Toolkit for people
who have been impacted
by a suicide attempt

Acknowledgments
The development of this document was made possible through the input, feedback and guidance of the Canadian Associationfor Suicide Prevention, the Centre for Suicide Prevention, the Public Health Agency of Canada and people with lived experience
related to suicide.

THIS DOCUMENT WAS INFORMED/DEVELOPED BY:
Working Group members:

Advisory Committee members:
1. Ally Campbell

5. Chris Summerville

1. Rebecca Sanford

2. Amanee Elchehimi

6. John Dick

2. Robert Olson

3. Andrea Rowe

7. Katherine Tapley

3. Jodie Golden

4. Austin Mardon

8. Melynda Ehaloak

4. Yvonne Bergmans

Generously volunteering their time to add value, experience and rigor to the Toolkit, The Mental Health Commission of Canada
is grateful for their contributions in the development of this project.

Toolkit for people who have been impacted by a suicide attempt

The views in this document do not necessarily refect

Mental Health Commission of Canada, 2018the views of the MHCC.

Ce document est disponible en françaisThis document is available at http://www.mentalhealthcommission.ca
Production of this document is made possible through a fnancial contribution from Health Canada.

Contents
Introduction

Telling your story safely . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

About the toolkit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

How to fnd hopeful messages for others within your experiences . . . 13
Advocacy for attempt survivors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Strategies and coping suggestions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Strategies to help cope with thoughts of suicide/
How and where to get help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Hopeful messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

How to communicate feelings of suicide and thoughts of suicide . . . . . . 5

For people who have thoughts of suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Resources for people with lived experience . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

For people who are supporting someone who has
attempted suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Peer support groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Counselling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Addiction services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Coping suggestions and crisis planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Crisis lines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Memoirs, case histories, and personal stories . . . . . . . . . . . . . . . . . . . . . . . . . 8
Coping strategies and developing a safety plan . . . . . . . . . . . . . . . . . . . . . . . . 8
Phone applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Suggested messages when contacting a suicide crisis line . . . . . . . . . . . . . 9

Share your own message of hope! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

About suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Background and context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
What is suicide? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Basic statistics on suicide in Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Safe language around suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Myths and facts about suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Tips on alleviating stress when going to hospital/emergency . . . . . . . . . . 9

Why do people attempt to die by suicide? . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Coping after an emergency room visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Social determinants of health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Risk and protective factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

How to support a loved one who is having thoughts of suicide . . . . 11
How to talk about suicide in an honest,
safe and age-appropriate way . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Risk of suicidality for family and friends of an attempt
survivor or death by suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Warning signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
The role of trauma and childhood experiences . . . . . . . . . . . . . . . . . . . . . . . 20
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Additional resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22

Training and other suicide prevention programs . . . . . . . . . . . . . . . . . . . . . 22
Books, directories, editorials, academic studies . . . . . . . . . . . . . . . . . . . . . . 23

Introduction
About the toolkit designed for people with lived experience related to a suicide attempt.

What it is

The content

The Mental Health Commission of Canada, in collaboration with the

There is no right or wrong way to seek help. This toolkit is not designed

Canadian Association for Suicide Prevention, the Centre for Suicide

to be an exhaustive list of the very wide variety of resources available

Prevention, the Public Health Agency of Canada, along with anacross Canada for support. This toolkit is a summary of the tools that

Advisory Committee comprised of people with lived experience related

have resonated most with the hundreds of people who completed ourto suicide, have developed toolkits to support people who have been

online survey and resources from a literature review completed by the

impacted by suicide. One toolkit is tailored for people who have

Centre for Suicide Prevention.

attempted suicide, and the other is focused on resources for people
who have lost someone to suicide.

If you are not fnding the tools and resources that resonate most withyou, you may consider talking with someone. You may wish to connect

In the summer of 2017, we conducted an online survey to elicit

with a trained volunteer by contacting your local distress centre or

feedback from people who have been affected by suicide. With over

Kids Help Phone.

1,000 responses, the survey helped us gain a better understanding ofwhat topics, content areas, resources, and information were important
to include in the toolkits.

Language
Many respondents indicated a preference for “people-frst” language
as opposed to “survivorship language”. For this reason, we sought toavoid this language within the toolkit. That said, survivorship language
resonates with many and therefore, we included links to resources that
use this language.
Please note that the toolkits are not intended to replace a conversation.
If you or someone you know is experiencing distressing thoughts
or thoughts of suicide, please contact your local distress centre or
Kids Help Phone.
Back to Table of Contents

Toolkit for people who have been impacted by a suicide attempt|4Strategies and coping suggestions
There is no single way or “right” way to cope with thoughts of suicide. People will experience thoughts of suicide differently andtherefore, coping with these thoughts will be different for every individual. The following strategies are suggestions that haveresonated with people who responded to our online survey and additional resources from a literature review. It is not intended
to be an exhaustive list.
If you are not fnding the tools and resources that resonate most withRESOURCES FOR PEOPLE WITH LIVED EXPERIENCE

you, you could try talking about your options with a trained volunteer

These websites and blogs feature the voices of those with lived

by contacting your local distress centre.

