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Suicide Prevention Month Resources:

The five action steps for communicating with someone who may be suicidal are supported by evidence in the field of suicide prevention.


How – Asking the question “Are you thinking about suicide?” communicates that you’re open to speaking about suicide in a non-judgmental and supportive way. Asking in this direct, unbiased manner, can open the door for effective dialogue about their emotional pain and can allow everyone involved to see what next steps need to be taken. Other questions you can ask include, “How do you hurt?” and “How can I help?” Do not ever promise to keep their thoughts of suicide a secret.

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Source: Eskenazi Health / Eskenazi Health

The flip side of the “Ask” step is to “Listen.” Make sure you take their answers seriously and not to ignore them, especially if they indicate they are experiencing thoughts of suicide. Listening to their reasons for being in such emotional pain, as well as listening for any potential reasons they want to continue to stay alive, are both incredibly important when they are telling you what’s going on. Help them focus on their reasons for living and avoid trying to impose your reasons for them to stay alive.

Why – Studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts. In fact, studies suggest the opposite: findings suggest acknowledging and talking about suicide may in fact reduce rather than increase suicidal ideation.


How – This could mean being physically present for someone, speaking with them on the phone when you can, or any other way that shows support for the person at risk. An important aspect of this step is to make sure you follow through with the ways in which you say you’ll be able to support the person– do not commit to anything you are not willing or able to accomplish. If you are unable to be physically present with someone with thoughts of suicide, talk with them to develop some ideas for others who might be able to help as well (again, only others who are willing, able, and appropriate to be there). Listening is again very important during this step – find out what and who they believe will be the most effective sources of help.

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Source: Eskenazi Health / Eskenazi Health

Why – Being there for someone with thoughts of suicide is life-saving. Increasing someone’s connectedness to others and limiting their isolation (both in the short and long-term) has shown to be a protective factor against suicide. Thomas Joiner’s Interpersonal-Psychological Theory of Suicide highlights connectedness as one of its main components – specifically, a low sense of belonging. When someone experiences this state, paired with perceived burdonsomeness (arguably tied to “connectedness” through isolating behaviors and lack of a sense of purpose) and acquired capability (a lowered fear of death and habituated experiences of violence), their risk can become severely elevated.

In the Three-Step Theory (or more commonly known as the Ideation-to-Action Framework), David Klonsky and Alexis May also theorize that “connectedness” is a key protective factor, not only against suicide as a whole, but in terms of the escalation of thoughts of suicide to action. Their research has also shown connectedness acts as a buffer against hopelessness and psychological pain.

By “being there,” we have a chance to alleviate or eliminate some of these significant factors.


How – First of all, it’s good for everyone to be on the same page. After the “Ask” step, and you’ve determined suicide is indeed being talked about, it’s important to find out a few things to establish immediate safety. Have they already done anything to try to kill themselves before talking with you? Does the person experiencing thoughts of suicide know how they would kill themselves? Do they have a specific, detailed plan? What’s the timing for their plan? What sort of access do they have to their planned method?

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Source: Eskenazi Health / Eskenazi Health

Why – Knowing the answers to each of these questions can tell us a lot about the imminence and severity of danger the person is in. For instance, the more steps and pieces of a plan that are in place, the higher their severity of risk and their capability to enact their plan might be. Or if they have immediate access to a firearm and are very serious about attempting suicide, then extra steps (like calling for emergency help or driving them to an emergency department) might be necessary. The Lifeline can always act as a resource during these moments as well if you aren’t entirely sure what to do next.

The Harvard T.H. Chan School of Public Health notes that reducing a suicidal person’s access to highly lethal means (or chosen method for a suicide attempt) is an important part of suicide prevention. A number of studies have indicated that when lethal means are made less available or less deadly, suicide rates by that method decline, and frequently suicide rates overall decline. Research also shows that “method substitution” or choosing an alternate method when the original method is restricted, frequently does not happen. The myth “If someone really wants to kill themselves, they’ll find a way to do it” often does not hold true if appropriate safety measures are put into place. The Keep Them Safe step is really about showing support for someone during the times when they have thoughts of suicide by putting time and distance between the person and their chosen method, especially methods that have shown higher lethality (like firearms and medications).


How – Helping someone with thoughts of suicide connect with ongoing supports (like the Lifeline, 800-273-8255) can help them establish a safety net for those moments they find themselves in a crisis. Additional components of a safety net might be connecting them with supports and resources in their communities. Explore some of these possible supports with them – are they currently seeing a mental health professional? Have they in the past? Is this an option for them currently? Are there other mental health resources in the community that can effectively help?

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Source: Eskenazi Health / Eskenazi Health

One way to start helping them find ways to connect is to work with them to develop a safety plan. This can include ways for them identify if they start to experience significant, severe thoughts of suicide along with what to do in those crisis moments. A safety plan can also include a list of individuals to contact when a crisis occurs.

Why – Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline found that individuals that called the National Suicide Prevention Lifeline were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls handled by Applied Suicide Intervention Skills Training-trained counselors. These improvements were linked to ASIST-related counselor interventions, including listening without judgment, exploring reasons for living and creating a network of support.


How – After your initial contact with a person experiencing thoughts of suicide, and after you’ve connected them with the immediate support systems they need, make sure to follow-up with them to see how they’re doing. Leave a message, send a text, or give them a call. The follow-up step is a great time to check in with them to see if there is more you are capable of helping with or if there are things you’ve said you would do and haven’t yet had the chance to get done for the person.

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Source: Eskenazi Health / Eskenazi Health

Why – This type of contact can continue to increase their feelings of connectedness and share your ongoing support. There is evidence that even a simple form of reaching out, like sending a caring postcard, can potentially reduce their risk for suicide.

