Background
Methods
Data compilation
Study | Size of panels | Number of items rated | Number of items endorsed |
---|---|---|---|
English-speaking countries | 41 professionals | 436 | 164 |
35 consumers | |||
Sri Lanka | 14 professionals | 531 | 304 |
Japan | 32 professionals | 176 | 56 |
India | 30 professionals | 168 | 71 |
Philippines | 34 professionals | 186 | 102 |
Refugee and Immigrant | 34 professionalsa | 553 | 345 |
17 consumer advocatesa |
Data analysis
Results
The first aider should be able to recognise the warning signs of suicide. | |
The first aider should appear calm and confident in the face of the suicide crisis, as this may have a reassuring effect for the suicidal person. | |
The first aider should allow the suicidal person to discuss their feelings. A suicidal person may feel relief at being able to do so. | |
The first aider should take all thoughts of suicide seriously. The lack of a plan for suicide is not sufficient to ensure safety. | |
The first aider should ask the suicidal person if they have a plan for suicide. | |
The first aider should ask the suicidal person if they have decided when they will carry out their plan. | |
The first aider should find out if the suicidal person has already taken steps to secure the means to end their life. | |
The first aider should ask the suicidal person if they have been using drugs or alcohol. | |
The first aider should ask the suicidal person if they have ever made a suicide attempt in the past. | |
The first aider should work collaboratively with the suicidal person to ensure their safety, rather than acting alone to prevent suicide. | |
The first aider must keep in mind that they may not be successful in preventing suicide. | |
The first aider should tell the suicidal person they care and want to help. | |
The first aider should express empathy for the suicidal person. | |
Suicidal thoughts are often a plea for help and a desperate attempt to escape from problems and distressing feelings. The first aider should therefore allow the suicidal person to talk about those thoughts and feelings. | |
The first aider needs to allow the suicidal person to talk about their reasons for wanting to die. | |
The first aider should find out what has supported the suicidal person in the past and whether these supports are still available. | |
Safety plans should include 24-h safety contacts in case the suicidal person feels unable to continue with the agreement not to attempt suicide (such as a suicide helpline, professional helper or family member). | |
The first aider should treat the suicidal person with respect and involve them in decisions about who else knows about the suicidal crisis. |
If the first aider thinks someone might be having suicidal thoughts, they should ask that person directly. | |
The first aider should not avoid using the word ‘suicide’. It is important to discuss the issue directly, without dread or expressing negative judgement. | |
If the first aider clearly states that thoughts of suicide may be associated with a treatable disorder, this may instil a sense of hope for the suicidal person. | |
The first aider should establish whether the person has definite plans and intentions to take their life as opposed to vague suicidal notions such as “what’s the point?” or “I can’t be bothered going on”. | |
If the suicidal person is psychotic, the first aider should call a doctor, psychiatrist or other professional right away for the suicidal person. | |
The first aider should remind the suicidal person that suicidal thoughts need not be acted on. | |
The first aider should not argue or debate with the person about their thoughts of suicide. | |
The first aider should encourage the suicidal person to do most of the talking. | |
The first aider should discuss the ‘good things’ in a person’s life, their hopes for the future, and other reasons to live. | |
The first aider should encourage the suicidal person to think about their personal strengths and the positive things in their life. | |
By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. | |
The first aider should make sure any potentially harmful items are not available to the suicidal person by removing access to these items. | |
The first aider should try to determine whether there is anything important in the person’s life which may reduce the immediate risk of suicide (e.g. attachments to children). | |
The first aider should ask for help from the person’s relatives, friends or housemates to ensure the person does not have access to weapons, poisons, or other means for suicide. | |
(When passing time during the crisis) It is preferable that the suicidal person chooses an activity which has been found in the past to help them to cope or that they enjoy. |
Expert panel | English-speaking country professionals | English-speaking country consumer advocates | Sri Lanka professionals | Japan professionals | India professionals | Philippines professionals | Refugee and immigrant professionals | Refugee and immigrant advocates |
---|---|---|---|---|---|---|---|---|
English-speaking country professionals | 1.00 | .92 | .79 | .71 | .66 | .68 | .91 | .84 |
English-speaking country consumers | .92 | 1.00 | .76 | .70 | .64 | .65 | .88 | .84 |
Sri Lanka professionals | .76 | .69 | 1.00 | .69 | .75 | .67 | .82 | .80 |
