ASIST

Applied Suicide Intervention Skills Training

About ASIST

Types of Suicide Prevention

Aim of ASIST

Help front-line caregivers from all disciplines and occupational groups to become more willing, ready and able to provide practical suicide first aid to persons at risk

• Developed in 1983 by a group of four professionals working in the fields of psychiatry, psychology and social work

• In response to growing concern about suicide in the region of Alberta, Canada

• The ASIST workshop is currently the most widely used and researched suicide intervention training programme in the world

Pathway for Assisting Life (PAL)

Ask about

Reasons for Living...

Ask for Reasons for Dying... Why suicide? Why now?

• May include events, the meaning the events have to the person at risk and their reactions to those event
• This is to understand what suicide means to the person at this point of time

• May include both internal and external things

• Internally they may be feelings, hopes, beliefs, values, attitudes or skills

• Externally they may be resource people or organizations to which the persons at risk belongs to, or economic assets or recreational activities and hobbies

Creating Ambivalence

Assisting Life

Connecting with Suicide

Understanding Choices

Explore Invitations

Follow-Up on Commitments

Use Both Ways of Working with Ambivalence

• Generate self-care ideas

• Who will be the safety contact/s?

• What are the crisis contact numbers?

• What are the most important parts?

• Have the person at risk confirm their actions with the caregiver.

Actions

giving away possessions, withdrawal, self-harm

Thoughts

self-deprecating, no hope; e.g. "I can't do anything right", "No one can do anything to help me now"

Physical

problems with sleep, weight, appetite, health complaints

Feelings

desperate, guilty, angry, worthless

• Patiently listen to the death side; help the person at risk talk about their reasons for dying

• Persistently listen for the life side of ambivalence; search for reasons for living or reinforce them when the person at risk discovers them

Ask about Suicide

Ask directly and clearly

Asking communicates that you care, even if you are incorrect.

Frame your question clearly:

"A lot of people who feel 'depressed' think about suicide; is suicide something that you have considered?"

In Summary...

• Make sure that both stay in the model.
• Make sure you are in sync
• Do not move to the next step until you have clarified completion of current step.

Agree that

suicide

is the focus

Agree that

they are

Safe for Now

Agree that

safety

is the focus