By Melissa Patrick, Kentucky Health News

This story discusses suicide. Anyone who may be experiencing suicidal thoughts can call or text the National Suicide and Crisis Lifeline at 988, 24 hours a day, seven days a week to speak to someone qualified to help.

Experts on a panel to discuss suicide prevention encouraged Kentuckians to learn how to intervene in a mental health crisis by participating in a free, online training called QPR, which stands for Question, Persuade and Refer.

September is National Suicide Prevention Month. And while this is a time to raise awareness of this important topic, the same experts who spoke on the panel, hosted by the University of Kentucky, said in a commentary piece published in Kentucky Lantern that raising awareness is “not enough on its own” and that “awareness must be coupled with action.”

Lindsay Jasinski, chief administrative officer at UK Eastern State Hospital, said during the panel discussion that the hour-long QPR training teaches people how to be first responders in the event of a mental health crisis, particularly suicide. It also allows people to learn how to connect others with the support and clinical care services they may need.

“It’s a very easy training. It’s very user-friendly, and it’s very helpful,” she said at a Sept. 17 online press conference. “Most folks who take the training find that they feel much more comfortable intervening or asking someone about suicide after completing that hour-long training.”

All Kentuckians can take this training at kyqpr.ukhc.org.

As part of the discussion about the importance of talking to people about the loss of their loved one who died by suicide and not ignoring the topic, Julie Cerel, a professor at the UK College of Social Work, said, “There’s no evidence anywhere at all that talking about suicide leads someone to think about suicide. So if somebody is already so miserable they’re contemplating ending their life, asking about that is often a relief, instead of putting some idea into their head.”

In Kentucky, suicide ranks as the second leading cause of death among people aged 10 to 34. Kentucky loses about 850 people every year to suicide and it affects every community, Cerel said.

“Half of us know someone that’s died by suicide. More of us know someone that has attempted suicide,” Cerel said. “And everyone that dies by suicide, about 135 of us are left behind and know that person.”

Children and suicide prevention

QPR offers training for suicide prevention with adolescents and adults. Asked what is available for younger children, the experts said Kentucky schools are required to do training on suicide every year.

Toward that requirement, Kentucky has a Garrett Lee Smith Youth Suicide Prevention grant to use in schools for suicide prevention training. One of the trainings called Code Red was developed at UK. This training allows students to create a safety plan for when and if they have their “worst day.” For example, the plan would include who the child would contact, a list of things the child has to live for and ways they could distract themselves.

Warning signs

Cerel said the problem with making a list of suicide warning signs for teenagers is that while the things on the list could be signs of suicide, a lot of the things on that list could also be normal teenage behaviors, like “being angry, withdrawing, being sad.”

“So the most prominent sign of suicide is actually saying that they don’t want to live anymore, they’re suicidal or that they want to die,” she said.

And, she said, that’s why QPR training is so important.

“QPR, for example, teaches people how do you have that conversation. How do you ask someone, are you thinking about suicide? And then once they say, ‘Yes,’ what do you do with it?” she said. “Because even if we can get over our stigma and ability to ask that really hard question, most of us just don’t even know what to do to get somebody to help.”

Role of new mental health emergency unit

Jasinski, who helped oversee the creation and opening of UK HealthCare’s new mental health emergency unit called EmPATH on the hospital’s campus, said the primary role of this unit is to provide low-barrier care that focuses on observation and treatment in a wide-open, calming and therapeutic space. EmPATH stands for Emergency Psychiatric Assessment, Treatment and Healing.

“What we know from the literature is that actually, about 70% of people who have a mental health crisis can be stabilized in that first 24 hours if they have rapid access to treatment,” she said.

She said that EmPATH has seen almost 600 people in the first six weeks of operation, and the vast majority of those, about two-thirds of them, have come in having suicidal ideation as the primary reason for their visit.

“What we are doing is using evidence-based interventions for suicide and we are stabilizing those folks quickly, and then we’re connecting with their families as well,” Jasinski said.

“Our goal is that nobody should die by suicide,” she said. “That we should have access to care very quickly in the right setting. A traditional emergency department is wonderful if you have a medical emergency, but it’s not a calming or therapeutic space for a mental health emergency, and that’s what EmPATH is.”

Kentucky Health News is an independent news service of the Institute for Rural Journalism in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.