Key Learning Points

This training opens up the conversation about suicide to reduce negative stigma surrounding suicide and decrease anxiety about talking to others about suicide. Key learning points of the seminar include:

• We can all play a role in supporting students’ mental health.
• By knowing the signs of suicidal risk and understanding the needs of a person at risk of suicide, we can support students.
• Conversations about suicide are never comfortable, but it is possible to develop skills and increase confidence about how to talk to someone about suicide.
• There are practical steps for starting a conversation about suicide with a student.
• We can make a difference to a person who is thinking about suicide by knowing how to recognize the signs of distress, responding empathetically, and knowing how to refer the student to campus and community resources.
• Listening without judgment is key when talking to a student who may be at risk of suicide.
• Staff and faculty are not expected to act as a counsellor and should not attempt to diagnose a student’s mental health.
• Staff and faculty need to be aware of their own boundaries and need for self-care. If they are overwhelmed by the session, they may want to talk to a counsellor.

Practical Considerations to Prepare for In-Person and Online Sessions

To prepare to facilitate this workshop, consider the following:

• Before giving a session, read through the facilitation guidelines and tips and think about your own feelings and experiences with suicide.
• Read through the facilitator’s guide and handouts to familiarize yourself with the content. You may want to download and print the guide as a PDF file.
• Download the presentation slides and make any modifications.
• Consider how many participants you expect will attend. The guide assumes a small to medium number of participants (approximately 6 to 30); if your group is very large, you may need to modify some of the small group and reflection activities.
• Prepare to give a territory acknowledgement to open the session. Also consider ways in which to Indigenize the content. (See Indigenous Considerations.)
• Add relevant examples and additional insights based on your own experience or that are relevant to the student population at your institution.
• Determine how you will share handouts and other resources, particularly when you are facilitating an online session. You may put PDFs in the chat, share a link in the chat, or email participants after the session.
• Consider providing participants with group guidelines prior to the session so people can prepare and create guidelines together. This will save time during the presentation. See Group Guidelines for more information.
• Consider sending a link to the video on the Live Through This website to give participants a chance to hear suicide survivors’ stories prior to the training. Alternatively, you could show the video during the session.

Know the Procedures and Contacts at Your Campus and in Your Community

• Become familiar with who to notify at your campus if you’re concerned about a student. For example, do you notify your chair, dean, supervisor? Do you contact counselling services? Is there an alert form you should to fill out?  (The procedures may vary from institution to institution.)
• Consider which resources, procedures, or policies at your institution are relevant to helping students who need assistance.
• Find out what on-campus and community resources are available that support student mental health and complete Handout 1 or create your own contacts sheet to share with participants (or have the website ready for viewing on screen).

Preparing for an In-Person Session

You will need the following:

• Laptop
• Projector
• Flipchart or whiteboard and markers
• Handouts
• Handout from your institution with contact information for student supports on campus

Preparing for an Online Session

• Schedule a meeting time in a video-conferencing program.
• Check that the screen share function is enabled for sharing slides.
• If using chat or breakout rooms, check that they are enabled.
• Share the meeting link and any passwords with participants prior to the session.
• Consider sending the meeting information at least twice, including once the day before the session. You may also want to share suggestions for online meeting etiquette for creating a safe learning space (i.e., sharing supportive comments, respecting confidentiality, etc.)
• Consider assigning someone to be the monitor responsible for responding to technical issues and questions posted to the chat.
• As noted above, make sure you have a plan for distributing any resources, such as handouts, online. Remember to let participants know how and when they can expect to receive these resources.

Working in Small Groups Online

If your video-conferencing software allows you to create breakout rooms, you can have people work together in smaller groups. Take some time before the session to get comfortable with the breakout room set-up process. It can be helpful to have someone assist you with setting up the breakout rooms, so you can facilitate the session while they handle the technical issues.

Breakout rooms will work well for discussing the scenarios, but you will want to do some advance preparation. It may be easiest to put the scenarios in the chat, so have the scenarios ready to add to the chat prior to the session. During the session, you can then assign each group to a specific breakout room to discuss the different scenarios. Alternatively, you could move people into breakout rooms and then visit each room to verbally provide a scenario to each group.

 Text Attributions

• This chapter is original text by Barbara Johnston and Liz Warwick.  CC BY 4.0 license.

Territory Acknowledgement

Acknowledging the traditional lands of the Indigenous people on which you live, work, and study is an important way to begin an event or meeting and can be included as part of classroom activities and taught to students. Meaningful territory acknowledgements allow you to develop a closer and deeper relationship with not only the land but the traditional stewards and peoples whose territory you reside, work, live, and prosper in. For more information on giving a territory acknowledgement, see Opening the Session.

The Truth and Reconciliation Commission Calls to Action explicitly state that each of us as members of Canadian society have a direct responsibility to contribute to reconciliation; how we discuss colonization in relation to mental health and suicide is a direct response to that responsibility.

The United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) is an international instrument adopted by the United Nations on September 13, 2007, to enshrine (according to Article 43) the rights that “constitute the minimum standards for the survival, dignity and well-being of the indigenous peoples of the world.” UNDRIP was adopted into the B.C. provincial legislature on November 26, 2019. Centring the history of colonization as a background and framework to mental health from a historical and current ongoing struggle is in direct response to our legal and moral obligation as members of Canadian society.

Curriculum Development and Indigenous Ways of Knowing and Being

Indigenization is a process of naturalizing and valuing Indigenous knowledge systems.Antoine, A., Mason, R., Mason, R., Palahicky, S., & Rodriguez, C. (2018). Pulling together: A guide for Indigenization of post-secondary institutions. A professional learning series. Retrieved from https://opentextbc.ca/indigenizationcurriculumdevelopers/; Little Bear, L. (2009). Naturalizing Indigenous knowledge, Synthesis paper. Canadian Council on Learning. https://www.afn.ca/uploads/files/education/21._2009_july_ccl-alkc_leroy_littlebear_naturalizing_indigenous_knowledge-report.pdf In the context of post-secondary institutions, this involves bringing Indigenous knowledge and approaches together with Western knowledge systems. This benefits not only Indigenous learners but all students, staff, faculty, and campus community members involved or impacted by Indigenization.

As you adapt this training for your particular context, consider how and in what ways you might interweave Indigenous content and approaches. Here are some examples of how you might include an understanding of Indigenous ways of knowing and being:

• Incorporate Indigenous pedagogical approaches such as holistic and relational perspectives, experiential learning, place-based learning, and intergenerational learning.
• Involve Indigenous students, faculty, and staff with reviewing, adapting, and evaluating resources.
• Integrate knowledge from Indigenous communities local to your institution.

As you do this work, as an Indigenous or non-Indigenous person, you will want to continue to draw upon and build on existing relationships with Indigenous people, both within and outside of your institution. As a way of continuing to work in intentional and respectful ways, you may want to reflect on questions such as:

• How does this work benefit Indigenous communities and help them to meet their goals?
• Will there be benefits for Indigenous students, faculty, and staff?
• Have the community or communities identified their own priorities or goals related to this work?
• How can this work support Indigenous efforts related to healing from past and ongoing colonial violence?

