Summer 2003
In spite of a slow economy, suicide prevention efforts are heating up! Let’s just clip the breaking news and recent events…

News! On top of the Surgeon General’s National Strategy for Suicide Prevention and the Institute of Medicine’s Reducing Suicide: a National Imperative, now comes the President’s New Freedom Commission on Mental Health report. Released on July 23, 2003, not only does this report endorse the national strategy, but lists as its top recommendation, “1.1 Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention.”

We have, now, yet another blueprint for action. It’s nice to know our growing ranks of Certified QPR Instructors are already in the heat of the action…, educating, training, referring and helping others to prevent the next suicide. We applaud your energy and commitment.

News! The Partnership of Community Resources for Douglas County, Nevada hosted the QPR Institute’s training of 20 new QPR Instructors. Participants included a cross section of people from all walks of life. This is the first group in Nevada to bring QPR to their community. Nevada has always ranked an unenviable number 1 in completed suicides in America and only in 2000 did Alaska take the lead.

News! In June, the University of Rochester Center for the Study and Prevention of Suicide held a national consensus conference in Washington DC on preventing suicide among men in their middle years (ages 25 to 54). In attendance were several major US corporations and leaders from the National Institutes of Health, the US Air Force, the Employee Assistance Society of North America, the National Institute for Occupational Safety and Health, the Veterans Health Administration, the QPR Institute, researchers, representatives of the healthcare industry and several international experts. Keynoters highlighted a stark and alarming fact: men in their middle years kill themselves at twice the baseline rate of other Americans, a death rate of more than 22 deaths per 100,000 persons per year.

Of note to QPR Instructors, whereas schools are the venue for youth suicide prevention efforts, conference attendees agreed that the workplace is a potential venue for suicide prevention efforts for working adults. Since smart businesses have embraced physical and psychological wellness programs as cost-effective strategies in protecting the human capital necessary to achieve corporate goals, it was further agreed that cost-effective suicide prevention efforts delivered in the workplace might be well received by innovative and bold corporate leaders.

In the coming months, the QPR Institute will be developing a “corporate model” for introducing and delivering suicide prevention training in the workplace. We invite all QPR instructors to think “out of the box” on how to get suicide prevention awareness and prevention programs into the work place and we invite your ideas. Once we produce “business-friendly” entry strategies, we will share these with you in future tool kit updates and via the password protected area on our web site.

We also invite you to think about how to access suicidal men in their middle years, both in and out of the workplace. Historically our national focus and funding for suicide prevention has been targeted toward youth and to a lesser degree, a few special populations. One of the speakers at this conference noted that she was able to find “only two studies” dealing with suicide by men in their middle years. For our part here at the QPR Institute, we are working to address this unexplored territory.

We are exploring a federal grant opportunity to take suicide prevention training into the workplace and it would be most helpful for our research team to hear some first person “impact” stories on the problem of suicide in the workplace. We are most interested to determine what variables should be considered in a cost-benefit analysis of why suicide prevention education is a “good investment.” Any ideas you have can be emailed directly to Paul Quinnett at pquinnett@mindspring.com. Thanks.
News! Suicide Prevention Outreach Opportunities Through Van’s Warped Tour: The National Hopeline Network is seeking volunteers for an outstanding suicide prevention awareness outreach opportunity through the Van’s Warped Tour (summer concert series). In exchange for free admission to the concert, as well as the opportunity to interact with nearly 10,000 concert goer's at each show, volunteers are asked to help discuss suicide prevention and raise awareness of suicide prevention resources such as 1-800-SUICIDE. For tour dates and cities, visit http://www.warpedtour.com/dates.html; to volunteer, email info@hopeline.com or call 1-800-442-HOPE (4673), option 3.”
Item: According to Franklin Cook of the Front Porch Coalition in Rapid City, South Dakota whose staff are teaching QPR to many Native Americans, the Lakota Souix translation of QPR is, “tiopa awanyanka” which translates to “watching at the door” or “protecting the door.” Do you have a translation for another language? If yes, please share, and remember, your QPR slides, booklets and cards are available in Spanish by special request.
Item: We have had a tremendous response to the announcement of the free, downloadable Suicide: the Forever Decision. If you have not done so, please visit our web site and download a copy to share when you are training. Burn it on a CD, print it out, and distribute as you see fit. Also, the French and German editions are being scanned, edited and updated and will also be made available free throughout the world.
Announcement! As was covered in an earlier newsletter, the new QPR on CD-ROM web-enabled training program has been thoroughly tested and is now available for purchase on our web site. We know how difficult funds are to raise for suicide prevention. We also know how important it is to “get the message out.” Thus, we wish to announce that for those Certified Instructors who wish to participate in our new Partners in Prevention program, we have developed a revenue sharing plan which will enable you and/or your organization to earn up to $8.00 per CD sold without any up front investment by you or your organization. We have posted this offer in detail on the password protected area of the QPR web site. (To refresh your memory, click on www.qprinstiute.com, click on Teaching QPR, scroll to Instructor Site, enter “ask” and you’re in).