Strategies to help cope with thoughtsof suicide/how and where to get help•

For someone experiencing thoughts of suicide, the following
resource addressing the fear of stigma, the shame and self-blamefor having those thoughts and the things you could do when thethoughts emerge, may resonate: Speaking of Suicide: A site forsuicidal individuals and their loved one, survivors, mental healthprofessionals, & the merely curious.

HOW TO COMMUNICATE FEELINGS OF SUICIDE AND THOUGHTSOF SUICIDE•

Talking about thoughts of suicide, ways to keep safe, and people withlived experience talking about depression, anxiety and suicidality are
offered at: Talking to someone about your suicidal feelings.

•

Videos of people telling their stories of lived experience related tomental health, by the Canadian Mental Health Association.

•

Booklet on how to communicate your feelings of suicidal intent,
offering coping strategies and suggestions on where to go for help
and support: How to cope with suicidal feelings.

•

A script between a client and her therapist that shows how tocommunicate feelings of suicidality.

experience who have attempted suicide:•

Live through this: A collection of stories of suicide attempt survivors,
as told by those survivors.

•

Reasons to go on living: Inspiring collection of stories of people whohave attempted or seriously thought about dying by suicide.

•

Talking about suicide: A collection of interviews of attempt survivors
describing their experiences with suicide and recovery.

•

Blogs by survivors by Our Side of Suicide.

•

Mental Health Warriors Podcasts discuss topics around mental healthwith the goal of ending the stigma and the myths that surroundmental health.

PEER SUPPORT GROUPS
National Action Alliance for Suicide Prevention (2014) identifes thatthe voices of those living with the experience of a suicide attempt are
essential for meaningful peer support, and “mutual help groups, warmlines over the telephone, internet groups for online support, and mental
health services delivered by peers.” (p. 26).
As of the writing of this toolkit, there was a signifcant lack of research
examining peer support and its effcacy on suicide-related behaviours.
•

What is peer support?

•

The role of peer support in suicide prevention: Advancing peer
support in suicide prevention.

Toolkit for people who have been impacted by a suicide attempt

|

5

•

Chat, text or call the Warm Line to talk to a peer support worker.
A warm line is not a crisis line, but rather a confdential andanonymous service for adults (18+) living in Ontario.

Canadian Attempt Survivors Support Groups

In the same way that not all therapists will be a good ft for everyone,
the same goes for the type of therapy that will suit you best. Here arejust a few options:•

Cognitive Behavioural Therapy (CBT) can help people examine
how they interpret events around them and can provide practical,
short-term psychotherapy. Find out more about what is Cognitive
Behavioural Therapy (CBT) by the Centre for Addiction and
Mental Health.

•Interpersonal Therapy examines feelings in the context ofrelationships that may be contributing to the person’s mood. Find out
about Interpersonal Therapy at PsychCentral.

•

Dialectic Behavioural Therapy is described by John Grohal as a typeof psychotherapy or talk therapy that utilizes a cognitive behaviouralapproach. Find out more here.

•

Psychoeducation involves formal education groups, usually run bymental health professionals, which are used to inform patients about
their mental health. It is a strength-based, reciprocal relationshipbetween patient and therapist. Find out more in Psychoeducation by
Ellen Luken (2015).

Find a Peer Support Group across Ontario by Mood Disorders
Association of Ontario.
•

Skills for safer living: an intervention group co-facilitated by peerswith lived experience for people experiencing suicide-related
behaviours. Graduates of this 20-week skills group can thenparticipate in a voluntary ongoing peer support group in somelocations.

•

A Reason to Hope. The Means to Cope by the British Columbia
Schizophrenia Society.

•

Toronto’s Stella’s Place peer support program and training.

•

Manitoba’s Andrew Dunn organisation.

COUNSELLING
Finding the right counsellor may take time. It may also take time to fnd
the appropriate therapy and therapist that best suits you. As a starting
point, you may want to start a conversation with your family physician.

ADDICTION SERVICES•

Narcotics Anonymous.

required in the short term and may also be helpful in recommending a•

Adult Children of Alcoholics.

good counsellor for you.

•

12-step program of Alcoholics Anonymous.

•

Addiction Services Directory helps you search for a variety of
support and treatment programs in Canada including gambling,
sex and eating disorders.

•

Changing the language of addiction, by the Canadian Centre on
Substance Use and Addiction.

