Suicide intervention skills training

Dear friends -

I have been shocked to learn that mental health professionals, primary care doctors, and even psychiatric nurses are required to take little or no suicide awareness, assessment and intervention training, and that there is no requirement for them to sustain any particular level of training in this area over the course of their careers. This means that someone at risk of suicide or someone dealing with a person at risk of suicide could be seeking support from a professional who does not have the knowledge or skills to provide it.

That was the situation for me when I sought counseling after Cliff was admitted to hospital in early December because he had tried to kill himself. None of the three counselors from whom I sought help had any training in suicide assessment and intervention, and so none were able to help me address the situation in which Cliff and I were in. They were very skilled and supportive in other aspects -- but the risk of Cliff dying was the elephant in the room that never was addressed.

Tragically, the psychiatrist treating Matt Adler, a lawyer in Washington with a wife and two young children, likewise did not have the knowledge and skills to intervene effectively when suicide became a serious risk. Matt died by suicide on February 8, 2010.

Matt's widow, Jennifer Stuber, was instrumental in getting Washington state legislation passed in June 2012 requiring mental health professionals to take 6 hours of suicide assessment and intervention training every six years. Washington is the only state to require this. There are no similar requirements for mental health professionals or primary care doctors in B.C. -- the latter of whom may be the only people from whom a suicidal person seeks help.

Can you imagine doctors, nurses, and paramedics being unable to perform CPR? That is the state of our mental health system. One of my objectives is to lobby the government and professional organizations so that is changed.

Strategy #2: Mental health first aid / Suicide intervention skills training for mental health professionals and lay people

LivingWorks in Calgary has developed programs in suicide awareness and intervention that are now used by the University of British Columbia, the U.S. Military, and other organizations in Canada, the U.S., Australia, Norway, and other countries. I took ASIST (Applied Suicide Intervention Skills Training) through the Crisis Centre of B.C. in October, and highly recommend it. This type of training should be the minimum standard for anyone working in mental health or primary care.

Opportunities for Action

Bruce Lee said, "We don't rise to the level of our expectations. We fall to the level of our training."

1. Training like ASIST saves lives. It might have saved Cliff's life. You don't know ahead of time when you might need this, and by the time you do know, you may not have the opportunity. Don't place yourself in that position. You don't have to be a medical professional to make a difference.

• Find an ASIST workshop (2 days)
• Find a safeTALK workshop (1/2 day)
• Find a mental health first aid course (2 days)

2. Ask your family physician, counsellor, and friends in the medical or mental health professions how prepared they feel to deal with patients who are suicidal or the people who are supporting them. Do they have consistent processes of assessing clients and patients to determine whether someone might be at risk of suicide? Do they feel confident addressing the situation if they do determine someone is at risk? Are there adequate resources to which to refer clients? Are they aware of the training that's available? Just having the conversation raises awareness and helps us move in the right direction.

Good News

On the positive side, I received an email this week from Cliff's psychiatrist letting me know that he and his colleagues at Vancouver General Hospital are preparing a brochure for visitors taking patients in the psychiatric units out on a pass so that they will be better prepared to respond if they have concerns; and another brochure for any family members and friends who may have accompanied someone to hospital as the result of a suicide attempt. I was heartened to know that these steps towards involvement and education of family and friends are being initiated.

Thank you for taking the time to read these updates, provide feedback and questions, and for your words of support. It means a great deal to me that there are people out there to whom this matters.