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The Mississippi Lawyer Winter 2016 13 Lawyer suicide is an issue about which weve seen growing nation- al concern in recent years. We in Mississippi are not immune. In FY 2014-2015 seven Mississippi lawyers ended their own lives. It is disheart- ening to even write that but the good news is that your LJAP is pushing hard to equip our colleagues with the necessary tools to save lives that might otherwise be tragically lost to suicide. QPR is a suicide prevention gatekeeper train- ing program. A gatekeeper is someone in a position to recognize a crisis and the warning signs that someone may be contemplating suicide. Most of us are familiar with CPR Cardiopulmonary resuscitation - the emergency proce- dure performed in an effort to manu- ally preserve intact brain function in a person who is in cardiac arrest. Stated most simply QPR is CPR for the psyche. Its an intervention designed to interrupt the deadly progression of a person in a suicidal crisis. In my opinion the most impor- tant aspect of the QPR training is the fact that were talking about suicide. Though much more progress is needed our society has become increasingly open to dialogue on formerly taboo topics in recent years sexuality mental health and addiction sexual abuse and domestic violence. Suicide seems to be among the last. Frank discussion of it is absolutely key to saving lives. Im grateful that The Mississippi Bar has afforded LJAP the opportunity to undertake such dialogue and Id like to provide a thumbnail sketch of QPR training. In QPR training one of our first and most important tasks is to confront long standing misconceptions about suicide. We want to be clear about what we know to be true and what fal- lacies have guided our action or inac- tion. Among the myths we attack head on are these Suicide is actually the most prevent- able cause of death. Most people who commit suicide are dealing with sig- nificant life crises or a highly treatable mental illnesses. If they can be brought safely past the crisis and obtain proper mental health treatment and support they will likely not be suicidal again. I frequently tell groups in our train- ing that I will concede that once the act itself is undertaken little or noth- ing can be done by a layperson BUT UNTIL THAT POINT EVERYTHING IS NEGOTIABLE. We are after all lawyers trained to assess and persuade. Asking someone directly about sui- cidal intent lowers anxiety opens up communication and lowers the risk of an impulsive act. The longstand- ing misconception that asking about suicidal ideation or intent will actually cause the person to commit suicide is dangerously false. . Anyone can help prevent this trag- edy. Awareness willingness to act and basic skills can in nearly all cases save a life. Suicide prevention is everyones business. This one is very tough especial- ly for those of us who have been around suicides and their aftermath. However the truth is that most people communicate their suicidal intent in the daysweeks prior to the act. There are signs. We simply need to know and recognize them. The next step in QPR training is to identify signs that a person may be contemplating suicide. These are some of the most common signs Common behavioral signs Threats of suicide direct or veiled Putting personal affairs in order or giving away prized possessions or Extreme and increasing withdrawal and isolation. Situational keys Loss of job or career Loss of any major relationship or Anticipated loss of financial secu- rity or freedom. As weve now done our best to dis- prove dangerous myths and worked to identify the signs of possible suicidal- ity we move to training in the QPR method itself. Question. First and foremost THE QUESTION. We strongly encourage gatekeepers to ask THE QUESTION directly. While the idea is initially very daunting the most effective way to intervene is to ask directly Are you thinking of suicide Obviously theres more to it than a blunt question but it really boils down to this first and most important step. Persuade. If the person confides that they are in fact thinking about sui- cide we want to move quickly into the process of persuading them to accept help as opposed to following through on their ideation. People in deep crisis or struggling with severe depression may have no belief that they can be helped may have no energy to seek a solution and may be unable to ascer- tain what is necessary. Our persua- sion must be informed by these facts. Merely suggesting help will not likely suffice. The person in crisis will prob- ably need our support and leadership to take the steps required. Refer. All of the forgoing brings us to referral. Having intervened and pos- sibly saved a life we need to do every- thing in our power to get our friend the professional help he or she needs. This step requires some homework. As gatekeepers we must know what resources are available. Its best if we can work as part of a team committed to this process. Question Persuade Refer. Straight- forward no-nonsense practical train- ing that can save a life. It works. If youre interested in scheduling a QPR training in your area please contact LJAP. Your call could be a first step in saving the life of someone you know. QPR - Suicide Prevention Gatekeeper Training