QPR

Ask A Question, Save A Life

QPRQuestion, Persuade,

Refer

QPR• QPR is not intended to be a form of counseling or treatment.

• QPR is intended to offer hope through positive action.

In School

QPR Suicide Myths and Facts• Myth Confronting a person about suicide will only make

them angry and increase the risk of suicide.• Fact Asking someone directly about suicidal intent lowers

anxiety, opens up communication and lowers the risk of an impulsive act.

• Myth Only experts can prevent suicide.• Fact Suicide prevention is everybody’s business, and anyone

can help prevent the tragedy of suicide.• Myth Those who talk about suicide don’t do it.• Fact People who talk about suicide may try, or even

complete, an act of self-destruction.

In School

How can I help? Ask the Question...

QPR

Suicide Clues And Warning Signs

The more clues and signs observed,

the greater the risk.

Take all signs seriously.

In School

QPR Strongest Predictors• Previous suicide attempt• Current talk of suicide/making a

plan• Strong wish to die/preoccupied

with death (i.e., thoughts, music, reading)

• Depression (hopelessness, withdrawal)

• Substance use• Recent attempt by friend or

family member

In School

QPR Verbal Clues:• “I’ve decided to kill myself.”• “I wish I were dead.”• “I’m going to commit suicide.”• “I’m going to end it all.”• “If (such and such) doesn’t

happen, I’ll kill myself.”

In School

QPR Indirect or “Coded” Verbal

Clues:• “I’m tired of life, I just can’t go

on.”• “My family would be better off

without me.”• “Who cares if I’m dead anyway.”• “I just want out.”• “I won’t be around much longer.”• “Pretty soon you won’t have to

worry about me.”

In School

QPR Behavioral Clues:• Past suicide attempt• Getting a gun or stockpiling pills• Giving away prized possessions• Impulsivity/increased risk taking• Unexplained anger, aggression,

irritability• Self-destructive acts (i.e., cutting)• Chronic truancy, running away• Perfectionism

In School

Situational Clues:• Being expelled from school /fired from job• Family problems/alienation• Loss of any major relationship• Death of a friend or family member, especially

if by suicide• Diagnosis of a serious or terminal illness• Financial problems (either their own or within

the family)• Sudden loss of freedom/fear of punishment• Feeling embarrassed or humiliated in front of

peers• Victim of assault or bullying

QPR

In School

Other Related Clues:• Change in interaction with family and friends

• Recent disappointment or rejection

• Sudden decline in academic performance

• Physical symptoms: eating disturbances, changes in sleep patterns, chronic headaches, stomach problems

• Increased apathy

QPR

In School

Find the Signs

A 22-year-old single male who is on an athletic scholarship has just been arrested for a DUI. He also recently separated from his girlfriend, andsaw her on a date with another member of his team last week. He’s beendrinking since age 16, but the drinking has increased since his girlfriendleft him to the point that now he has been stopped by the police. He isangry because he has been referred to the counseling center for anassessment and anxious about what will happen with his scholarship anddriver’s license. He is also ashamed because he is very successful as astudent athlete and many students look up to him. He feels that everythingis coming down on him all at once and feels hopeless about his future anddoesn’t think he can handle it without drinking.

• A young woman has been trying unsuccessfully for the past two months to find a job after having been let go from her last job. She is really starting to have struggles financially and doesn’t know how she is going to be able to cover any bills this month, or any month. She has had several fights with her roommates. She was informed earlier in the week that she was being moved to another dorm room because the fighting is loud and there have been too many complaints about them.

QPR Tips for Asking the Suicide Question• If the person is reluctant, be persistent• Talk to the person alone in a private

setting• Allow the person to talk freely• Give yourself plenty of time• If in doubt, don’t wait, ask the question• Have your resources handy: QPR Card,

community resources phone numbers and know your school protocol for handling suicide risk

•

Remember: How you ask the question is less important than

that you ask it

In School

QQUESTION

HOW TO ASK THE SUICIDE QUESTION

Less Direct Approach:

• “Have you been unhappy lately?” “Have you been very unhappy lately?” “Have you been so unhappy lately that you’ve been thinking about ending your life?”

