Presentation on theme: "QPR: A Brief Orientation"— Presentation transcript:
1QPR: A Brief Orientation Paul Quinnett, PhDPresident and CEOThe QPR Institute
2PerspectiveSo long as suicide remains a mystery, we have no responsibility to prevent it. But once we begin to understand suicide, we must act boldly in good faith to save lives. The QPR Institute Staff and Faculty
3Suicide is Not a Mystery Suicidal behaviors are not rare… Suicide is understandable… Suicide makes sense to the suicidal person…. If suicide is to be prevented, how will it be done? AWARENESS TRAINING EDUCATION ACTION
4If Suicide is Preventable, What Must We Do? Increase our sense of shared responsibility for the prevention of suicideImprove our collective competence to prevent suicide attempts and completionsLeadership must agree that suicide is a serious problem and that it is preventable
5Orientation to QPR Gatekeeper Training and the QPR Institute Orientation goals:What is QPR?Why is it important?How does it work?What is the evidence base?Who is using it?How long does it take to learn?What are the end goals?What training is available?
7Official 5 QPR Training Outcomes As measured by independent university researchers… QPR training increases:Knowledge about suicideGatekeeper self-efficacyKnowledge of suicide prevention resourcesGatekeeper skillsDiffusion of gatekeeper training informationThese are minimum measureable outcomes…
8Why QPR? Each letter in QPR represents an idea and an action step QPR intentionally rhymes with CPR – another universal emergency interventionQPR is easy to rememberAsking Questions, Persuading people to act and making a Referral are established adult skills“Out of clutter, find simplicity” Albert Einstein
9QPRIs a simple, direct, behavioral intervention designed to produce a predetermined outcome: a referral for professional helpIs designed to produce a helpful dialogue between someone at risk for suicide and a trained GatekeeperTeaches Gatekeepers to take bold, positive action to access professional care
10Theory QPR is theory-based Recognizes that even socially isolated suicidal individuals have contact with potential rescuersQPR reaches out to at-risk people within their own environments and does not require suicidal people to ask for help.
11People in crisis often do not ask for help Assumption: passive systems don’t work-Those most at risk for suicide:- tend not to self-refer for help- tend to be treatment resistant- often abuse drugs and/or alcohol- dissimulate their level of despair- go undetected- go untreated (and remain at risk for suicide)
12Research to Practice Most suicidal people send warning signs Warning signs can be taughtGatekeepers can be trained to a) recognize suicide warning signs and, b) intervene with someone they knowGatekeepers must be fully supported by policy, procedure, and professionals in their communityThe person most likely to prevent you from taking your own life is someone you already know
13The QPR Chain of Survival (think CPR) 4 necessary links…Early recognition of warning signsEarly application of QPREarly referral to professional careEarly assessment and treatmentKnowledge + Practice = Action
15Gatekeeper rolesStrangers don’t prevent suicide, people you already know do…Friends, family members, co-workers, and professionals with a duty to public safety have the greatest opportunity to recognize, detect, and refer….The more people trained the better the odds an at-risk person will be detected before a suicide attempt is made
16QPREffective QPR depends on the recognition of suicidal communications and warning signs, risk factors and quick, compassionate, positive action. Just as tightness in the chest, radial left arm pain and sweating are warning signs of a pending heart attack, so are clinical depression, statements of hopelessness and giving away prized possessions warning signs of a pending suicide attempt.
17QPR is like CPR… The more people trained the more lives are saved. Experiencing an out-of-hospital cardiac arrest?To survive, where do you want to be?In one American county your odds of survival are 56%; in most others it is less than 5%.Learn why one county in America leads the world in preventing death by cardiac arrest:Google “Cardiac Arrest Seattle.”
18For QPR to be successful…. Train as many people as possible to recognize symptoms of distress and direct and indirect suicide warning signs and to take quick action to interveneQPR training gives people the knowledge, skills, and – most importantly – the permission and courage to reach out to those in distress….Just one story…
19A life saved? From a QPR gatekeeper… A few months after participating in a QPR Gatekeeper Training, a gentleman who participates on our pastoral support team received a call from a woman indicating she was suicidal, had a plan and means, and was ready to 'do it now'. He remembered QPR, and supported this woman, talking to her about her value and purpose. She indicated she was willing to have someone come to help her, so while they were talking, he asked a colleague to dial The police arrived at the woman's home while he was still on the line with her. They took her in for assessment and care. The woman is now on her way to recovery. She is so thankful to the man who helped her through her crisis, and is doing very well.