Elders and Knowledge Keepers

Elders have always been the foundation for emotional, social, intellectual, physical, and spiritual guidance for Indigenous communities. As you find ways to naturalize Indigenous context, perspectives, and traditional ways of being into your training, we recommend you consider inviting an Elder or Knowledge Keeper from your local community to support your sessions. One way of doing this is to speak with your Indigenous Student Services Department at your institution and share with them some of the recommendations in this guide and see how they might wish to support this work.

Not all institutions will have an Elder-in-Residence but each should have ways for you to contract an Elder or Knowledge Keeper to come in and support your work. Elders and Knowledge Keepers often support the whole post-secondary institution community, not just the Indigenous students. Involving Elders and Knowledge Keepers can help support reconciliation by helping to build respectful, reciprocal relationships that are deep and meaningful.

Whenever you plan to bring in a community member, Elder, or Knowledge Keeper, it is important to plan for the honorarium required to remunerate them for their time and sharing their lifetime of wisdom and traditional teachings. In many communities, it is seen as most respectful to offer payment on par with what you would pay a Ph.D. holder to do a keynote presentation. However, consulting with the Indigenous services staff at your institution on what is a typical amount for this type of event is also a good practice.

Text Attributions

• This chapter is adapted from Consent & Sexualized Violence Training and Facilitator Guide: Preventing and Responding to Sexual Violence in B.C. Post-Secondary Institutions by Sexual Violence Training Development Team.  CC BY 4.0 license.

Creating a Safe Learning Space

Participants need to feel comfortable, safe, and respected during the seminar. As you prepare to facilitate, you will want to consider factors such as when and where to hold the training, key messages on promotional materials, whether to use group guidelines, how to ensure diverse representation, and ways of working with co-facilitators or guests. In this section, we discuss several strategies for helping to create a positive learning space.

Opening with Intention

Facilitators have an enormous role to play in setting the tone for a session. As people enter the space (online or in person), you can welcome them and help them get oriented. You can let them know if you’ve started or whether you’re waiting for a few more people and share housekeeping information such as where the bathrooms are, where they can put their things, or how to use online interactive features. You may want to consider using a breathing exercise together or an icebreaker activity to help put people at ease. As you begin your session, you can use opening questions that help create inclusivity such as correct pronouns, check-in questions, or information about accessibility needs and requests.

Scope of the Session

It is important to hold space in a presentation for people’s feelings and experiences – shared or not. However, there also need to be boundaries that will enable the training to move forward and be completed within the stated time frame.

You will want to establish at the beginning that the training is a learning space and not a counselling session. (You may also want to send an email to all participants with this message prior to the session.) If a participant is starting to take over the discussion with their personal experiences, you will want to gently redirect the conversation back to the material that you need to cover. It is a good idea to stay after the session is over to talk to any participants one-on-one.

It’s also important to provide a clear scope at the beginning to reassure participants who worry that they must “save” a student who expresses suicidal thoughts.

Group Guidelines

It can be helpful to ask participants to agree to a list of guidelines or a code of conduct when they register or sign up for the training. You can either send the group guidelines to participants before the session or you can take some time at the beginning of the session to establish the guidelines together.

Or, you might share a list of guidelines at the beginning of the training and ask learners if they feel comfortable with them or if they have something they would like to add or change.

Group guidelines can be an important tool for supporting safer discussion about difficult topics. You can remind participants of the guidelines if the discussion is getting difficult. Important group agreements relate to listening to and showing respect for others (e.g., not talking when others are speaking, not making rude comments, not talking on the phone), confidentiality, and participation.

It’s also important to establish guidelines about how much people will share. Suicide is a topic that could trigger some people and remind them of past experiences.

Group guidelines come in all shapes and sizes. Some groups have a few guidelines while others have many. Here are suggestions of possible guidelines:

• Share the learning, not the names or the stories (confidentiality).
• Participants have the right to “pass” on activities/questions that feel uncomfortable.
• It is all right to feel uncomfortable or not to know answers to everything.
• It is okay to step out of the session at any time.
• Treat others with respect.
• Be mindful of your language; respect everyone’s names and pronouns.
• Remember that there may be participants who know someone who has either attempted suicide or died by suicide. The session may bring up strong emotions for them.
• Speak for yourself. Use “I statements” to state opinions or feelings.
• Seek to replace judgment with curiosity.
• Take care of yourself.
• Take space, make space (allow everyone a chance to participate).

Content or Trigger Warnings

Content warnings (also called trigger warnings) are a statements made prior to sharing potentially difficult or challenging material. The intent of content warnings is to provide learners with the opportunity to prepare themselves emotionally for engaging with the topic or to make a choice to not participate.

Different departments and institutions will have different approaches to content warnings and this may guide your decision about including content warnings on registration or sign-up forms, in learning materials, and in the learning environment. Below is an example of a content warning:

“We will be discussing topics related to suicide in this training. During the training, you can choose not to participate in certain activities or discussion and can leave the room at any time. If you feel upset or overwhelmed, please know that there are resources to support you.”

There are a number of other facilitation strategies you may want to consider in addition to or instead of a content warning:

• When discussing difficult content, check in with participants from time to time. Ask them how they are doing, whether they need a break, etc. Let them know that you are aware that the content is difficult.
• Ask people to be mindful of their fellow learners during the discussion and remind them that survivors of suicide may be present in the room (regardless of whether this information has been shared with others).

Trauma Awareness

Some people participating in the session may have direct experience with someone close to them taking their own lives. There are a number of strategies you can use to help create a trauma-aware learning space.

Before the Session

Sometimes, during training on suicide awareness, a participant may be reminded of someone they have lost from suicide. Before you start facilitating in this area, you will want to ensure that you are knowledgeable about receiving disclosures and available supports and resources on campus and in the community. Some institutions have developed practices such as expedited counselling for participants who might need support after a training session or making intensive crisis supports available for a short time after a training or particular initiative.

To Start

At the beginning of the training, acknowledge that the topic of suicide is difficult and let participants know that they have the right and freedom to take care of themselves in a way that works for them. In particular, let participants know that they can leave the room or choose not to participate in an activity. You could say something like “If at any time you feel you need to leave, that’s fine with me. You are empowered to take care of yourself.” You can also let learners know that reactions to difficult material can sometimes be delayed and that they may wish to connect with you a few days after the training or to access support from family, friends, or other people in their lives.

If you feel comfortable, you can share information about grounding activities that may be helpful to participants during the session. Grounding activities, such as breathing exercises, are simple activities that can help people to relax, stay present, and reconnect to the “here and now” following a trauma response. Examples include pressing or “rooting” your feet into the ground, breathing slowly in and out for a count of two, repeating a statement such as “I am safe now. I can relax,” or using your five senses to describe the environment in detail.