Your doctor may be able to discuss with you whether medication is••

Finding the right psychologist for you can be diffcult. Finding thePsychologist For You, by the Canadian Psychological Association,
maintains a list of all the provincial and territorial associations of
psychology.
You may fnd a good counsellor or therapist using the Good Therapy:
Canada Counseling Directory by GoodTherapy.org.

Toolkit for people who have been impacted by a suicide attempt|

6

REFERENCES
Anna, C. (2015). Talking about suicide. Because it’s not taboo.
Retrieved from http://talkingaboutsuicide.com/
Beyondblue (2016). Talking to someone about our suicidal feelings.

March, C. (2016). How to cope with your suicidal feelings. London,
UK.: Mind (National Association for Mental Health).
McMaster University (2018). Talking about suicide. Retrieved fromhttp://thereasons.ca/

Retrieved from https://www.beyondblue.org.au/the-facts/suicide-

National Action Alliance for Suicide Prevention: Suicide Attemptprevention/worried-about-suicide/talking-to-someone-about-your-Survivors Task Force (2014). The Way Forward: Pathways tosuicidal-feelings

hope, recovery, and wellness with insights from lived experience.

Dalgin, R., Maline, S., & Driscoll, P. (2011). Sustaining recovery throughthe night: Impact of a peer-run warm line. Psychiatric Rehabilitation
Journal, 35(1), 65-68.
Briggs, S., Webb, L., Buhagiar, J. & Braun, G. (2007). Maytree: A respite
center for the suicidal. Crisis, 28(3), 140-147.
Fractured Atlas (2017). Live through this. Retrieved fromhttps://www.livethroughthis.org/about/
Freedenthal, S. (2018). Speaking of suicide: A site for suicidal individuals
and their loved ones, survivors, mental health professionals, & the
merely curious. Retrieved from https://www.speakingofsuicide.com/
2017/10/03/10-things-to-say/Washington, DC: Author.
Ostrow, L. & Croft, B. (2016). Results of from the 2016 peer respite
essential features survey. Retrieved from https://power2u.org/wpcontent/uploads/2017/01/PREF-Report-05.05.16.pdf
Pfeiffer, P., Heisler, M., Piette, J., Rogers, M. & Valenstein, M. (2011).
Effcacy of peer support interventions for depression: A meta-analysis.
General Hospital Psychiatry, 33(1), 29-36.
Reed, J. (2013). Advancing peer support in suicide prevention.
Retrieved from https://www.sprc.org/news/advancing-peer-supportsuicide-prevention
Back to Table of Contents

Toolkit for people who have been impacted by a suicide attempt|7

Coping Suggestions and Crisis Planning
CRISIS LINES•

Find your local distress line here.

•

1-866-Appelle for residents in Quebec.

•

Kid Help Phone for 24hr, bilingual phone, web and referral service
for children and youth.

•

National Moral & Welfare Services for military families and Canadian
Forces members.

•

Crisis Services Canada, “a pan-Canadian network of local andregional crisis and distress centres, launched the new Canada Suicide
Prevention Service (CSPS) that enables callers anywhere in Canada
to access crisis support using the technology of their choice (phone,text or chat), in French or English.”– Text: 45645

COPING STRATEGIES AND DEVELOPING A SAFETY PLAN•

Coping strategies to remain calm webpage by the Anxiety andDepression Association of America.

•“Let’s get Physical”: 7 Tips to Calm Anxiety” webpage by Stacey
Freedenthal addresses the issues of attaining a “calm state” during
a crisis situation.

•

Coping with Suicidal Thoughts by Joti Samra & Dan Bilsker addresses
how to cope with thoughts of suicide and other means of keeping
yourself safe.

•

How to cope with thoughts of suicide by Kids Help Phone facilitates
the conversation around reaching out for help.

•

Things to consider when creating a safety plan by the National
Suicide Prevention Lifeline demonstrates how to create a safety plan.

•

How to make a suicide safety plan by SuicideLine, Victoria, Australia.

•

Suggested readings:– Phone: toll free 1-833-456-4566– Helping the suicidal person (2018 pp. 118-121) by Freedenthal.

– Chat: www.crisisservicescanada.ca– Safety planning initiative: A brief intervention (2012) by
Stanley & Brown.

MEMOIRS, CASE HISTORIES, AND PERSONAL STORIES•The Gospel according to Josh: A memoir by Josh Rivedal (2013) isa story of a young man’s struggles with suicidal behaviours and his
pursuit of recovery.

•

Cracked not broken (2014). Kevin Hines’ story of surviving a suicide
attempt after jumping off the Golden Gate Bridge and his inspiring
work in suicide prevention and advocacy in recovery.

•

Children of Jonah: Personal Stories by Survivors of Suicide Attempts(edited by James Clemons) (2001) offers insight into the stories ofpeople with lived experience and their strengths.

