3QPR QPR is not intended to be a form of counseling or treatment. In SchoolQPR is not intended to be a form of counseling or treatment.QPR is intended to offer hope through positive action.
4QPR Suicide Myths and Facts In SchoolMyth 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.How can I help? Ask the Question...
5QPR Suicide Clues And Warning Signs The more clues and signs observed, In SchoolSuicide Clues And Warning SignsThe more clues and signs observed,the greater the risk.Take all signs seriously.
6QPR In School Strongest Predictors Previous suicide attempt Current talk of suicide/making a planStrong wish to die/preoccupied with death (i.e., thoughts, music, reading)Depression (hopelessness, withdrawal)Substance useRecent attempt by friend or family member
7QPR In School 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.”
8QPR Indirect or “Coded” Verbal Clues: In School “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.”
9QPR Behavioral Clues: In School Past suicide attempt Getting a gun or stockpiling pillsGiving away prized possessionsImpulsivity/increased risk takingUnexplained anger, aggression, irritabilitySelf-destructive acts (i.e., cutting)Chronic truancy, running awayPerfectionism
10QPR Situational Clues: In School Being expelled from school /fired from jobFamily problems/alienationLoss of any major relationshipDeath of a friend or family member, especially if by suicideDiagnosis of a serious or terminal illnessFinancial problems (either their own or within the family)Sudden loss of freedom/fear of punishmentFeeling embarrassed or humiliated in front of peersVictim of assault or bullying
11QPR Other Related Clues: In School Change in interaction with family and friendsRecent disappointment or rejectionSudden decline in academic performancePhysical symptoms: eating disturbances, changes in sleep patterns, chronic headaches, stomach problemsIncreased apathy
12Find the SignsA 22-year-old single male who is on an athletic scholarship has just beenarrested 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.
13A 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.
14QPR Tips for Asking the Suicide Question In SchoolIf the person is reluctant, be persistentTalk to the person alone in a private settingAllow the person to talk freelyGive yourself plenty of timeIf in doubt, don’t wait, ask the questionHave your resources handy: QPR Card, community resources phone numbers and know your school protocol for handling suicide riskRemember: How you ask the question is less important than that you ask it
15Q QUESTION 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 wake up?”
16Q QUESTION 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.
17WAYS 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 fromthe 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.
18What 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."
19You're called to a dorm room because a student is belligerent 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.
20A 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."
21P PERSUADE FOR QPR IN SCHOOL SETTINGS Listen to the problem and give them your full attentionRemember, suicide is the solution to a perceived insoluble problem. Suicide is not the problem.Do not rush to judgmentOffer hope in any form
22P PERSUADE CONT. THEN SAY: “Go with me to talk with someone at the counseling center.”“I am going to refer you to the counseling center”
23P PERSUADE CONT.“Are you willing to talk to a counselor within the next minutes?”Continue to monitor them closely until they are with the counselor.
24P PERSUADE 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.
25R REFER 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.
26ResourcesCounseling Center – 3rd Floor, Schuster Center; Phone:CSU Police:BART Team Referral
27NOTE:You are not being disloyal or violating a trust when you share of a young person’s suicidality with a counselor or administrative staff.
28For 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?
29For 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.
30REMEMBER Since almost all efforts to persuade a young person to live instead of attempt suicidewill be met with agreement and relief,don’t hesitate to get involved.