During the Session

If you do notice that someone has left the group and you suspect that they were reminded of previous trauma by the session, follow up with them one-on-one after the session to check in and offer them any resources that you think might be helpful to them.

During the training, if the conversation becomes intense or you believe that a number of participants have become overwhelmed or affected by the discussion, it can be helpful to take a break or use an activity that involves the body or movement to help people reconnect to the present moment.

Let learners know that you will be available after the training if they would like to debrief or share their responses to the session or how they are feeling. If possible, schedule at least 30 minutes after a session so that you can be available to your learners. If you are delivering training in an online context, you can let learners know that they can private message/email you.

Participants may need some time near the end of the session to ask questions, share a reflection, or simply sit with what they heard and discussed. If possible, try to ensure you have this time built in at the end so no one feels rushed when concluding the session.

After the Session

Plan to stay after the session to talk to any participants who have questions or concerns they want to discuss. If you are concerned about a participant, ask them if they would find it helpful for you to check in with them later in the day or the following day. You could also ask them if they have a friend or family member that they might find it helpful for them to speak with following the training. If so, help them make a plan to connect with them, e.g., via phone or text or in person or at a certain time.

Questions That May Come Up and How to Respond

Facilitating conversations about suicide can be challenging. Participants likely bring many different experiences, assumptions, ideas, and worries about how best to support students who are struggling with these issues.

It’s important to create a space where people feel safe and supported so they share and listen to others with respect and empathy. This section offers ideas and tips for creating such an environment, but facilitators also have a time limit in which to present material. It’s important to keep an eye on the clock and know how, and when, to direct people’s attention to the next topic.

As mental health and wellness affects all parts of our lives, participants may bring up related issues or concerns or they may disclose that someone they know has taken their own life or attempted suicide. Below are some questions that might come up during the presentation, with suggestions for responses. The goal is to acknowledge people’s comments, thank them for their contribution, and point them to resources they may find helpful. Then the discussion can move back to the specific topic at hand.

Transitions and Difficult Conversations

While facilitating, you are likely to encounter challenging moments when you may not be sure how to respond. Someone may start to dominate the discussion with their own story of suicide, a participant may make a negative remark about suicide, or the conversation may shift in a direction that makes you concerned for the comfort of other participants.

Below are some potential responses for bringing participants back to the topic or handling challenging moments:

• “This is a really great dialogue, but I would like to bring us back to the topic at hand.”
• “Thank you for sharing that story. I’d like to follow up with you after the workshop today if we can save this conversation for later.”
• “I’m getting conscious of time here. Let’s move on for now.”
• “Your feelings are important and I want to be able to provide you with my full attention. Would you like to step out and have a conversation about it? My colleague can continue with the presentation.” (This can work if there are two co-facilitators. If there is only one facilitator you can suggest continuing the conversation after the session.)
• “We’re not here today to argue about the ethics or morality of suicide. We want to focus on questions, feelings, worries, and thoughts people might have about supporting someone who is at risk of suicide.”
• It’s okay for us to agree to disagree. Let’s move on; I’d like to bring us back to some of the activities and questions we had planned.

A Note on Language

We should avoid language that sensationalizes or normalizes suicide or presents it as a solution to problems. For example the terms “failed attempt” or “successful” or “completed attempt” are best avoided as they depict suicide as a goal, project, or solution. Below are some guidelines for language when talking about suicide.

Self-Care and Community Care

Self-care and community care are about looking after yourself and those around you. Facilitating a session about suicide can range from satisfying and rewarding to challenging and overwhelming. It is important to make sure that you are able to take the time to take care of yourself and that you are willing to reach out to co-workers, friends and family, or professional support if needed.

Ideally, you will be in a situation where you are able to deliver the training with a co-facilitator. Not only is this helpful if a learner needs support during a session, it also helps to have someone with whom to share the joys and challenges of facilitation. After a session, plan for time afterwards to check in with each other about your experiences and any successes or challenges in facilitating. This allows for time to reflect on issues related to your own mental health, to consider any feedback that you received from participants, and to discuss any facilitation successes and challenges. If you are facilitating alone, you might use the time after a session to reflect or use a journal to make notes as a way of processing the experience, or you may want to debrief with a colleague or counsellor.

Check-In/Reflection Questions for Facilitators

Taking time after a session to debrief can be a helpful way to care for yourself. Here are some sample debriefing questions.

• What was a positive moment or success in this session?
• How did the learners engage with the different activities? Is there something I want to facilitate or do differently next time?
• Did I or a participant seem to have a response to the material, a shared story, or another participant that was challenging? If so, how was it responded to or resolved?
• Is there something that would be helpful for me to learn about or check with a colleague about?

Resources on Suicide for Further Reading and Preparation

• Canadian Association for Suicide Prevention: This organization provides information and resources to communities to reduce the suicide rate and minimize the harmful consequences of suicidal behaviour.
• Centre for Addiction and Mental Health: The Centre for Addiction and Mental Health (CAMH) has many resources around suicide awareness, including a Get Help page with information on crisis lines and immediate help.
• Centre for Suicide Prevention: A branch of the Canadian Mental Health Association, the Centre for Suicide Prevention provides information and resources on how to respond to people at risk of suicide. They have toolkits, information sheets, and training resources.
• Live Through This: This website is a collection of personal stories from people who have attempted suicide and survived. The diverse voices illustrate that suicide can affect anyone, and reading some of these stories is a helpful way to prepare for the seminar.
• LivingWorks ASIST Suicide Prevention Training Program: This organization offers workshops on how to prevent suicide by recognizing signs, how to provide a skilled intervention, and how to develop a safety plan.
• Mental Health Commission of Canada: The Mental Health Commission of Canada has a number of fact sheets, research reports, and webinars on suicide prevention.
• Self-Injury Outreach and Support: A non-profit outreach initiative providing information and resources about self-injury to those who self-injure, those who have recovered, and those who want to help.
• The Trevor Project – Saving Young LGBTQ Lives: The Trevor Project is the world’s largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) young people.
• We Matter Campaign: We Matter is an Indigenous, youth-led, nationally registered organization dedicated to Indigenous youth support, hope, and life promotion.

Text Attributions

• “Creating a Safe Learning Space,” “Trauma Awareness,” and “Self-Care and Community Care” are adapted from Consent & Sexualized Violence Training and Facilitator Guide: Preventing and Responding to Sexual Violence in B.C. Post-Secondary Institutions, Sexual Violence Training Development Team.  CC BY 4.0 license.
• “Scope of the Session,” “Questions That May Come Up and How to Respond,” “Transitions and Difficult Conversations,” “A Note on Language,” and “Resources on Suicide for Further Reading and Preparation” by Barbara Johnston and Liz Warwick.  CC BY 4.0 license.

This agenda offers some suggested times for the different sections of the workshop. You may need to adjust these depending on the needs of the group, your facilitation experience, and any time constraints you face.

Welcome

Welcome participants and open with a territory acknowledgement. If you’re unsure of your territory, the website Native-Land.ca is a helpful resource.

