1. Super Trans Peer Mentor Program Suicide Prevention and Intervention Workshop Sally Morris MindOUT! Queensland Coordinator smorris@qahc.org.au www.qahc.org.au/MindOUT

2. Learning objectives Identify why Trans people are at higher risk of poor mental health and risk of suicide Increased knowledge of how to respond in a situation where a trans person is at risk of suicide Increased confidence in how to respond to a trans person at risk of suicide Identify resources or supports

3. Values Place yourself along the continuum between strongly agree and strongly disagree  Everyone has the right to take their own life  I can understand why people suicide  All suicides are preventable

4. What is Suicide? Suicide is… A conscious decision to end one’s life A solution to make pain go away Seeing this as the only solution Suicide is not… A rational decision Taking into account all impacts or consequences of death Taking into account other options and solutions

5. At Risk Communities People experiencing mental ill-health or disability People with addiction to drugs or alcohol Aboriginal and Torres Strait Islander People Men aged between 25 and 44 years People who have previously attempted suicide Young People aged under 24 People bereaved by suicide Culturally and linguistically diverse people, especially refugees People in rural and remote areas, especially males and indigenous people People who are homeless People living with HIV

6. Lesbian, Gay, Bisexual, Transgender and Intersex community also have a higher risk of depression, anxiety and suicide.

7. Suicide Ideation (current) Suicide Attempts (lifetime)

8. The story of our lives Stigma and Prejudice Discrimination Homophobia and Transphobia Heterosexism and Heteronormative assumptions Internalised Homophobia and self hatred Social Exclusion and isolation Minority Stress LGBTI negative trauma Family and community rejection

9. Some Trans specific experiences Gender norms and rigid gender roles Cultural and family roles, responsibilities & expectations Mental disorder classification Gate keepers & hurdles to transition process Coming out & disclosing identity Transitioning Lack of services (especially in rural & regional areas) Unequal legal recognition and legal discrimination Name and gender documentation change process Higher risk of discrimination and violence Transphobia and lateral violence within LGBTI community

10. Indicators someone may be at risk of suicide Expressing suicidal thought through Direct Verbal Cues

11. Indicators someone may be at risk of suicide Expressing suicidal thought through Indirect Verbal Cues

12. Indicators someone may be at risk of suicide Behavioural warning signs

13. Indicators someone may be at risk of suicide Precipitating events

14. WHAT CAN I DO IF I AM WORRIED ABOUT SOMEONE? A LOT!!

15. Initiate Talk Invitation Invite your friend to talk about their thoughts and feelings

16. Initiate Talk Conversation Starters Using open-ended questions are a good way to start a conversation.

17. Initiate Talk Listen Listening, rather than talking, is a way of understanding how someone feels.

18. Initiate Talk Ask Questions Ask your friend about their mood and how they are coping with life

19. Assessing Risk Ask about Suicide Be direct, confident and stay calm Its ok to use the word ‘suicide’ Do not show any negative judgement

20. Assessing Risk Risk & Protective Factors Risk Factors Plan? Predisposing risk factors? Life Stressors? Continuous thought about suicide? Protective Factors Connection? Hope? Purpose? Meaning?

21. Assessing Risk Risk of Suicide is high when Thoughts of Suicide –Consistent or significant thinking over the past week Plan about their suicide –Specific how, where, when

22. Assessing Risk Making an Assessment Do you feel your friend is at risk of suicide? What are they telling you? Are there a lot of risk factors? Are there few protective factors? How immediate is the risk? What is your gut telling you?

23. REMEMBER!! If you feel that your friend’s life or safety is at risk contact the emergency services on 000 immediately Or take them to an hospital emergency department and stay with them until they are seen by a doctor.

24. Keeping them safe Let them know you are worried Let them know openly and honestly that you have concerns that they are at serious risk of suicide, and that you feel that their safety is at risk.

25. Keeping them safe Let them know you care Reminding them of their value and worth can help connect them to the serious impact that their suicide will have.

26. Keeping them safe Reducing Risk Delaying the opportunity and removing access to means can significantly reduce the risk of suicide.

27. Keeping them safe Be There For Them Don’t underestimate the value of having someone just simply be there. This reminds them that they aren’t alone.

28. Keeping them safe Find Alternatives Consider how easy, effective, safe and legal the alternative is. Check out ‘101 Alternatives to Suicide for Teens, Freaks and Other Outlaws’ by Kate Bornstein

29. Keeping them safe Linking With Professionals It is important to link them with a mental health professional as soon as possible

30. Keeping them safe Linking With Support Networks You can also encourage and assist them to broaden their supportive network

31. Keeping them safe Follow Through Suicidal thoughts may not go away quickly. You need to check in with your friend regularly to see how they are going.

32. Keep in Mind! Helpful Stay calm and don’t take their responses personally Be firm, fair and consistent Try not to panic if you don’t know or feel how to act. REMEMBER, just letting them talk can sometime be help enough until a professional can be contacted Reserve judgement Remember that you care a lot for your friend and that you want to help them Staying with someone Acknowledging your personal safety Know your boundaries Get support from professionals Unhelpful Pressure them to ‘snap out of it’, ‘get their act together’, ‘cheer up’ or ‘calm down’ Stay away or avoid them Tell them they just need to stay busy or get out more Pressure them to party more or wipe out how they’re feeling with drugs or alcohol Assume the problem will just go away. Tell them they are being ridiculous Ignore them, when they tell you they are considering suicide Tell them they are attention seekers Minimising situation Ignoring warning signs or requests for help

33. Resources list Immediate Crisis supports LGBTI organisations Suicide Prevention Resources LGBTI Mental Health Resources LGBTI Medical Centres