How to get a teen to open up about suicidal thoughts? This training may help
Saint Paul Pioneer Press - 11/24/2018
Nov. 23--Fred Anderson said he didn't know how to talk about suicide with anyone in his life -- not his co-workers, friends or his teenage children. Then he attended QPR suicide-prevention training in Stillwater.
QPR, which stands for Question, Persuade and Refer, is a method of suicide prevention being promoted by the Washington County Sheriff's office.
Anderson said the best part of the class he took at the Washington County Government Center was the role-playing.
"Imagine saying, 'Honey, I've noticed you have missed a lot of classes lately and are not taking care of yourself, can we talk about that?' eventually leading to 'Have you ever thought of ending it all or taking your own life?' " Anderson said.
"I can tell you, it was emotional, even though I was aware we were role-playing. I could tell it had a similar effect on others. It is really hard just to say those words," Anderson said.
Anderson, who lives in Stillwater, also learned what not to say to his 14- and 16-year-old children.
"They said men often say something along the lines of 'You're not thinking about doing anything stupid, are you?' When they said that, I could almost hear those words coming out of my mouth, or something I could easily imagine my father saying to me," he said.
Anderson said the training was difficult to get through, but he strongly recommends it.
After the questioning phrase of QPR, participants work to persuade others to be active in getting help and refer them to a mental health professional.
Cmdr. Andrew Ellickson of the sheriff's office recommends QPR as "great basic training for anyone wanting to learn more about suicide and how to be an ally to anyone with mental illness."
The sheriff's office is working with the county's Public Health and Environment Department as well as schools and organizations to promote the training, which can be taken online or in person.
HOW IT WORKS
One of the cooperating organizations is the east metro Suicide Prevention Collaborative, which was founded in 2011 after several teen suicides in Woodbury and surrounding towns. Psychologist Renee Penticoff, one of the collaborative's founders, leads QPR training sessions.
Penticoff said the training is for "moms and dads, coaches, employers and teachers" and is recommended by the National Institutes of Health.
Body language and the wording of questions can make a difference in how someone opens up about thoughts of suicide, Penticoff said. Saying things like "You're not thinking of killing yourself, are you?" while shaking your head almost always makes someone respond "No," even if they are, she added.
"We want to say things like 'You wouldn't do that, would you?' because that's what we're all thinking," Penticoff said. "But that's more about our own comfort of wanting them to say no rather than giving them the opportunity to open up truthfully."
Penticoff said it's difficult to measure the effectiveness of in-person QPR training versus online sessions, but she thinks the in-person sessions have the advantage of role-playing.
"Any in-person training is going to allow people to connect more emotionally with the topic and ask questions of the person leading the training directly. It's more organic and natural, but online training is good, too. Any training is good training," she said.
SPREADING THE WORD
Natalie Vasilj, community health specialist with the county's Public Health Department, said they bought QPR webinars for the community last year and have been receiving positive feedback.
"QPR helps debunk myths about suicide, especially the myth that discussing it puts the idea in people's heads, which is proven to not be the case," Vasilj said.
To promote the training, one sheriff's squad is designed with the colors of suicide prevention, teal and purple, and information about QPR. Vasilj said local coalitions have also helped spread the word, and the county has promoted it on social media.
The local chapter of the National Alliance on Mental Illness, or NAMI Minnesota, is also working with the county.
NAMI's Cat Gangi said there is national evidence that QPR is the most effective form of suicide prevention. She said having the training available in Washington County is important because data from the Minnesota Department of Human Services shows a high number of suicides there.
According to the Minnesota Health Department, national and state suicide rates have been steadily increasing since 1999.
Melissa Heinen of the Health Department said QPR is like a steering wheel to a car -- you need it to drive, but you need many other components, too.
NAMI's Gangi said QPR is the most widely taught gatekeeper-training program in the United States, with more than 1 million adults having been trained in classroom settings in at least 48 states.
She said that for every death by suicide, there are 25 attempts. People trained in QPR can stop those attempts from succeeding.
Though the county has offered QPR training for years, Gangi said the recent involvement of the sheriff's office, the Public Health Department, schools and other coalitions has made it more visible to the community.
HIGH SCHOOL RAMPS UP RESPONSE
After a student at Stillwater Area High School died by suicide a year and a half ago, the school became an advocate of QPR training, according to Stillwater Schools Superintendent Denise Pontrelli.
Three years ago, the district had called together about 80 people -- from the county, the district, private providers and other community members -- to talk about how to provide mental-health assistance for students.
"Then we started to form action groups to decide what work the community can do," Pontrelli said.
Those groups led to classes for students of all ages about suicide and mental health.
Pontrelli said a new certification requirement for teachers is to have some suicide prevention training, so many teachers appreciate having access to QPR.
Besides teachers, Pontrelli said, it's important for the greater community -- students, parents, anyone who works with children -- to have opportunities to discuss mental health.
ESPECIALLY GOOD FOR MINNESOTANS
Margaret Thomas of Stillwater, who also took the QPR training at the Washington County Government Center, is the mother of two children in Stillwater schools, one a sophomore at the high school and the other a sixth-grader at Stillwater Middle School.
Thomas said it's especially important for Minnesotans to get involved in QPR training because "we are culturally prone to suppress or push aside the things we are dealing with."
The training "stops the default response of 'Oh, I'm doing fine' and encourages people to actually open up and be honest about the way they're feeling," she said.
Thomas said she appreciated the QPR training but warns that it's just a beginning step.
"I don't think people should go through QPR and then assume they have the same level of expertise as someone who is trained in mental health support," Thomas said. "It isn't supposed to replace mental health professionals but to expand the network of people who are supporting mental health."
Thomas said she would welcome discussing the training further.
"It would be great for people who have already done the training to be steered toward refresh conversations or an opportunity to connect with others who have also done the training to see how they have been implementing it," she said.
For information about online and in-person QPR training, visit www.co.washington.mn.us.
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