Opening Check In

After the welcome, introduce yourself. You could ask participants to very briefly introduce themselves, or you may want to start the session with a short participant check-in as a way to invite people into a learning space. You could ask participants to share their name, where they work, and what they are hoping to get out of the session. If you’re offering the session online, you could do an online poll that asks people to choose the type of weather that matches how they are feeling. There are many different ways to have participants check in with themselves and the group, and we invite you to use questions and reflections that are meaningful to you and the group.

Goals and Objectives

Review the overall goal of this presentation: to help faculty and staff develop the knowledge, skills, and confidence to support students who are in distress and possibly thinking of suicide.

After participating in the presentation, participants will be able to:

• Explain myths and misunderstood ideas about suicide.
• Recognize the different signs that indicate someone is in distress or at risk of suicide.
• Ask if a student is considering suicide, express support, and refer the student to appropriate resources.
• Discuss roles and appropriate boundaries for faculty and staff responding to a student considering suicide.

Participants will leave this session with a clear understanding of their role in responding to students in distress and have basic tools for approaching and referring students to campus resources and crisis lines.

Practical Information

Suggest that as people engage with the presentation, they reflect and think about how the information might apply to situations they have already had with students, or situations that they can imagine coming up in their role as faculty or staff.

Encourage participants to provide feedback and share their input during the discussions as this helps improve the learning opportunities. Also encourage people to jot down notes during reflection activities. Encourage them to ask questions if they have any questions during the session.

Let everyone know that after the presentation, they will have access to printable (PDF) handouts. If possible, have a handout with contact information of your institution’s support services for students.

If you are giving this session online, remind online participants that they can turn off their cameras and move around the room during the session. Ask them to be mindful of using the mute button to reduce noise in the online space. You may also want to encourage participants to use the chat feature to ask questions and make comments.

Self-Care When Talking About Suicide

To create a safe space, spend some time talking about how the topic of suicide can be sensitive for all of us and can bring up memories of people we know, love, and have lost. Many of us have been affected by suicide in some way.

Tell participants that self-care is not an afterthought, and they should keep the concept of self-care in mind while going through this session. Remind them that they are not alone, they are all colleagues, and they are here to support each other and share resources. This is meant to be a supportive community.

Remind people to take care of themselves in whatever way makes sense, including permission to “pass” or to not share, permission to take time or to leave the room. People should feel free at any time to pause, take a break, stretch, and ground themselves. To feel emotionally touched is expected but can be surprising and unsettling.

For in-person sessions, you could suggest that if a participant does need to leave a session that they give a thumbs-up as they go to let you know they’re okay. Tell everyone that if you don’t see a thumbs-up, you’ll ask a colleague to look for the participant outside the session to make sure they are all right.

Also, remind participants that they can share at the level that they feel comfortable with. Suggest that if anything comes up in the session that feels too important or difficult to handle on their own, people shouldn’t hesitate to reach out to the appropriate services – a counselling office or an employee assistance program – to debrief or discuss it further.

Group Guidelines

It is helpful to set some expectations and boundaries for the discussion. Remind participants that this is a learning environment, and not a therapy group. Sometimes a topic like suicide brings things up for people, but what comes up in this room – whether in person or online – stays in the room. It is also expected that participants will be non-judgmental of each other and show extra sensitivity when engaging in discussion during the seminar. This is about gaining a little more comfort and confidence in dealing with this topic.

You could ask participants to share ideas for group guidelines at the beginning of the session, or you could share a list of guidelines before the session begins to save time during the session. Some examples of group guidelines:

• Share the learning, not the names or the stories (confidentiality).
• Participants have the right to “pass” on activities/questions that feel uncomfortable.
• It is all right to feel uncomfortable or not to know answers to everything.
• Treat others with respect.
• Be mindful of your language; respect everyone’s names and pronouns.
• Remember that there may be participants who know someone who has either attempted suicide or died by suicide. The session may bring up strong emotions for them.
• Speak for yourself. Use “I statements” to state opinions or feelings.
• Seek to replace judgment with curiosity.
• Take care of yourself.
• Take space, make space (allow everyone a chance to participate).

Text Attributions

• This chapter was adapted from Let’s Talk: A Workshop on Suicide Intervention by Dawn Schell, University of Victoria.
• New text: “Welcome,” “Opening Check-in Activity,” “Goals and Objectives,” “Practical Information,” and “Understanding the Role of Faculty and Staff” by Barbara Johnston and Liz Warwick. “Territory Acknowledgement and Indigenous Ways of Knowing and Being” by Jewell Gillies.  CC BY 4.0 license.

Media Attributions

• Slide 1: Two Brown Trees by Johannes Plenio is in Public Domain.
• Slide 2: Lake in Dome Creek, B.C. by Jakub Fryš is licensed under a CC BY-SA license.
• Slide 5: Flowers and the beach by Andrey_and_Lesya is licensed under a CC0 license.
• Slide 7: reflections of heart by Álvaro Bueno, ES from the Noun Project is licensed under a CC BY 4.0 license.

Video: Live Through This

Live Through This is a series of portraits and true stories of suicide attempt survivors. Its mission is to change public attitudes about suicide. To start this section, you may want to show a short four-minute video of suicide survivors from the Live Through This website. Alternatively, you could share the link with participants prior to the session to help them prepare.

A YouTube element has been excluded from this version of the text. You can view it online here: https://opentextbc.ca/suicideawareness/?p=81

Myths and Commonly Misunderstood Ideas

Because we don’t talk about suicide a lot, people often have a lot of questions and there are a lot of misunderstood ideas and myths about suicide. Let’s take some time to talk about some of these myths.

Debrief with the group. Below are some talking points about the myths.

Looking at Statistics

Every expression of suicide needs to be taken seriously because no one can predict who will die by suicide even though many people have had thoughts of suicide at some point in their lives. Anyone can be at risk for suicide. Let’s have a look at some statistics for more insight.

An average of 10 people die by suicide each day in Canada.

For every 1 suicide death there are:

• 5 self-inflicted injury hospitalizations
• 25 to 30 attempts
• 7 to 10 people affected by suicide lossStatistics Canada. (2019, July 22). Suicide in Canada. https://www.canada.ca/en/public-health/services/publications/healthy-living/suicide-canada-infographic.html

In the post-secondary context, Canadian data from the 2019 National College Health AssessmentAmerican College Health Association. American College Health Association-National College Health Assessment II: Canadian Reference Group Data Report Spring 2019. Silver Spring, MD: American College Health Association; 2019. https://www.acha.org/documents/ncha/NCHA-II_SPRING_2019_CANADIAN_REFERENCE_GROUP_DATA_REPORT.pdf tells us that:

• 10.1% of students had seriously considered suicide within the previous 12 months
• 1.9% had attempted suicide within the previous 12 months
• 6.0% intentionally cut, burned, bruised, or otherwise injured themselves within the previous 12 months

(For this survey, 58 Canadian post-secondary institutions self-selected to participate and over 55,000 surveys were completed.)

