This Suicide Prevention Month, the CARE TA Center presents the following 5 Things Digest with a focus on helping people who are experiencing suicidal crisis get through crisis. This 5 Things Digest centers the experiences of people most impacted by suicide with resources created by and for our communities with the highest and/or fastest growing rates of suicide: LGBTQ youth, Black and Indigenous people, Veterans, and people with prior histories of suicidal crisis.
Suicide prevention is a difficult topic for many behavioral health providers because we believe that we can and should prevent suicide among our clients. Those of us who have lost clients or loved ones to suicide know that ultimately there is only one person who can prevent a suicide, and it is the person experiencing the suicidal crisis. For those who have survived suicidal crises of our own, we know that it is not about wanting to die, but rather, wanting the pain to end.
Many well-intentioned clinicians and family members ask people experiencing suicidal crisis to promise that they will not hurt themselves. Research demonstrates that these “no-suicide contracts” do not work and can even cause harm. No-suicide contracts can increase, rather than decrease, distress and disrupt therapeutic trust by asking people to tolerate the intolerable without helping to reduce the pain. Conversely, research demonstrates several interventions that do reduce the risk of suicide, including risk assessments, safety plans, and lethal means restrictio.
While a critical tool, suicide risk assessments do not actually prevent suicide. The truth is that properly utilized suicide risk assessments only connect people experiencing crisis to crisis care services. What happens before and after the person accesses the service if the pain remains intolerable? And worse yet, what happens when the crisis care services exacerbate the pain?
In 2021, many people avoid crisis care services due to the risks associated with institutional, racial, and generational trauma experienced today and throughout history. Fearing that a call to a crisis line or entrance to a crisis care service will be met with implicit bias from staff and program policies informed by racism, sexism, homophobia, transphobia, and other forms of discrimination, BIPOC and LGBTQ+ people delay or forgo seeking help during moments of crisis. Thus, the CARE TA Center calls on crisis care continuum service providers to consider during Suicide Prevention Month to go beyond suicide risk assessments and safety plans which focus on the individual and consider instead institutional discrimination. Providers and administrators are encouraged to ask, “to what extent are our crisis services places of healing and/or injury to diverse clients?”
