How QPR Works

QPR trained citizen gatekeepers help create a community safety net for suicidal people by identifying them, questioning them, and persuading them to accept a referral for professional evaluation and/or care. Initiating this chain of events is a significant responsibility, not unlike initiating CPR until professional medical help arrives.

To be successful, the actions of citizen gatekeepers must be acknowledged and supported by the professional community. When a QPR intervention is attempted, and if a referral is made, professional providers must respond. Professionals must not only endorse QPR gatekeepers as credible suicide prevention volunteers, but must also honor and respect their efforts to make life-saving interventions.

Volunteer QPR gatekeepers must be fully informed, not only about the community resources available to them as citizens, but specifically who they should contact for support, consultation and/or advice when faced with what might prove to be a difficult intervention.

The possible outcomes from a QPR intervention may include any of the following:

• Concerns for suicide are not warranted and suicidality is clearly denied. No professional action is warranted.
• Someone believed to be suicidal refuses all contact by the gatekeeper. Once suicidality has been established, even by a third party, further action by a professional is required.
• The suicidal person accepts a referral, and a referral is available. No professional action is necessary except to implement the referral.
• The suicidal person accepts a referral for help, but refuses to travel to the site of the appointment. Further professional action is required, i.e., a home visit for further evaluation.
• The suicidal person is ambivalent about accepting a referral and is clearly lethal. Professional consultation and intervention is required.
• The suicidal person is ambivalent about accepting a referral but is not clearly lethal. Professional consultation and possible intervention is required.

For volunteer QPR gatekeepers to be effective, community professionals must help and support their courageous efforts. The skills necessary to properly evaluate relative suicide risk, imminence of a suicidal act and what, if any, treatment may be needed, is clearly beyond the skills of citizen volunteers.

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