Japan professionals | .68 | .67 | .69 | 1.00 | .80 | .78 | .72 | .66 |
India professionals | .65 | .60 | .76 | .78 | 1.00 | .87 | .70 | .65 |
Philippines professionals | .69 | .63 | .68 | .74 | .87 | 1.00 | .70 | .65 |
Refugee and immigrant professionals | .91 | .88 | .87 | .71 | .71 | .70 | 1.00 | .91 |
Refugee and immigrant consumers | .85 | .85 | .82 | .64 | .66 | .65 | .92 | 1.00 |
English-speaking professional panel | |
More likely to endorse: | |
• The first aider should be aware that if a person is not suicidal, asking them cannot put the idea of suicide in their head. | |
• The first aider should not discuss with the person whether suicide is right or wrong. | |
Less likely to endorse: | |
• If the first aider clearly states that thoughts of suicide may be associated with a treatable disorder, this may instil a sense of hope for the suicidal person. | |
• The first aider should remind the suicidal person that they are loved and would be missed. | |
• By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. | |
English-speaking consumer panel | |
More likely to endorse: | |
• The first aider should be aware that if a person is not suicidal, asking them cannot put the idea of suicide in their head. | |
• The first aider should not discuss with the person whether suicide is right or wrong. | |
Less likely to endorse: | |
• If the first aider clearly states that thoughts of suicide may be associated with a treatable disorder, this may instil a sense of hope for the suicidal person. | |
• By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. | |
Philippines panel | |
More likely to endorse: | |
• If the person is using drugs or alcohol, the first aider may not be able to believe them if they say they are not suicidal. | |
• The first aider should ask the suicidal person if they have ever known anyone who has died by suicide. | |
• The first aider does not need to be with the suicidal person all the time, but should check on them regularly. | |
• If the person is suicidal, the first aider should call a doctor, psychiatrist or other professional right away for the suicidal person. | |
• If the suicidal person has a weapon, the first aider should try to take it away from them. | |
• The fact that the suicidal person is still alive, and talking to the first aider about their feelings, means that they are not quite sure about suicide. The first aider should point this out as a positive thing. | |
• By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. | |
• If the suicidal person agrees to hand over the means of suicide, on the condition that they can have them back if they want them, the first aider should agree to this. | |
India panel | |
More likely to endorse: | |
• If the first aider clearly states that thoughts of suicide may be associated with a treatable disorder, this may instil a sense of hope for the suicidal person. | |
• The first aider should reassure the suicidal person that they understand how badly they feel. | |
• By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. | |
• If the suicidal person agrees to hand over the means of suicide, on the condition that they can have them back if they want them, the first aider should agree to this. | |
Sri Lanka panel | |
More likely to endorse: | |
• If the first aider clearly states that thoughts of suicide may be associated with a treatable disorder, this may instil a sense of hope for the suicidal person. | |
• The first aider should ask the suicidal person if they have ever known anyone who has died by suicide. | |
• The first aider should reassure the suicidal person that they understand how badly they feel. | |
• By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. | |
• The first aider should encourage the suicidal person to consider the consequences of suiciding, especially the effect it may have on the people they care about. | |
Japan panel | |
Less likely to endorse: | |
• The first aider should establish whether the person has definite plans and intentions to take their life as opposed to vague suicidal notions such as “what’s the point?” or “I can’t be bothered going on.” | |
• If the suicidal person is psychotic, the first aider should: Call a doctor, psychiatrist or other professional right away for the suicidal person. | |
• The first aider should remind the suicidal person that suicidal thoughts need not be acted on. | |
• The first aider should not discuss with the person whether suicide is right or wrong. | |
• The first aider should encourage the suicidal person to do most of the talking. | |
• The first aider should discuss the ‘good things’ in a person’s life, their hopes for the future, and other reasons to live. | |
• The first aider should encourage the suicidal person to think about their personal strengths and the positive things in their life. | |
• By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. | |
Immigrant & refugee professional panel | |
More likely to endorse: | |
• The first aider should be aware that if a person is not suicidal, asking them cannot put the idea of suicide in their head. | |
• By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. | |
Immigrant & refugee consumer panel | |
More likely to endorse: | |
• By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable. |