‘First aid’ to prevent suicide

Suicide is perhaps the saddest cause of death because it is often preventable. Every day more than a dozen people kill themselves in the UK and the recent tragic suicides in Bridgend makes intervention training seem ever more important.

Recently I attended a two-day Applied Suicide Intervention Skills Training (ASIST) workshop run by Lewes and Wealden Mind, which has delivered the course since 2003. Commissioned by Southwark PCT as part of its suicide prevention strategy, the training was free for voluntary and statutory sector staff.

Starting the course by establishing the core principles of the ASIST approach, the trainers reassured participants that, although suicide is an uncomfortable topic, the outlook of the course is optimistic – with the belief that suicide is preventable and that life is worth living. In small groups participants explored their own attitudes towards suicide, enabling an understanding of the impact that one’s own attitudes have on intervention.

Safe plans

Next, participants were given the knowledge and skills to recognise risk and develop safe plans to reduce the risk of suicide. Although there are often indicators that someone intends taking their own life, this is not always the case. But, having established those who intend to harm themselves, there are ways to create safer environments through agreeing a safe plan with the individual at risk.

On the second day, participants put into practice the model for suicide intervention, developing their skills through observation and supervised simulation experiences. One of the most important things I took from this part of the course was the confidence to broach the subject of suicide.

ASIST was developed in Canada and some course participants were put off by some of the terminology in the training materials. Others felt that the course was not much more than a lightweight form of counselling. But, overall, the course benefits from having a model that has been developed over the past 20 years and been delivered worldwide. Also notable was the high quality handbook and audio-visuals. These give the course a more professional feel than the photocopied notes and flip chart exercises that are the mainstay of most voluntary sector courses.

Complementary to other models

There’s an inclusive feel to this course. Unlike some courses – I once did a counselling course where the tutor spent most of the time bad-mouthing other therapeutic models – the ASIST trainers consider their model to be complementary to others, such as the Samaritans helpline. They say this is a simple model that works, and that it can be used alongside people’s existing professional practice or religious beliefs.

The course is not intended to replace longer-term support. It is considered to be “first aid” in a time of crisis, and acknowledges support is needed from other professionals in the long term. At the heart of the course is the belief that a small gesture of support can be life-saving – that strong reasons for death can be counterbalanced by the smallest reason for living. Support from another may be the tipping point to carry on living.

However much it is in the news, suicide is seldom a water cooler topic. And yet, in the past 10 years I’ve lost a family member, a friend and a service user – all of whom took their own lives. It takes courses like ASIST to bring people together to realise that there is something we can do locally as individuals and as a community. Having completed the course, I feel better able to identify the risk of suicide and provide help.

What we should be doing is equipping everyone to learn these skills and I’ve been urging colleagues to go on this course – even those with the most hectic of work schedules. After all, what could be more important than learning how to save a life?

Related article

Recognising the warning signs

Further information

Living Works


Suicide trends and geographical variations in the United Kingdom, 1991–2004

Suicide in Southwark – A strategy for prevention

Mark Drinkwater is a community worker in Southwark, south London.

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