Question, Persuade, Refer (QPR) Training
QPR stands for Question, Persuade and Refer, an emergency mental health gatekeeper training intervention that teaches lay and professional gatekeepers to recognize and respond positively to someone exhibiting suicide warning signs and behaviors. Like CPR, QPR uses a “chain of survival” approach in which the gatekeeper learns to recognize early suicide warning signs, Question their meaning to determine suicide intent or desire, Persuade the person to accept or seek help, and Refer the person to appropriate resources.
The training is delivered in a standardized 1.5-2 hour multimedia format by a certified QPR gatekeeper instructor. Classes must have a minimum of 5 people and can include up to 35 persons per session. If you have questions about this training, please contact Rhonda D’Amico, Suicide Prevention Program Coordinator, at or 208.239.5227.
National Depression Screening Day
With depression being one of the most common mental health disorders in the United States, screening should be a routine part of healthcare. Depression is caused by a combination of genetic, biological, environmental, and psychological factors (NIMH). Anybody at any age can experience depression with significantly different symptoms. Since depression looks and feels different for everybody, it’s important for individuals to routinely check in with themselves and their loved ones.
Depression screening online questionnaire:
Printable depression screening questionnaire:
Screenings are not a professional diagnosis. Screenings point out the presence or absence of depressive symptoms and provide a referral for further evaluation if needed.
If your results or a loved one’s results indicate depression, visit a health care provider or mental health professional for diagnosis and treatment. Once diagnosed, treatment plans may include medication, talk therapy, or a combination of both. During treatment it’s suggested to stay active, spend time with loved ones, avoid alcohol and drugs not prescribed to you, and remember that with time and treatment depression will lift.
Suicide is a major public health concern. Over 40,000 people die by suicide each year in the United States; it is the 10th leading cause of death overall. Suicide is complicated and tragic but it is often preventable. Knowing the warning signs for suicide and how to get help can help save lives.
Signs and Symptoms
The behaviors listed below may be signs that someone is thinking about suicide.
- Talking about wanting to die or wanting to kill themselves
- Talking about feeling empty, hopeless, or having no reason to live
- Making a plan or looking for a way to kill themselves, such as searching online, stockpiling pills, or buying a gun
- Talking about great guilt or shame
- Talking about feeling trapped or feeling that there are no solutions
- Feeling unbearable pain (emotional pain or physical pain)
- Talking about being a burden to others
- Using alcohol or drugs more often
- Acting anxious or agitated
- Withdrawing from family and friends
- Changing eating and/or sleeping habits
- Showing rage or talking about seeking revenge
- Taking great risks that could lead to death, such as driving extremely fast
- Talking or thinking about death often
- Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
- Giving away important possessions
- Saying goodbye to friends and family
- Putting affairs in order, making a will
If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently. One resource is the National Suicide Prevention Lifeline, 1-800-273-TALK (8255). The Lifeline is available 24 hours a day, 7 days a week. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889.
Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk. Suicidal behavior is complex and there is no single cause. In fact, many different factors contribute to someone making a suicide attempt. But people most at risk tend to share certain characteristics. The main risk factors for suicide are:
- Depression, other mental disorders, or substance abuse disorder
- Certain medical conditions
- Chronic pain
- A prior suicide attempt
- Family history of a mental disorder or substance abuse
- Family history of suicide
- Family violence, including physical or sexual abuse
- Having guns or other firearms in the home
- Having recently been released from prison or jail
- Being exposed to others' suicidal behavior, such as that of family members, peers, or celebrities
Many people have some of these risk factors but do not attempt suicide. It is important to note that suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress, not a harmless bid for attention, and should not be ignored.
Often, family and friends are the first to recognize the warning signs of suicide and can be the first step toward helping an at-risk individual find treatment with someone who specializes in diagnosing and treating mental health conditions. See the resources on our “Find Help for Mental Illnesses” page if you're not sure where to start.
Do gender and age affect suicide risk?
Men are more likely to die by suicide than women, but women are more likely to attempt suicide. Men are more likely to use deadlier methods, such as firearms or suffocation. Women are more likely than men to attempt suicide by poisoning. The most recent figures released by the CDC show that the highest rate of suicide deaths among women is found between ages 45 and 64, while the highest rate for men occurs at ages 75+. Children and young adults also are at risk for suicide. Suicide is the second leading cause of death for young people ages 15 to 34.
What about different racial/ethnic groups?
The CDC reports that among racial and ethnic groups, American Indians and Alaska Natives tend to have the highest rate of suicides, followed by non-Hispanic Whites. African Americans tend to have the lowest suicide rate, while Hispanics tend to have the second lowest rate.
5 Action Steps for Helping Someone in Emotional Pain
- Ask: “Are you thinking about killing yourself?” It’s not an easy question but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
- Keep them safe: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal means can make a difference.
- Be there: Listen carefully and learn what the individual is thinking and feeling. Findings suggest acknowledging and talking about suicide may in fact reduce rather than increase suicidal thoughts.
- Help them connect: Save the National Suicide Prevention Lifeline’s number in your phone so it’s there when you need it: 1-800-273-TALK (8255). You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
- Stay Connected: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.
Free eBooks and Brochures
- How to Help Someone Thinking of Suicide: this information from the U.S. National Library of Medicine is available in English, Arabic, Burmese, French, Hakha Chin, Karen, Nepali, and Swahili
- Preventing Suicide: A Technical Package of Policy, Programs, and Practices: A resource for communities and states from the Centers for Disease Control and Prevention
- MedlinePlus, information from the National Library of Medicine
- Mindfulness Meditation May Reduce Risk of Suicidal Thoughts in Middle Schoolers, results from a recent study by the National Center for Complementary and Integrative Health
- National Action Alliance for Suicide Prevention, a public-private partnership advancing the national strategy for suicide prevention
- National Strategy for Suicide Prevention: Goals and Objectives for Action, 2012
- App: Virtual Hope Box. This free mobile app was developed by the Department of Defense for patients working with a behavioral health provider. The highly personalized content is available to support users any time they have access to their mobile devices.
- #BeThe1To is the National Suicide Prevention Lifeline’s message for National Suicide Prevention Month.
- Ask Suicide-Screening Questions (ASQ), a free resource for medical settings (emergency department, inpatient medical/surgical units, outpatient clinics/primary care) that can help nurses or physicians successfully identify youth at risk for suicide.