When we consider gender, Statistics Canada tells us that males account for 75% of suicide, but females account for 58% of hospitalizations for attempted suicide.

Women are three to four times more likely to attempt suicide than men, but men are three times more likely to die by suicide than women.Canadian Mental Health Association. (2016). Preventing suicide. (2019, July 22). https://cmha.ca/documents/preventing-suicide There are several reasons for this:

• Men often use more lethal means of suicide than women.
• Men are less likely than women to seek help when they are struggling.
• Men are often socialized not to talk about their emotions and may mask their stress and deal with emotional pain through harmful behaviours and actions.Buddy Up. (n.d.) The gender paradox. https://www.buddyup.ca/learn/

Among non-binary students, the suicide rate is very high: 44% of non-binary students had seriously considered suicide, and 17% had attempted suicide in the past year.McCreary Centre Society. (2018). B.C. adolescent health survey. https://www.mcs.bc.ca/about_bcahs

What Stats Don’t Tell Us

Stats don’t take into account the impact that suicide has on others. For each death by suicide it has been estimated that the lives of 7 to 10 people will be affected.

The more we have these types of conversations, the more of the iceberg is brought to the surface.

Adaptations

Statistics can quickly show how prevalent suicide or thoughts of suicide are among post-secondary students. The slides include information about suicide in Canada. However, there may be statistics on student mental health and suicide at your institution or in your community that you can use. Or you may want to share information and statistics about groups at higher risk of suicide. Some examples to consider:

• People with experience of abuse, trauma, conflict, or disaster, including bullying, cyberbullying, and peer victimization are at higher risk of suicide.
• Those who have been bereaved or affected by suicide in others may have a higher risk.

Or you may want to use both quantitative data and qualitative data (for example, brief statements from students).

Risk Factors and Protective Factors

Suicide is a complex topic and there is no single cause that makes an individual suicidal. When a person feels helpless or alone, overwhelmed by pain, fear, and suffering, their hope wanes and they may consider ending their life.

Many people experience passing thoughts of ending their lives without ever having any intention to act on those thoughts. Suicidal thinking becomes more concerning when it is persistent and driven by increased emotional distress. When a person’s thoughts become directed toward how and when they might kill themselves and actual gestures or attempts elevate the overall level of risk.

Factors that may increase risk of suicide:

• Prior suicide attempt
• Triggering life events (losing a loved one, physical illness, discrimination, harassment)
• Trauma (violence, abuse, or events that affect generations of one’s family)
• Mental illness, such as depression
• Alcohol or drug addiction
• Chronic physical illness
• Barriers to accessing care
• Lack of support from family, friends, community
• Personal identity struggles (cultural, sexual)
• Feelings of isolation

Marginalized Groups

When we talk about mental health and suicide risks, we also need to be aware of factors like race, sexual orientation, social class, age, disability, and gender and the unique life experiences and stressors that accompany them. Some students face inequality, discrimination, and violence because of their race or gender orientation. These unique and specific stressors impact mental and physical health, and these students often experience greater mental health burdens while at the same time facing more barriers to accessing care. Research and statistics tell us that suicide risk is higher for Indigenous and LGBTQ2S+ (lesbian, gay, bisexual, transgender, queer, two-spirit) than it is for the general population.

Indigenous People

Suicide among Indigenous people is significantly higher than the general population. Estimates suggest that, in some years, the suicide rate for Indigenous people in specific communities is as much as 30% higher than that for non-Indigenous people.Statistics Canada. (2019). Suicide among First Nations People, Métis and Inuit (2011–2016): Findings from the 2011 Canadian Census Health and Environment Cohort (CanCHEC). https://www150.statcan.gc.ca/ n1/daily-quotidien/190628/dq190628c-eng.htm

Suicide rates are highest for youth and young adults (15 to 24 years) among First Nations men and Inuit men and women. However, there is great variability in suicide rates at the community level; some Indigenous communities may have a very high suicide rate; other communities may have a very low rate.

For Indigenous communities, high rates of suicide are connected to a variety of factors including the historical and ongoing trauma from colonialism, systemic racism, discrimination, and the loss of culture and language. The impact of residential schools and other colonial policies have created ongoing adversity for Indigenous people, and these effects have been passed on from one generation to the next, causing intergenerational trauma.

Many Indigenous people lack trust in educational and health care institutions because of the negative or traumatic experiences they or family and friends have experienced in the past. The 2020 report In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care reported on the widespread systemic racism against Indigenous peoples in the B.C. health care system. The study reported that 84% of Indigenous people described personal experiences of racism and discrimination that discouraged them from seeking necessary care.Turpel-Lafond, M. E. (2020). In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care. https://engage.gov.bc.ca/app/uploads/sites/613/2021/02/In-Plain-Sight-Data-Report_Dec2020.pdf1_.pdf

It is important to note, however, that while the suicide rate is higher for Indigenous people compared with non-Indigenous people, not all Indigenous communities have regular incidents of suicide. In communities where there is a strong sense of culture, community ownership, and other protective factors, it is believed that there are much lower rates of suicide and sometimes none at all.Kirmayer, L., et al. (2007). Suicide among Aboriginal people in Canada. Aboriginal Healing Foundation.

LGBTQ2S+ People

People who are LGBTQ2S+ are at a much higher risk than the general population for mental health disorders, substance abuse, and suicide. Homophobia and negative stereotypes about being LGBTQ2S+ can make it challenging for a student to let people know this important part of their identity. When people do openly express this part of themselves, they worry about the potential of rejection from peers, colleagues, and friends, and this can exacerbate feelings of loneliness. Health needs may be unique and complex for some LGBTQ2S+ people, and health care settings can feel unsafe or uncomfortable for many.

Lesbian, gay, and bisexual youth are more at risk for suicide than their straight peers. They are five times more likely to consider suicide and seven times more likely to attempt suicide.Suicide Prevention Resource Center. (2008). Suicide risk and prevention in gay, lesbian, bisexual and transgender youth. Education Development Center, Inc. http://www.sprc.org/sites/default/files/migrate/library/SPRC_LGBT_Youth.pdf

Transgender people are at an even greater risk for suicide as they are twice as likely to think about and attempt suicide than LGB people.Haas, A., et al. Suicide and suicide risk in lesbian, gay, bisexual and transgender populations: Review and recommendations. Journal of Homosexuality, 58(1),10-51. DOI: 10.1080/00918369.2011.534038; McNeill, J. et al. (2017). Suicide in trans populations: A systematic review of prevalence and correlates. Psychology of Sexual Orientation. DOI:10.1037/sgd0000235.; Irwin, J. et al. (2014). Correlates of suicide ideation among LGBT Nebraskans. Journal of Homosexuality, 61(8), 1172–1191. Studies have shown that 22% to 43% of transgender people have attempted suicide.Bauer, G., et al. (2015). Intervenable factors associated with suicide risk in transgender persons: A respondent driven suicide risk sampling study in Ontario, Canada. BMC Public Health. DOI: 10.1186/s12889-015-1867-2. Transgender people face unique stressors, including stress from being part of a minority group, as well as stress related to not identifying with one’s biological sex. Transgender people also experience higher rates of discrimination and harassment than their cisgender counterparts and, as a result, experience poorer mental health outcomes.

