Suicide First Aid


According to the American Foundation for Suicide Prevention, 47,173 Americans died by suicide and an estimated 1,400,000 attempted suicide in 2017. These numbers themselves can be frightening and disheartening. However, due to the stigma around suicide, these numbers are estimated to be even higher than what is reported. So, what part, however small, can we play in order to reduce these numbers, even if it is only by one person?

In July, I attended an Applied Suicide Intervention Skills Training (ASIST). This is a suicide first aid training and discussed how to approach someone who you believe is thinking about suicide or suiciding.

With ASIST, they utilize the Pathway for Assisting Life (PAL) model, which approaches suicide first aid in three phases:

  • Connecting with Suicide: exploring invitations/the signs and asking about whether the person is contemplating suicide.

  • Understanding Choices: Listening to their story and understanding why they are contemplating suicide and not devaluing their decisions.

  • Assisting Life: Develop a safe plan with the individual and confirm the action and follow through of this plan.

There is this belief that if you ask someone if they are feeling suicidal, you give them the idea to suicide. This idea is the opposite of what is true. Asking someone if they are feeling suicidal, if they have a plan, and if they have intent of acting on this plan are the questions that need to be asked in order to get the individual, whether they are family, friends, or someone we serve, the help that they need. Understand that they believe suicide is the answer they are looking for, whether it is to end the pain they are experiencing, feeling like they don’t have any hope, or just want to get out of the turmoil that they are feeling. Try and find their “turning point,” when they reject suicide, determining some sort of hope for the future, feeling uncertainty about the choice, or maybe just being willing to try some other solution, and develop a plan in order to keep them safe at this time, in this moment.

As service professionals who are working with what is considered a “high-risk” population, it is important for us to make sure we are caring of ourselves first. We can have all the skills in the world at our disposal, but if we are drained, stressed, or overworked, we start to miss the signs that could mean life or death for people that are around us. Something that we could see as an “invitation” can quickly become “attention-seeking,” or “not a big a deal.” The reality is, someone might be seeking attention – but to get help. That is a big a deal.

I recommend people checking out the training for ASIST in order to know how the use these skills that I mentioned in the correct, most beneficial way. There is also a training called safeTALK which is for both service providers and friends and family in order to help people identify the signs of when someone is thinking about suicide and connect them to someone who is trained in suicide intervention (such as someone who is ASIST certified). It is important to remember that everyone is at risk to suicide, and you never know when the decisions that you make and the things that you say might give someone one more day.