Reminder! The new Instructor’s Edition of the QPR on CD ROM is available for purchase. In our effort to stay on the leading edge of suicide prevention education, we have integrated the QPR video, Power Point slides (including a voice over presentation of the QPR curriculum by Dr. Quinnett in case you have a sore throat), two new multimedia presentations on the size and scope of the problem of suicide in America, the relationship of depression to suicide, a variety of document masters for evaluation, handouts, and Certificates of Course Completion. You will still need your booklets and cards for all participants, and you will need a computer and LCD projector to deliver this program. Early testers of the program have been, as they say, “blown away” by the power of this program. The CDs come with instructions and several program delivery options. As you know, our goal is to elevate suicide prevention education and training to the highest possible standards. The cost of the CD-ROM and instructions is $29.95 each, and are only available to Certified QPR Instructors.
QPR Instructor Toolkit Update

The “so-called” No-Suicide Contract

As you know, part of what we teach in QPR is for the gatekeeper to secure a commitment by a potentially suicidal person to stay alive and not attempt suicide. As you may or may not know, there is little published research to support this intervention. Still, based upon years of clinical experience, the staff and faculty of the QPR Institute have taken the position that it is better to ask someone to stay alive than to not ask them. Anyone who admits to having suicidal thoughts, feelings and plans and who refuses help and/or refuses to agree to stay alive is – based upon common sense alone – at higher risk for a suicide attempt or completion.

Points to consider when participants query you about this aspect of the training:

  • Despite clinical lore and according to the research literature and expert clinical suicidologists, there is no scientific evidence that so-called “no suicide” contracts actually save lives or prevent suicide attempts.
  • Specific training in the use of “no-suicide” contracts is largely unavailable, including for those working in the helping professions.
  • “No-suicide” contracts are sometimes wrongly used by professionals in an effort to avoid complaints of malpractice. In a word, the practitioner’s duty is to assess and manage suicide risk, not secure a “contract.” Our position has been that for healthcare practitioners the use of contract language is not justified and should be replaced with “informed consent” treatment/referral language.
  • Experts agree, however, that the refusal of a suicidal person to enter into any good-faith agreement to remain safe (which implies a willingness to accept a referral and/or participate in recommended treatment), suggests the risk for suicide attempt may be high. This is the common sense argument you can make to your audiences.
  • Some of the reasons why getting a commitment to stay alive include the following:
    *The person in crisis may feel supported by the gatekeeper and come to believe that at least one person wants him or her to live
    *The gatekeeper provides a “hot link” to help and thus may reduce the impulse to attempt suicide
    *The person in crisis may experience some comfort and relief at making a public commitment to life
    *Agreeing to stay alive is an affirmation that life is still worth living

In summary, we discourage the use of the so-called no-suicide contract per se (including written versions), but do endorse and embrace the intervention of asking a suicidal person to recommit to life and to promise the gatekeeper they will postpone any suicide attempt and wait until help can be gotten, or the crisis passes. We also strongly support any research in this area of inquiry.

The Staff and Faculty of the QPR Institute
Keep up the wonderful and life-saving work!
The QPR Institute
P.O. Box 2867
Spokane, WA 99220
e-mail: qinstitute@uswest.net
www.qprinstitute.com
Phone: 888-726-7926