I’ve been writing about the Safety Plan as a brief suicide intervention, Tear up that no-harm/no-suicide contract, and we are looking at the first step, Safety Plans: What am I looking for?

In 2005, The American Association of Suicidology published an acronym of major warning signs to look for:

I – Ideation

S – Substance Abuse

 

P – Purposelessness

A – Anxiety

T – Trapped

H – Hopelessness

 

W – Withdrawal

A – Anger

R – Recklessness

M – Mood Changes

In the early 1990’s I realized that the reason so many people say after a suicide that they had no idea their friend, relative, coworker, etc. was considering suicide was because they didn’t know the warning signs.  How can you know what to look for if you’ve never learned the warning signs?  So I began teaching courses on suicide awareness, detailing what to look for and what to do when you see these warning signs.

You may have heard a recording at your airport saying, “If you see something, say something.”  The same statement applies in suicide awareness.  If you see the signs listed above, do something – talk to the person, listen to them, help them get to a higher level of care – whatever that means in your situation.

Within the context of Safety Plans, we want people who are thinking about suicide to recognize these signs in themselves, and move on to the next step in the Safety Plan – Internal Coping Strategies.

If you are interested in my upcoming trainings or my new online training format, or want to review my CV, please visit my website at criticalconcepts.org.

I’ve been writing about the Safety Plan as a brief suicide intervention, Tear up that no-harm/no-suicide contract and The Safety Plan Initiative, and how it is an improvement over the no-harm/no-suicide contract.

The first step in the Safety Plan is recognition of warning signs.  Within the field of suicidology, we distinguish between warning signs and risk factors.  Warning signs apply only to individuals, and indicate an immediate risk for suicide.  Risk factors may apply to individuals or groups, and indicate a heightened risk for suicidal behaviors.

Think of what you’ve learned about heart attacks, perhaps thru public service announcements.  Risk factors for heart attacks include physical inactivity, obesity, high LDL cholesterol, and tobacco use.  For people who have these risk factors, their overall risk for a heart attack is higher, but not necessarily imminent.  Similarly, with suicide, risk factors include substance abuse, mood disorders, access to lethal means and prior attempt(s).  These signs mean the risk for suicidal behaviors is higher, but not necessarily imminent.

Warning signs, however, do indicate immediate risk.  In heart attacks, we’ve learned that chest pain, shortness of breath, nausea, and lightheadedness indicate a heart attack may be imminent.  Urgent action is highly recommended.  Likewise, in suicide, feelings of hopelessness, increased substance abuse, threats of self-harm, and seeking lethal means indicate suicidal behaviors may be imminent.

One of the things I have always emphasized in my writings and trainings is to please take both warning signs and risk factors seriously.  I believe we always want to err on the side of caution.

Next time, we’ll talk more about warning signs, and I’ll share an acronym to help remind you of the most important signs.

If you are interested in my upcoming trainings or my new online training format, or want to review my CV, please visit my website at criticalconcepts.org.