While there is a growing awareness of the needs and challenges faced by LGBTQ2S+ community members, much still needs to be done to create truly inclusive and safe spaces within health and educational environments.

What We Need to Keep in Mind

We need to take care to understand and acknowledge oppressions faced by Indigenous people, LGBTQ2S+, people with disabilities, and people from racialized and other marginalized groups. By providing a culturally safe environment, we can all play a role in ensuring that each student feels their personal, social, and cultural identity is respected and valued.

It is helpful to know the campus and community resources for students from marginalized groups. Connecting an Indigenous student to an Elder or to someone from Indigenous services or introducing an LGBTQ2S+ student to a pride centre on campus can help to reduce feelings of isolation and help students feel heard and supported. We’ll talk more about supports and referrals a bit later in the session.

Text Attributions

• This chapter was adapted from Let’s Talk: A Workshop on Suicide Intervention by Dawn Schell, University of Victoria.
• New text: “Risk Factors and Protective Factors,” “Marginalized Groups” by Barbara Johnston. “The Tree of Life” by Jewell Gilles. CC BY 4.0 license.

Media Attributions

• Slides 8 and 18: Trees and sunshine by Richs5812 is in Public Domain.
• Slides 10 and 11: Person by asianson.design is licensed under a CC BY 4.0 license.
• Slide 10: Map of Canada, vector map. Modified by Lokal_Profil is licensed under a CC BY-SA license.
• Slide 15. Iceberg in the Arctic with its underside exposed by AWeith is licensed under a CC BY-SA license.
• What is Live Through This by Dese’Rae L. Stage is licensed under a Standard YouTube License.

Feelings and Attitudes

Before we start to talk about how we can provide a support role for others, let’s take a moment to explore our own feelings and attitudes around suicide. It’s helpful to think about this ahead of time so that you don’t bump into surprising feelings or attitudes while trying to support someone; this way you can make sure the experience is more about them. You don’t have to do a complete assessment of yourself at this point, but this is an invitation to consider your own feelings and attitudes because you likely do have some beliefs and thoughts about this topic.

It’s okay to have different feelings and attitudes about suicide. Some of these beliefs will be more helpful than others. The goal is to forget about some of the less helpful ones to make sure that the interaction is about supporting someone else.

There are people who believe that suicide is wrong. We’re not here today to argue about the ethics or morality of it. We’re going to focus on questions, feelings, worries, and thoughts. Please be honest but also remember that there may be people here who have experience with loved ones dying by suicide. Let’s make sure we treat each other with compassion and respect.

The thought of asking someone about suicide can be overwhelming. One concern that people often have is that if they bring up suicide and a person isn’t considering it, this person may start thinking about it as an option. That is untrue. Asking about suicide will not put the thought into someone’s mind. It can give the person a sense of relief, (for example, “Finally, someone has seen my pain,”) or give them permission to open up further about something they have been hiding.

What We Need to Consider Before a Difficult Conversation

Before having a difficult conversation, there are a few things to first ask yourself. If there is a student you think may be at risk of suicide, first think about your own emotions, thoughts, beliefs, and values. Ask yourself how you feel about starting this conversation with a student. You may realize you are not emotionally ready to talk to the student, and this is okay. You can reach out to other people on campus, such as a counsellor, to get their advice and support.

If you feel ready to have this sensitive conversation, you will want to think about how and where the conversation will happen. You will want to:

• Create an atmosphere and environment of non-judgment and openness
• Consider any possible triggers
• Consider risk factors
• Ensure you are in a private space where you will not be interrupted
• Remember that compassion counts
• Be patient
• Be hopeful

Text Attributions

• This chapter was adapted from Let’s Talk: A Workshop on Suicide Intervention by Dawn Schell, University of Victoria.

Media Attributions

• Slide 19: Writing Tools – paper pen laptop by Pete O’Shea is licensed under a CC BY 4.0 license.
• Slide 20: reflections of heart by Álvaro Bueno, ES from the Noun Project is licensed under a CC BY 4.0 license.

Signs That Someone Is Contemplating Suicide

There are thoughts, feelings, physical effects, actions, and events that are common to a person’s experience and may give us clues to the possibility of suicide.

We need to be observant and notice these things, which by themselves may not be definitive indicators but will give us valuable clues to probe further. Remember:

• You already have these skills.
• Noticing the signs is the starting point.

Thoughts

What are possible thoughts that people who are contemplating suicide might be having?

They may be thinking:

• I can’t do anything right.
• I just can’t take it anymore.
• I can’t carry on like this.
• I wish I were dead.
• People will be better off without me.
• No one can do anything to help me.

Feelings

If you hear a student say they feel helpless, hopeless, or worthless, these are red flags that they may be thinking about suicide. They may also be feeling angry, guilty, lonely, or sad.

People may feel ambivalent about dying. There is a huge difference between wanting to die and not wanting to live. Suicidal thoughts often come when pain exceeds a person’s resources.

Statements

Sometimes a person will make statements about their intention.

Direct statements could be:

• “I’m going to end it all.”
• “I’d be better off dead.”
• “If X happens (or doesn’t) I’m going to kill myself.”

Indirect statements could be:

• “I am a burden and people would be better off without me.”
• “My life has no purpose. I’ve lost hope.”
• “Nothing will ever change and I give up.”

Physical Signs

What physical signs might indicate someone is contemplating suicide?

• Lack of interest in appearance and hygiene
• Sleep disturbances
• Change or loss of appetite, weight
• Physical health complaints

Actions

A person’s actions can be a sign that they are considering suicide. Any of the following actions could be a warning sign:

• Withdrawing
• Loss of interest in favourite activities
• Misuse of drugs or alcohol
• Reckless behaviour
• Extreme behavioural changes
• Impulsivity
• Self-injury

Stressful Events or Loss

Ask the group: What stressful events would likely contribute to a person contemplating suicide?

Write down people’s answers, which may include:

• Academic failure
• Recent relationship breakup
• Financial instability
• Other suicides on or off campus
• Depression or other mental illness
• Family history of mental health events
• Humiliation, bullying, or harassment
• Recent death of family member or friend
• Anniversary date of the death of a family member or friend
• Critical health diagnosis or injury

The two most common themes are:

• Loss
• Change beyond a person’s control

Sometimes a person doesn’t give any signs that they are having suicidal thoughts before they end their life. This is a very difficult and painful thing to deal with. It brings us back to the importance of resiliency, self-care, and supporting each other.

However, there are things we can do. The next section looks at how we can respond to and support someone who may be thinking of suicide.

Text Attributions

• This chapter was adapted from Let’s Talk: A Workshop on Suicide Intervention by Dawn Schell, University of Victoria.