20From a QPR instructor…One of the training participants approached me immediately after the training and said that she needed to go home immediately to talk to her brother, who lives with her. She said that he has been exhibiting multiple warning signs for suicide that were just taught in the QPR class, but she never recognized them as such. She and I talked about this and prayed together, and then she went home to her brother. After she walked in the door, he just happened to tell her that he was feeling suicidal. Because of the QPR training she had just participated in, she knew exactly what to do. She talked to her brother, and they called the Access & Crisis Line together. The folks at the crisis line referred them to help. He subsequently went to a psychiatrist for assessment, and began therapy. Had this woman not participated in the QPR Gatekeeper Training, she wouldn't have known what to do. But, I'm happy to report now that the turn-around has been drastic! He is now involved in supportive groups, and the church.
21Skills taught to QPR Gatekeepers QPR Gatekeepers are: - Are alert to the possibility of suicide - Recognize suicide risk and protective factors - Recognize symptoms of distress and depression - Recognize suicide warning signs - Know what to say, when to say it, and what to do
22Evidence for QPR: Does it work? QPR Training is safe and effective15 university published studiesOnly gatekeeper training program listed in SAMHSA’s National Registry of Evidence Based Practices and PoliciesAFSP/SPRC Best Practice RegistryUsed by 500+ colleges and universitiesMore than one million gatekeepers trained20,000 gatekeepers/month trained in 2012No adverse outcomes reported since 1996
23How long does it take to learn QPR? Classroom training: minutes, or longerOnline training takes minutes, or longer if downloadable guided practice session is usedPost training discussions with others typically follow, as each person trained shares what they learned with average of five peopleSharing QPR training and materials with co- workers, friends, and family members is a key outcome of the training experience.
24What QPR is NotQPR training is not designed to produce therapists, but to provide ordinary people with enough of those skills that have been shown to produce significant behavior changes via brief interventions, including the value of imparting hope, empathic and active listening, and behavioral steps to immediately reduce risk factors and enhance protective factors.
25SEVEN LIFE-SAVING EVENTS Detection of suicidal personsActive interventionAlleviation of immediate risk factorsEnhancement of protective factorsAccompanied referralAccess to treatmentAccurate diagnosisAggressive treatment“Ask the question, save a life.”
26Features of QPR Classroom training Only taught by well-trained Certified QPR Instructors licensed by the QPR InstituteMulti-media, lecture, and interactivePractice session includedVideo hosted by actress and author, Carrie FisherIncludes official printed QPR booklet/cardCustomized referral/crisis response by QPR instructor or hosting organizationAnnual 30-minute review recommended
27Features of QPR Online Interactive, self-paced, multimedia training Hosted by actress and author, Carrie FisherUnlimited user access (3 years), exam and certificateFree mental health screening for learner or family memberPrintable materials (QPR booklet/card)On demand review and/or annual reviewImmediate crisis service accessCustomized referral/crisis response by hosting organization
28Advanced training for professional gatekeepers…. It is not known to what degree intervention on this “last professional contact” might prevent suicideOlder adults have the highest rates of “last contact” and, therefore, provide the greatest opportunity for interventionAlternative approaches are needed for identifying those who make no contactPrimary Care Providers have most frequent “last contacts” with those who die by suicideLuoma, Martin and Pearson, Am. J. Psychiatry, 2002
29IOM: Reducing Suicide, 2002“Most people who complete suicide had contact with a health professional within a year of death, and 40 percent of these contacts were within one month of their death. Many people die by overdose on the prescription medications provided them at these visits.”Since most suicides are premeditated, are these missed opportunities? Professionals need advanced training in suicide risk detection, assessment, treatment, and management.
30Advanced Best Practice Training for all Professional Stakeholders Options: Classroom, online, or blended online + classroom trainingT4T training for Advanced TrainersBasic QPR enhanced, enriched, and practice- specific online and blended courses for: mental health and chemical dependency professionals, nurses, physicians, PAs, NPs, EMT/firefighters, law enforcement and correctional professionals.Training creates a “culture of safety”
31Creating a “culture of community safety” LeadershipPolicyProceduresCultureTraining matches level of dutyWhere possible training is mandatoryProfessional competencymust be demonstratedMental Health/Chemical Dependency ProfessionalsQPRT Training – 8-10 hrsPrimary Care Providers, First responders & School Counselors, Corrections, ClergyTriage training 6-10 hrsEvery willing citizen/student completesbasic QPR gatekeeper training
32Let it begin with you…We must train hundreds to save one, thousands to save hundreds, and millions to save thousands… and only faith, hope, and technology can get us there….
33Wrap upQPR Gatekeeper Training for Suicide Prevention is the most widely taught basic suicide prevention program in the United States. Advanced training for professionals is the next order of business in the suicide prevention movement Independent researchers have shown online QPR training is equally effective to classroom training and the same results are achieved.
34QPR Institute taglines… Saving lives through excellence in education Ask a question, save a life Preventing suicide… It’s what people do
35Learn more…Visit your local or state suicide prevention leadership websitesJoin in the causeVisit the QPR Institute atFree e-book, Suicide: the Forever Decision is also free as a download.Search your smart phone apps under QPR for free crisis support downloads or our book