicidal thoughts could take this as a sign that the questioner wasn’t really comfortable talking about suicide. Further, the person could truthfully respond with a “No” if the suicide method being considered wasn’t going to be painful. Likewise, an affirmative response of “Yes” could indicate that the client only plans to self-harm via cutting, burning, etc., – ways which are not necessarily indicative of suicidal ideation. Therefore, SafeTALK maintains that one should always directly ask whether they are thinking of committing suicide rather than beating around the bush.
SafeTALK’s goal is to train as many ordinary citizens as possible to be able to identify people with suicidal thoughts or urges and provide them with references for follow-up counselling and treatment. This workshop provides this training and moves toward reducing the stigma about having direct, open and honest discussions about suicide.
1. The National Suicide Prevention Lifeline is available 24/7 and can connect the caller to a skilled, trained counselor at a crisis center in their area. You can also use the therapy finder on their website:
• 1-800-273-TALK (8255)
2. Register for the next “SafeTALK: Suicide Alertness for Everyone” and for other classes here: http://dmhtraininginstitute.networkofcare4elearning.org/
3. LivingWorks Education (designer of SafeTALK and other suicide prevention curriculum and training) http://livingworks.net/page/programs
4. Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment – Treatment Improvement Protocol (TIP) 50
5. Columbia-Suicide Severity Rating Scale (C-SSRS)
Simone Fary is the Instructional Design and Technology Specialist for the Central East ATTC, a program of the Danya Institute