• “Do you ever wish you could go to sleep and never wakeup?”

QQUESTION

Direct Approach:• “You know, when people are as upset as

you seem to be, they sometimes wish they were dead. I’m wondering if you’re feeling that way, too?”

• “You look pretty miserable, I wonder if you’re thinking about suicide?”

• “Are you thinking about killing yourself?”

NOTE: If you can not ask the question, find someone who can.

WAYS NOT TO ASK THE QUESTION

“You’re not thinking about suicide are you?”

OR

“You’re just kidding about killing yourself, right?”Asking in this way encourages a negative response from

the person you are talking with. It may also implythat you are frightened by the intensity of their feelings.

Similarly, be aware of your own non-verbal clues.

What would you say?

You meet with a 22-year-old senior who will graduate in two months. As of right now, they have not been offered any interviews for the jobs they have applied for. They have also had increased conflict with their parents. At some point during the conversation, the student says: "Can I donate my stereo system to the dorms? I won't need it anymore, and I'm sure another student could get good use out of it."

You're called to a dorm room because a student is belligerent. You learn that his mother recently died of cancer. He continues to make good grades, has friends, but his girlfriend decided to end their relationship. He says "I just can't take this anymore" and becomes tearful.

A freshman student is speaking to you and tells you that she's been having a hard time being far away from her family. She's made very few friends and does not interact much with others. Her parents tell her she has to stick it out for the year, and this has been causing her to lose sleep. She makes the statement "It's just not worth it anymore."

PPERSUADE

FOR QPR IN SCHOOL SETTINGS

• Listen to the problem and give them your full attention

• Remember, suicide is the solution to a perceived insoluble problem. Suicide is not the problem.

• Do not rush to judgment• Offer hope in any form

PPERSUADE CONT.

THEN SAY:• “Go with me to talk with

someone at the counseling center.”

• “I am going to refer you to the counseling center”

PPERSUADE CONT.

• “Are you willing to talk to a counselor within the next 10-15 minutes?”

• Continue to monitor them closely until they are with the counselor.

PPERSUADE CONT.

• “If you are unable or unwilling to talk to a counselor, I want you to know that I care enough about you that I will let them know.”

Ultimately: The counseling center should be informed if you believe you are seeing suicidal clues or warning signs from a student.

RREFER FOR QPR IN SCHOOL

SETTINGS• Suicidal people often believe they cannot be helped, so you may have to do more.

• The best “referral” involves taking the person directly to see the counselor.

• The next best “referral” is when the student wants you to talk to the counselor first, or when they agree to talk to the counselor on their own within the immediate future. (The young person should be monitored closely in the interim.)

• The third best option is to make sure the student is safe, is under observation by an adult, and then you tell the counselor the warning signs you have observed.

Resources

• Counseling Center – 3rd Floor, Schuster Center; Phone: 706-507-8740

• CSU Police: 706-568-2022 • BART Team Referral

NOTE:

You are not being disloyal or violating a trust when you share of a young person’s

suicidality with a counselor or administrative staff.

For Effective QPR In School Settings

• Say: “I want you to live,” or “I’m on your side and we’ll get through this.”

• Communicate with the counseling center.

• Get Others Involved. Ask the person who else might help. Family? Friends? Teachers? Brothers? Sisters? Pastors? Priest? Rabbi? Bishop? Physician?

For Effective QPR Cont.

• Join the Team. Offer to work with other school personnel and concerned members of the community members to help reduce youth suicide.

• Follow up with a visit, a phone call, a card, or in whatever way feels comfortable to you, to let the young person know you care about what happens to them. Caring may save a life.

REMEMBER

Since almost all efforts to persuade a young

person to live instead of attempt suicide

will be met with agreement and relief,

don’t hesitate to get involved.