1. The History, and Future, of Peer Support for People with Suicidal Thoughts
Tony Trahan
Deputy Director, Office of Consumer Affairs
NYS Office of Mental Health

2. Emile Durkheim – Suicide
Found that Protestants, males, an the unmarried took their lives at a higher rate than Catholics, Jews, females, and the married.
Social integration found to have a significant influence on suicidal behavior.
Protective factors. – NYC vs. ROS

3. 1966! Early Attempts at Creating Peer Support Groups
Indin described a special group program exclusively for suicidal and depressed persons.
This treatment modality has been slow to take hold in mental health settings.
1966!

4. Source
“Resistances Encountered in Starting a Group Therapy Program for Suicide Attempters in Varied Administrative Settings.”
Jacqueline Hackel, MA and Chrisula T. Asimos, MA Suicide Prevention of Alameda County and University of California at San Francisco

5. Concerns Contagion Funding
Fear that a patient’s suicide will be a reflection on clinical competence.
Legal Liability

6. Strategies
Helpful to define the group as adjunctive and supportive to other treatment modalities
The ability to convey a willingness to collaborate on the care of the patient was found to allay the fears of administrators and primary therapists.

7. Managing Stigma
Some suicidal patients find it difficult to engage in treatment because they fear the risk of being considered or labeled crazy for their suicidal feelings and experiences.
This special group setting serves to minimize this risk and encourages an open discussion of such experiences

8. Other Challenges and Benefits
Transference – Hostility towards therapist.
Drop out of tx
Group and peer support helps to dilute the intensity of the feelings while helping to keep people connected to tx

9. 1981

10. Survivors of Suicide Attempt(s) Groups
Didi Hirsch

11. http://www.didihirsch.org/ 8 week group Closed group
Phone screening and Risk Assessment Intake
Co-led by and Clinician and a Peer with lived experience
(handout)

12. 8 Week Overview Group Overview/Introductions Talking about Suicide
Giving and Receiving Support
What Causes My Thoughts?
How Can I Cope with the Thoughts
Resources
Hope
Where Do We Go From Here?

13. Adjunctive and Supportive
Therapy group
Risk assessment
CBT
DBT
Safety Planning
Group Process
Support Group
Connection
Peer support
Managing stigma
Empowerment
Resources

14. Facilitator Self Assessment
I can understand the reasons why a person may want to take their life.
I accept that there are limits to what I can do to keep a person safe from suicide
I feel confident managing high-risk situations
I am able to listen to a person’s wish to die
I am comfortable simultaneously working with multiple people who are at risk for suicide in a group setting.

15. Qualitative Findings It just keeps me alive – F - 50
Everyone understands each other- M - 35
There is community here – F - 48
It is different than therapy. It is a miracle in my life. – F - 21
It is a safe place to let it all out.- F – 50
Group opened my eyes to realize that I am not the only one going through stuff. – M – 21

16. Summary
The value of Peer Support groups for suicidal and depressed persons has been recognized for at least 50 years
Real and perceived fears, stigma, and erroneous beliefs about suicide have prolonged progress in peer support and engaging people into treatment.
Being comfortable with managing and sharing risk is an essential first step.
There are emerging best practices available.