Tools that may help laypersons start a conversation about suicide and mental health with someone who is in crisis are available at no cost through the QPR evidence-based suicide prevention/intervention training offered by AgriSafe online or in person in their QPR training program at www.agrisafe.org/courses/qpr.
QPR stands for Question, Persuade, Refer. The goal of this process and the training is to equip people in rural communities to help family and friends exhibiting suicidal thoughts or actions connected with professional help.
One Agrisafe QPR trainer, Laura Siegel, MA, explains that suicide victims often believe that no one understands or cares about their struggles. It’s one of the prevailing emotions of those vulnerable to suicidal acts.
“That experience of feeling isolated is an indication that someone is in a suicide crisis,” Siegel says. “QPR training helps family and friends recognize when someone is at risk for suicide and helps them learn how to approach and talk to that individual. This training is recognized by SAMHSA (Substance Abuse and Mental Health Services Administration) as a best practice.”
Siegel notes that suicide is often considered a “taboo” topic, causing many to be apprehensive about talking to someone and offering help if they are experiencing suicidal thoughts. One inhibition for most people is the myth that talking to someone about suicide will push them further toward enacting their thoughts.
“We think if we confront someone who appears to be at risk and ask if they are having suicidal thoughts that we make matters worse,” Siegel says. “In our training, we work to dispel that myth because it isn’t true. When we approach someone struggling, we allow them to learn how to deal with and resolve their issues.”
Online QPR training, which takes about 1.5 hours, is free. The training explores how the unique challenges farmers face can lead to stress, depression and suicide. The course includes examples of how to implement each component of QPR. It offers strategies for helping someone who is at risk of suicide.
“People in rural and agricultural communities feel more comfortable reaching out to friends or family,” Siegel says. “Often, they reach out to their spiritual counselors, so churches may serve as a main hub for helping someone get connected to appropriate care. They serve as a bridge for gaining access to care.”
The Center for Disease Control (CDC) reported in August 2023 that “after declining in 2019 and 2020, suicide rates increased approximately 5% in the United States in 2021. (And) suicide deaths further increased in 2022, rising from 48,183 deaths in 2021 to an estimated 49,449 deaths in 2022.
The CDC report notes, “One life lost to suicide is one too many. However, too many people still believe asking for help is a sign of weakness. We must continue to eliminate the stigmatization of mental health and make care available to all Americans.”
Symptoms and warnings of suicidal thoughts include:
• Talking about suicide, i.e., “I’m going to kill myself,” “I wish I were dead,” etc.;
• Getting the means to take one’s own life, such as purchasing a gun or stockpiling medications;
• Withdrawing from social contact and isolating oneself;
• Experiencing mood swings, such as emotionally high one day and deeply discouraged the next;
• Preoccupation with death, dying or violence;
• Feeling trapped or hopeless about a situation;
• Increasing usage of alcohol or drugs;
• Changes in everyday routines such as eating, sleeping;
• Risky or self-destructive behavior;
• Giving away belongings or getting affairs in order without a logical explanation for doing so;
• Saying goodbye as if they’ll never see others again; and
• Personality changes or severe anxiety/agitation.
Symptoms and behaviors vary from person to person. Someone struggling with suicidal thoughts may:
• Reach out to a close friend or loved one;
• Contact a minister, spiritual leader or someone in their faith community;
• Call a suicide hotline; or
• Make an appointment with a doctor or other health care provider or a mental health professional.
Suicidal thoughts may occur because of feelings of hopelessness or inability to cope with a situation. Tunnel vision may cause the person to believe suicide is the only solution to their issue.
Genetics may play a role in suicidal thoughts. Those who complete suicide plans or have suicidal thoughts or behavior are more likely to have a family history of suicide.
Factors that elevate the risk of suicide include:
• Attempted suicide before;
• Persistent feelings of hopelessness, worthlessness, agitation, social isolation, loneliness;
• Experiencing a stressful life event such as the death of a loved one, military service, relationship breakup, etc.;
• History of substance abuse;
• Underlying psychiatric disorder;
• Family history of mental disorders; and
• Medical conditions linked to depression and suicidal thinking, such as chronic disease, pain, or terminal illness.
Children and teens who experience stressful life events may be at risk for suicide. Often, youth may be reluctant to talk about stressors they’re experiencing.
AgriSafe’s QPR training was developed through a longtime collaboration between the University of Kentucky, AgriSafe, and occupational health professionals. The training offered through AgriSafe has been made relevant to individuals working in agricultural settings.
“In the first portion of the training, you learn what stressors are common to the ag population,” Siegel says. “In the second half of the training, learners discover how to apply the concepts through the QPR method. Research has shown that those at risk of suicide, if they do talk about it, are likely to talk to people they trust. By completing this training, you can understand how to have that conversation in a way that helps guide them toward appropriate care.”
In-person training is available by contacting AgriSafe and arranging a two-hour presentation.
Siegel advises against focusing on gaining the “right language” for a successful conversation about suicide.
“That focus may lessen your willingness to engage in a conversation and intervene when you recognize a problem,” she says. “By overcoming our inhibitions related to talking about suicide, we’re much more ready to help someone who finds themselves in that situation.
“This training gives you another tool in your toolbox to reach out to others,” Siegel adds. “We can always refine our tools, always do better with handling those tools. The most important thing is to have that tool to implement.”
Online training dates can be found at agrisafe.org/qpr.