Studies have shown a reduction in the number of deaths by suicide when following up was involved with high risk populations after they were discharge from acute care services. Studies have also shown that brief, low cost intervention and supportive, ongoing contact may be an important part of suicide prevention. Please visit our Follow-Up Matters page for more.

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Source: Eskenazi Health / Eskenazi Health

QPR: Question. Persuade. Refer.

Three steps anyone can learn to help prevent suicide.

We can all save lives. The QPR mission is to reduce suicidal behaviors and save lives by providing innovative, practical and proven suicide prevention training. The signs of crisis are all around us. We believe that quality education empowers all people, regardless of their background, to make a positive difference in the life of someone they know.

Ask a Question. Save a Life.

QPR stands for Question, Persuade and Refer- the 3 simple steps anyone can learn to help save a life from suicide. QPR is not a form of counseling or treatment. Rather it is intended to offer hope through positive action. By learning QPR you will come to recognize the warning signs, clues and suicidal communications of someone in trouble and gain skills to act vigorously to prevent a possible tragedy.

The QPR method was developed specifically to detect and respond to anyone emitting suicide warning signs. However, independent researchers and federal agencies who funded the original assessments of QPR have suggested that the QPR intervention could be useful in far broader application. Indeed, QPR is widely applied as a universal intervention for anyone experiencing emotional distress. QPR meets the requirements of HEA 1430- Suicide Awareness and Prevention.

Goals of QPR Gatekeeper Training:

  • Recognize the Risk Factors, Warning Signs and Protective Factors of suicide
  • Know how to offer hope
  • Know how to get help and save a life


  • CRISIS TEXT HOTLINE: Text HELLO to 741741 – Free, 24/7, Confidential


What is Lifelines?

Lifelines is a comprehensive youth suicide prevention program that targets the entire school community. It has four sequential components for administration, school faculty/staff, parents, and students.

What are the goals of Lifelines?

  • To increase the likelihood that members of the school community can more easily identify potentially suicidal youth, know how to initially respond to them and how to rapidly get help for them.
  • To increase the likelihood that troubled adolescents are aware of and have immediate access to helping resources and seek such help as an alternative to suicidal actions.

According to the American Association of Suicidology, suicide ranked as the third leading cause of death for young people (ages 15-19 and 15-24.) While suicides accounted for 1.4% of all deaths in the U.S. annually, they comprised 12.2% of all deaths among 15-24-year-olds.

In order to address this important issue, we offer a revised and updated version of this top suicide education program, Lifelines®: A Comprehensive Suicide Awareness and Responsiveness Program for Teens. This is a whole-school program made up of three unique components:

Lifelines: Prevention, Lifelines: Intervention, and Lifelines: Postvention

This trilogy of programs is the only existing model of its kind available for teens, and it has been recently updated to be an even stronger asset to your community. The following updates are new to this edition:

  • Updated language to reflect today’s youth culture and best practices
  • Content covering social media’s influence on suicide prevalence
  • New videos and handouts on suicide warning signs and how to do a warm handoff
  • Now includes grades 5-6 and 9-12, in addition to 7-10
  • The complete Lifelines Trilogy is based on over 20 years of suicide-in-youth research that indicates an informed community can help to prevent vulnerable teens from ending their lives.

Lifelines Prevention: Building Knowledge and Skills to Prevent Suicide

This first part of the Lifelines Trilogy educates middle and high school faculty, parents, and students on the facts about suicide and their roles in suicide prevention. It gives students the opportunity to learn what to do when faced with a suicidal peer through role-playing, and shows them the importance of getting help for themselves if needed. Nine included video segments depict real-world situations among peers and help bring abstract concepts into focus. Among these are interviews with recent high school graduates in a variety of educational and career paths to help students visualize what life after high school can look like. Finally, in two additional video segments for adults, Lifelines author Maureen Underwood provides coaching on vital skills in suicide prevention.

Designed for implementation in middle schools and high schools, Lifelines Prevention targets the whole school community by providing suicide awareness resources for administrators, faculty and staff, parents, and students. It fits easily into health class programming and lesson plans.

Lifelines Intervention: Helping Students at Risk for Suicide

The second installment in the Lifelines Trilogy provides information on how to be prepared to address and respond to threats or signs of suicide and intervene—before it’s too late.

Lifelines Intervention provides clear guidance on how best to involve parents and guardians as partners and builds on the foundation of the ‘competent and compassionate school community.’ Furthermore, this program introduces the “Tell Me More” format of intervening on a student at risk for suicide, and provides information on how to prepare to interview an at-risk student, gather collateral information about the student’s risk for suicide, and address specific topics. This revised version includes two new handouts explaining suicide warning signs and how to do a warm handoff when you suspect a student may need more care, as well as updated language to reflect today’s best practices and youth culture.

Lifelines Postvention: Responding to Suicide and Other Traumatic Death

This comprehensive third installment of the Lifelines Trilogy educates everyone in middle and high school community on how to successfully address and respond to not only suicide, but any type of traumatic death that profoundly affects the school population.

With in-depth references and detailed plans, this resource outlines a response strategy that reflects the challenges schools face in dealing with a death within the school community. This newly revised edition includes updated language and new topics to reflect today’s society, and now also covers grades 5-6 and 11-12.

Although the research and outcomes are based on school-wide implementation, any part of the Lifelines Trilogy can be a successful component to community-based programs, such as Girl Scouts, Boy Scouts, Boys and Girls Clubs of America, youth groups, afterschool programs, and summer camps.


  • CRISIS TEXT HOTLINE: Text HELLO to 741741 – Free, 24/7, Confidential





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