How Using ‘QPR’ Can Prevent Suicides Ask a Question and Save a Life

By David Susman Ph.D.

Originally published by Psychology Today



Chances are you’re familiar with CPR (cardiopulmonary resuscitation), a well-established emergency procedure used to save lives when a person is in cardiac arrest. But have you ever heard of QPR? QPR stands for “Question, Persuade, Refer,” and it’s used to intervene to prevent suicide.

Recently I was given the opportunity to attend a comprehensive training program to learn about QPR. What’s really interesting about this approach is that you don’t have to be a mental health professional to use it. In fact, QPR is designed to train anyone how to offer hope and take action when they are concerned that someone may be at risk for suicide.

The term “gatekeeper” refers to anyone who may benefit from learning how to use QPR to intervene to stop a suicide. Gatekeepers are people who may be in a position to recognize warning signs of suicide and that someone is considering taking their own life.

Gatekeepers can include school and college personnel, clergy, law enforcement, correctional staff, work supervisors, community volunteers, health care providers, family, and friends. In other words, virtually everyone can benefit from learning QPR.

Over the past 20 years, more than 2,500 communities and organizations have implemented the QPR Gatekeeper training program. Over 8,500 instructors have been certified, who have delivered the QPR intervention to more than one million people throughout the US and several other countries.

Having worked with many persons who were at risk for suicide, I was already quite familiar with many of the statistics on this issue. Nonetheless, some of the facts and figures are staggering and bear repeating:

More deaths occur by suicide in the US each year than by homicide or automobile accidents.

In 2013, over 41,000 Americans took their own lives or about 113 per day.

Suicide is the 10th leading cause of death and the second leading cause among ages 15-24.

For each death by suicide, about 25 people around them experience a major life disruption.

Firearms remain the leading method for suicide, followed by poisoning and suffocation.

More Vietnam War veterans have subsequently died by suicide than were killed in the conflict itself.

Currently, it’s estimated that 22 veterans die by suicide each day.

It’s also important to understand that about 90% of people in a suicidal crisis will give some kind of warning to those around them. Warning signs can include previous suicide attempts, alcohol and drug abuse, statements revealing or suggesting a desire to die, sudden behavior changes, depression, giving away personal belongings, and purchasing a gun or stockpiling pills.

Although we can’t predict suicide for any one individual, we can prevent a suicide if someone reveals their plans and we can intervene quickly and effectively. This is where QPR comes into play.

The QPR approach has three steps:

Q = Question

If you believe someone is considering suicide, ask them directly “Are you thinking about suicide or wanting to kill yourself?” Don’t say “Do you want to hurt yourself?” as self-harm can be non-lethal and it’s not the same as wanting to die. Also remember that if you ask someone if they want to kill themselves, this does NOT drive them toward that action. That’s a myth that’s not accurate. Don’t be afraid to ask the question.

2) P = Persuade

Persuade the person to allow you to assist them in getting help right now. Say “Will you go with me to get help?” or “Will you let me assist you to get help?” Another option can be to enlist their promise not to kill themselves until you’ve arranged help for them. If persuasion doesn’t work, call a local mental health center, crisis hotline or emergency services.

3) R = Refer

Refer the person to an appropriate resource for assistance. It’s ideal if you can personally escort them to see a health care professional. Next best would be to assist in making arrangements for help and getting their agreement to follow through on this plan. Less preferable is to provide referral resources and have them seek one of the options on their own.

An excellent crisis intervention resource in the US is the National Suicide Prevention Lifeline. To access the lifeline, call 1-800-273-TALK (8255). This same number also connects military personnel to the Veterans Crisis Line, a hotline providing confidential help to veterans or service members and their families.

In the QPR training, it was stated that if, as a result of learning QPR, just one person uses the approach, and that person saves one single life, then the training will have been worth it, and then some!

So, what can you do to make a difference? Attend a QPR training, particularly if you fit one of the “gatekeeper” categories or you believe you may come into contact with people who may be considering suicide.

Just as CPR prepares you for stepping in to assist with a cardiac emergency, QPR will give you the skills and knowledge to intervene to possibly prevent a suicide. Remember: if you ask the question, you may just save a life.


David Susman, Ph.D.

About the Author:
David Susman, Ph.D. is a clinical psychologist, mental health advocate, and Assistant Professor of Psychology at the University of Kentucky.

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