Media Attributions

• Slide 23: Trees and sunshine by Richs5812 is in Public Domain.

If you observe clues that lead you to suspect someone may be suicidal, it is important that you check it out in more detail.

It can be difficult to acknowledge clues that seem to indicate that a person you know may be planning to kill themselves. But it can be tragic to disregard them.

• Trust yourself. Believe your suspicions.
• This is about being alert to suicide and being aware.
• The aim is to connect a person with thoughts of suicide to other help.

What Do People Need at This Point?

The main thing that people need is to be heard and not judged. The most effective intervention you can do is to listen with empathy and be non-judgmental.

Let the person know you hear them, believe them, and understand their distress as best you can. Tell them that you will help connect them to appropriate resources.

It does not have to be a lengthy conversation. Sometimes a conversation and a referral can be made within 10 minutes. What is most important is that the conversation is based on active listening and care. Sometimes just a few genuine words of concern and understanding can make a big difference and help get a person to connect with a counsellor or the best person to help them. You can’t take away their pain or solve their problems. But you can care.

There are no magic words. Be yourself. If you are concerned, your voice and manner will show it. Be patient, calm, accepting. This is more important than having the perfect words.

You may think that it’s all just talk and wonder how that’s going to help, but asking a person and having them talk about how they feel greatly reduces feelings of isolation and distress. Simply talking about their problems for a length of time will give a suicidal person relief from loneliness and pent-up feelings. They become aware that another person cares, and this can give them a feeling of being understood. A conversation can take the edge off their agitated state, and it may help them get through a bad night.

Communicate your concern for their well-being by offering to listen. Good listening is more than just listening quietly. It means demonstrating that you can be supportive without being judgmental. It means accepting their feelings as the truth for the person, no matter how irrational they might appear to you. It means that you are comfortable enough with your own feelings to set them aside and listen to theirs.

What Else Can Help?

• Approach with concerned care.
• Understand with empathy.
• Recognize and relate with kindness.
• Ask with respect.
• Lead with hope.
• Introduce help with community.

Adaptations

To demonstrate how to respond in a helpful, compassionate way, you could show a short video from well-known sociologist Brené Brown: Brené Brown on Empathy. The BCcampus resource Capacity to Connect: Supporting Students’ Mental Health and Wellness has more information on developing empathetic listening skills if you want to explore empathy more with your group.

A YouTube element has been excluded from this version of the text. You can view it online here: https://opentextbc.ca/suicideawareness/?p=96

Starting the Conversation

Here are some ways you can introduce the signs that you notice:

• “I noticed…”
• “Sounds like you are…”
• “I used to see you … recently I noticed…”

These questions can start a conversation with someone you are concerned about, and this is also just normal empathic human interaction. You can check things out without it being a scary conversation. The goal is to practise asking about things you have noticed and to probe and listen for other warning signs.

Ask Directly and Clearly

You could start with:

• “At this point I need to ask you something…”
• “I might be way off base, but when you said… I wondered…”

You could then ask directly: “Are you feeling so bad that you’re considering suicide?”

Or:

• “That sounds like a lot for one person to take. Has it made you think about killing yourself to escape?”
• “Do you have a plan to end your life?”
• “Are you planning to kill yourself?”

Other ways to ask about suicide:

• “Has all that pain you’re going through made you think about hurting yourself?”
• “Have you ever felt like just throwing it all away?”
• “I see what you are doing and how much you must be hurting. I’m concerned about you. I want to talk. I want to hear what’s going on with you.”

What If They Say No?

If the person says they are not thinking of suicide, accept their response. You’ve shown you are ready, willing, and able to engage in a serious conversation.

When a person says no, they usually will explain why not:

• They didn’t really mean it to come across that way.
• They have thought about it but would never act on it.
• They have many reasons to live.

They may say they have stronger reasons for living and usually are reluctant and have concerns about the effect on others they care about. Listen supportively and offer resources as necessary.

What If They Say Yes?

If a person says they are thinking about suicide:

• Take them seriously. Let them know you feel this is important to talk about.
• Listen without judgment and give them your complete attention.
• Acknowledge their thoughts and feelings with compassion.

The goal is to keep the other person safe. Now is not the time to solve all problems.

Consider the Risk

If a person says they are thinking of suicide, you need to consider the risk. Ask them:

• How often are you thinking about this?
• Do you have a plan? Have you thought about how you would kill yourself?
• Have you thought about when?

By asking these questions, you can get a sense of how serious they are. The more prepared they are, the greater the risk.

It is similar to taking a trip and the preparations a person makes before the trip. How serious is this person about the trip? Are they just talking about wanting to take the trip or have they started looking into trip destinations? Or are they really prepared for the trip and have already booked their flight and started packing their bags?

More often than not, people do not have a plan for suicide, but if the plan is immediate, if steps have already been taken (pills, self-harm), or if a conversation is not possible, call 911 and stay with them until help arrives.

Text Attributions

• This chapter was adapted from Let’s Talk: A Workshop on Suicide Intervention by Dawn Schell, University of Victoria.

Media Attributions

• Slide 32: Trees and sunshine by Richs5812 is in Public Domain.
• Slide 34: Coloured icon with bubbles in different languages by Rodelar is licensed under a CC0 license.
• Brené Brown on Empathy by RSA is licensed under a Standard YouTube license.

Referring to Resources

When talking to a student in distress, you will want to look for a natural point in the conversation to mention resources.

To introduce the idea of a referral, you could say:

• “We need extra help. I want to connect you with someone who can help you keep safe.”
• If they are reluctant, you could say, “I have to do this. I’m not going to take a chance on losing you.”
• Point out that seeking help is a sign of strength and courage.

If it is not an emergency situation, you can refer the student to supports on campus. There may be a list with services and contact information for these services at your institution. If not, Handout 1 is a fillable PDF that has space to add in contact information for key supports. Below are some of the services available at most campuses:

• Counselling services help students manage personal, academic, and life concerns. Professional counsellors provide individual and group counselling sessions for students.
• Campus security helps coordinate responses to student emergencies and crises. If you call 911, call security first, as security can help first responders locate you.
• Student services offers many supports for students.
• Indigenous student centre offers support, mentorship programs, and a gathering place. Many campuses have an Elder who can talk to students.
• Health or medical services offer health and mental health care for students.
• International student services help students with personal or academic issues, study and work permits, and visa applications.
• Accessible learning services provide services and coordinate academic accommodations for students.
• Pride centre provides support to LGBTQ2S+ students.
• Sexualized violence resource centre offers support for victims of sexualized violence.

If the student is not on campus, you can connect with these services and ask that they connect with the student by telephone or video.

Provincial Mental Health and Crisis Lines

There are a number of provincial crisis lines that offer support. Here are some key ones:

• BC Suicide Line: 1-800-784-2433
• Mental Health Support Line: 310-6789
• Here2Talk: 1-877-857-3397 (a 24-hour phone and chat counselling support for B.C. post-secondary students).
• KUU-US Crisis Line: 1-800-588-8717 (a 24-hour crisis line for Indigenous people)

If you haven’t already passed out Handout 1: Quick Reference: Responding to Students in Crisis, share handout out now so participants have a sheet with referral information.

