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- Promoting mental resilience through optimism and connectedness.
- Education about suicide, including risk factors, warning signs and the availability of help.
- Increasing the proficiency of health and welfare services at responding to people in need. This includes better training for health professionals and employing crisis counselling organizations.
- Reducing domestic violence and substance abuse are long-term strategies to reduce many mental health problems.
- Reducing access to convenient means of suicide (e.g. toxic substances, handguns).
- Reducing the quantity of dosages supplied in packages of non-prescription medicines e.g. aspirin.
- Interventions targeted at high-risk groups.
- Research. (see below)
Suicide Prevention Research
Suicide Attempt Prevention and Intervention - a Group Psychotherapy Strategy
A psychosocial-psychoeducational group therapeutic intervention for recurrent suicide attempters is being developed which involves a combination of open discussion of the daily lived experience of individuals who have made repeated suicide attempts, and teaching new skills that can be used to "stay safe". The goal outcome of skill use, staying "safe", means avoiding making an attempt or engaging in behaviour that is harmful to the person. Participants in this program are taught skills which they can reasonably apply in their everyday lives, from "basic personal rights" to self-soothing, setting boundaries in interpersonal relationships, distraction tactics, problem solving strategies, and the idea that distress felt in the moment, no matter how unendurable, is not permanent but an experience that will pass. The goal of the program is to provide a supportive environment in which skill use is discussed each week, and succesfull skill use is consistently met with praise from other participants and the facilitators.
Basic Personal Rights
Many individuals who make recurrent suicide attempts come from backgrounds that were abusive or otherwise detrimental. Often individuals with such backgrounds have been given the message that they have no rights. Teaching basic personal rights, such as "I have the right to say no to a request" and "I have the right to make choices that take care of ME." helps to promote a sense of self-efficacy among participants. This can help set the stage for teaching skills that require participants to actively choose to care for themselves. Though a flaw may arise, when they think that they have the right to choose the personal course of the life they want, including whether or not they should die.
Self-soothing, a skill that is taught in suicide prevention groups and also in Dialectical Behavior Therapy, involves using one of the five senses to provide some sort of stimulation that is calming to the individual. For example, many find a hot beverage such as a tea or coffee to be comforting. Other self-soothing activities might include a warm or cool bath or shower, putting on favourite comfortable clothes, stroking a pet, burning incense, or listening to music. The goal of self-soothing is to lessen the person's current level of distress by providing stimulation that feels positive.
Individuals who make recurrent suicide attempts often feel that they have very little control over their lives, or that their lives are controlled by other people rather than themselves. The goal of teaching boundary setting skills is to make the participants aware that it is okay for them to have needs and wants and to go about getting these needs and wants met. Boundary setting also encourages participants to be aware of when other people in their lives are asking for things the participant would rather not give/share, or acting in a way that makes the participant feel unsafe. Boundary setting means choosing actively which things will be shared and which will not, when someone is welcome to visit and when not, and so on.
Another skill that this particular therapeutic intervention and DBT have in common is the use of distraction tactics. The goal of using a distraction is to survive the period of distress by doing things that take one's mind off of it. Distraction tactics may range anything from a quiet task like reading a favourite book, to an active task like going for a run. Distraction does not act to lessen the emotional pain, but it can take the mind off of it long enough for it to recede, which may prevent a suicide attempt that is made to escape unendurable pain.
Problem Solving Strategies
Because a suicide attempt is often seen by the attempter as the only possible solution to an insurmountable set of problems, problem solving strategies are also taught in this type of group intervention. Problem solving strategies are usually "mental tricks" such as breaking a task or problem into very small steps and then taking the steps one at a time, or working backwards from how the problem would look when solved to how it looks now, in order to identify steps that could be taken.
References & Bibliography
- Silverman, M.M., & Maris, R.W. (Eds.). (1995). Suicide prevention: Toward the year 2000. New York: Guilford Press.
- Suicide & Life-Threatening Behavior; New York - Guilford Publications, Inc
- Farberow, N. L. Vital process in suicide prevention: Group psychotherapy as a community concern. Life Threatening Behavior, 1972, 2, 239-251.
- Silverman, M.M., Davidson L., & Potter, L. (Eds.). (2001). National suicide prevention conference background papers. Suicide and Life-Threatening Behavior, 31(1) (Suppl.).
- Silverman, M.M., & Felner, R.D. (1995). Suicide prevention programs: Issues of design, implementation, feasibility, and developmental appropriateness. Suicide and Life-Threatening Behavior, 25, 93-105.
- Taylor, S. J., Kingdom, D., & Jenkins, R. (1997). How are nations trying to prevent suicide? An analysis of national suicide prevention strategies. Acta Psychiatrica Scandinavica, 95, 457-463.
- United Nations/World Health Organization. (1996). Prevention of Suicide: Guidelines for the formulation and implementation of national strategies (ST/ESA/245). Geneva: World Health Organization.
Bergmans, Yvonne; Links, Paul S. (December 2002). A description of a psychosocial/psychoeducational intervention for persons with recurrent suicide attempts. Crisis: The Journal of Crisis Intervention and Suicide Prevention 23: 156-160.
Journals of suicide prevention research
- Crisis: The Journal of Crisis Intervention and Suicide Prevention
- U.S. Surgeon General - Suicide Prevention
Suicide prevention organizations
- Suicide Prevention Action Network USA
- Suicide Prevention Resource Center
- Befrienders Worldwide
- The Samaritans (United Kingdom)
- Centre for Suicide Prevention in Canada
- Kids Help Phone (Canada)
- Choose Life (Scotland)
- National Suicide Prevention Lifeline (USA)
- Second Wind Fund (USA) - teen suicide prevention
- American Foundation for Suicide Prevention
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