When You Are Unsure What to Do

When you are unsure what to do, consult with your colleagues, chairs, deans, or others whom you trust. Counsellors can meet with staff and faculty who are concerned about a student and are unsure how to handle the situation. You can also call a crisis line if you have serious concerns about a student. You are encouraged to consult when:

• You are concerned about a student’s safety, academic performance, or well-being but are unsure how or whether to intervene.
• You are uncertain how to respond to a student’s approach for help.
• You continue to be concerned about a student who has declined help.

If a Student Won’t See a Counsellor or Seek Help

Sometimes a student may not want to see a counsellor or refuses help.

Your first step in these cases will be to consider safety: Is anyone at risk of immediate harm, whether it’s the student or someone else? If so, share your concerns with a counsellor or someone who can help ensure safety. If a student expresses thoughts about suicide, you don’t have to carry that knowledge alone or assess the risk yourself – consult, refer, and if the risk is imminent, then contact emergency services.

If there is no risk of harm to anyone, keep in mind that ultimately it is the individual’s right to choose whether to seek help. Individuals are resilient and often come to their own solutions or find their own supports when they are ready.

Ensure you are supported! Talk to friends, family, other instructors, an Elder, or a counsellor to share your concerns and decide how to proceed.

Privacy

Please be aware that if you refer a student to counselling services and are hoping to follow up to find out about the student, it is up to the student to give consent to release information.

Unless a student gives permission, faculty and staff won’t be notified of what has happened.

Key Points to Remember When Talking to Someone About Suicide

• Speak with the student directly and in a comfortable, safe setting. Maintain clear professional boundaries.
• Be specific about the behaviour you have observed, and don’t be afraid to express concern. Use objective, non-judgmental language.
• Stay calm and listen carefully. Acknowledge how the student is feeling and let them know you want to help. Take their concerns seriously.
• Make a referral ­– let them know about supports on and off campus and that seeking help is a sign of strength and courage.

If something still doesn’t feel right consult with your supervisor/chair/dean, student centre, campus security, or campus resources.

What Helps People Recover?

Remember: the most important thing you can do is listen and help connect the person to resources. Knowing that someone cares and that there is help available is what helps people recover.

Having a sense of purpose, hope, belonging, and meaning are essential to recovery.

People who are considering suicide have lost hope, and they need to be reminded that there is hope. Some hopeful messages for people who have thoughts of suicide:

• It will get better! One step at a time. One minute at a time.
• Please reach out for help; you are not alone and you matter.
• HOPE (Hold On, Pain Ends).

When you are supporting someone, remember:

• Be patient. Be hopeful.
• Always take the person seriously.
• Listen and ask them what they need to be safe.
• Ask them: What is the most helpful thing I can do for you?

Text Attributions

• This chapter was adapted from Let’s Talk: A Workshop on Suicide Intervention by Dawn Schell, University of Victoria.
• New text: “Support for Marginalized Groups” by Barbara Johnston.  CC BY 4.0 license.

Media Attributions

• Slide 44: Hope by Matthew Walton is licensed under a CC BY 4.0 license.

Options for Scenarios

Adaptations

You can adjust the scenarios to best suit your participants. Here are a few more suggestions for scenarios.

Student worried about their friend’s change in behaviour

You are talking to a student and they say, “I have a friend I am worried about.” The student tells you their friend has not been motivated to show up online for lectures, is sleeping a lot more than usual, is not doing any work for their courses, and hasn’t been connecting in any of the ways they usually would. They tried to talk to them about it, but their friend said it was “nothing and they just want to disappear cause nobody cares anyway.” The student you are talking to is worried about their friend, and they say they are not the only ones who have noticed a change.

Student who is applying to law school and has received a disappointing LSAT score

A student is applying to law school and recently received a disappointingly low LSAT score. They say, “I’m nothing. My life is over. I have no future. Everything I’ve worked for all my life is shot.”

Student who is distressed about their parents’ divorce and financial situation

A student has just learned that their parents are divorcing. They say, “I should have seen this coming. Now it’s too late. I don’t know what’s going to happen to my little sister. I want to help her but I don’t see how I can ever go home again. And there’s no point in staying here and studying because my parents won’t be able to afford tuition. I just want to go hide somewhere and never be seen again.”

International student who failed an exam

An international student who is on probation has just failed an exam. The student fears they will be suspended and forced to go back to their home country, but they would be a disgrace to their family and they couldn’t face them. The student says that they can’t see any other option but to end it all.

Text Attributions

• This chapter was adapted from Let’s Talk: A Workshop on Suicide Intervention by Dawn Schell © University of Victoria.
• Scenarios 1 and 4 are adapted from Capacity to Connect: Supporting Students from Distress to Suicide Armstrong, G., Daoust, M., Gil, Y., Seinen, A., & Shedletzky, F. © Vancouver Island University.
• Scenarios 2, 3, and 5 by Jewell Gillies. CC BY 4.0 license.

Maintaining Boundaries

When helping students, it is important to remember to maintain your own boundaries. Recognize what you can and can’t do, given the limitations of your role, and be clear with others. Refer students as appropriate and access your own support when needed. While you can be an empathetic listener and help connect a student to the proper resources, you are never expected to take on the role of a counsellor or to “fix” a person. There are services and supports to help a student at risk of suicide.

To conclude your conversation, let the student know you are glad they came to talk to you. You could say:

• • “I’m glad you told me…”
  • “I can’t do that, but I can do this….”
  • “I’m happy you chose to talk to me, and we need to talk about a transition plan because I’m not a counsellor. I’m struggling here because this is out of my depth. The best way I know how to deal with this is to talk to a counsellor.”

Remember that there’s an entry and an exit to the conversation. The conversation does not have to be a long one. By listening and referring a student to a counsellor you could be making a big difference to the person who needs to know someone hears them.

It’s also important to make time to take care of yourself after the session. It may be helpful to talk to a colleague or friend to debrief, or you may want to do something fun or relaxing to recharge. Think about what activities might you find helpful to try after the session.

Closing the Session

To end the session on a positive note, ask participants to share what they found most valuable in the session. Ask if anyone has any questions or comments, and let participants know that you’ll be available after the session if anyone has any questions or would like to talk about anything covered in the session.

Text Attributions

• This chapter was adapted from Let’s Talk: A Workshop on Suicide Intervention by Dawn Schell, University of Victoria.

Media Attributions

• Slide 50: Flowers and the beach by Andrey_and_Lesya is licensed under a CC0 license.
• Slide 52: reflections of heart by Álvaro Bueno, ES from the Noun Project is licensed under a CC BY 4.0 license.
• Slide 53. Diversity speech bubble icons by Louise Wigö is licensed under a CC0 license.