•

Wellness Recovery Action Plan (WRAP) Personal Workbook.
Note that the WRAP plan often necessitates a facilitated group.

PHONE APPLICATIONS•

15 Top Apps for Resilience, Mental Health Promotion & Suicide
Prevention by Dr. Sally Spencer Thomas.

•

Breathe to relax: “Breathe2Relax offers portable stress management
focused on diaphragmatic breathing skill-building that help withanger management, mood stabilization and anxiety reduction.”

Toolkit for people who have been impacted by a suicide attempt|8

TIPS ON ALLEVIATING STRESS WHEN GOING TO HOSPITAL/EMERGENCY•

MoodKit: “Based in Cognitive Behavioral Therapy, MoodKit helps
people improve their mood by engaging them in over 200 moodenhancement activities like thought-checking and journaling.”••

My3App: My3app is a safety plan tool that helps people who are athigh risk for suicide. It helps them develop a written list of coping
strategies and sources of support.

COPING AFTER LEAVING AN EMERGENCY ROOM VISIT•

Hello Cruel World is an application for iPhone and iPad offering
101 alternatives to suicide.

•

Suicide Safety Plan is an application that guides you through yourcustomised safety plan until you feel safe.

•

What it’s like going to the emergency room for suicidal thoughts(Ruriani, 2015). A blog about having thoughts of suicide in the ER.

After an attempt: A guide for taking care of yourself after yourtreatment in the emergency department (SAMHSA, 2009). Offers
coping strategies and advice for attempt survivors who have beendischarged from an ER or hospital.

SUGGESTED MESSAGES WHEN CONTACTING A SUICIDECRISIS LINE•

What to expect when contacting a crisis line by Crisis Support(Klinic Community Health, 2018).

•

Talking on a helpline:– “Hi. I am calling because I need some help. I’m going throughsome things that are tough and it sometimes feels like I can’t takeit anymore. It’s so bad there are times I think about suicide.”– “Hi. Things are really hard right now. I’m thinking aboutkilling myself.”•

Texting on a helpline:– “I need help. My life is bad right now and I’m thinking
about suicide.”– “I’ve been thinking about killing myself. Can you help me?”(Centre for Suicide Prevention, 2016).

•

Sample scripts by the Centre for Suicide Prevention.

Toolkit for people who have been impacted by a suicide attempt|

9

REFERENCES
Anxiety and Depression Association of America (2018).
Coping strategies. Retrieved from https://adaa.org/tips
Centre for Suicide Prevention (2016). Youth at risk. Retrieved fromhttps://www.suicideinfo.ca/resource/youthatrisk/
Freedenthal, S. (2018). Helping the suicidal person: Tips and techniques
for professionals. New York: Routledge.
Freedenthal, S. (2015). “Let’s get physical”: 7 tips to calm anxiety.
Retrieved from https://www.speakingofsuicide.com/2015/08/20/tipsto-calm-anxiety/
Gould, M., Munfakh, J., Kleinman, M., & Lake, A. (2012). National Suicide
Prevention Lifeline: Enhancing mental health care for suicidal individuals
and other people in crisis. Suicide and Life-Threatening Behavior,
42(1), 22-35.
Klinic Community Health (2018). Crisis support. Retrieved fromhttp://klinic.mb.ca/crisis-support/
Larsen, Nicholas & Christensen (2016). A systematic assessment ofsmartphone tools for suicide prevention. PLOS One, 11(4). Retrieved
from http://journals.plos.org/plosone/article/fle?id=10.1371/journal.
pone.0152285&type=printable
National Suicide Prevention Lifeline (2018). Things to consider whencreating a safety plan. Retrieved from https://create.piktochart.com/
output/3641390-how-to-create-a-safety-plan

Rivedal, J. (2013). The Gospel according to Josh: A memoir. Astoria, N.Y.:
Skookum Hill Publishing. 371 p.
Ruriani, A. (2015, November 23). What it’s like going to the emergency
room for suicidal thoughts. Retrieved from https://themighty.
com/2015/11/what-its-like-going-to-the-emergency-room-forsuicidal-thoughts/
Samra, J. & Bilser, D. (2007). Coping with suicidal thoughts. Consortiumof Mental Health. Retrieved from http://www.comh.ca/publications/
resources/pub_cwst/cwst.pdf
Spencer-Thomas, S. (2017). 15 Top Apps for resilience, mental
health promotion & suicide prevention. Retrieved from https://www.
sallyspencerthomas.com/dr-sally-speaks-blog/2017/10/8/15-top-appsfor-resilience-mental-health-promotion-suicide-prevention
Stanley, B. & Brown, G. (2012). Safety planning intervention: A brief
intervention to mitigate suicide risk. Cognitive and Behavioral Practice,19(2), 256-264.
Substance Abuse and Mental Health Services Administration (2009).
After an attempt: A guide for taking care of yourself after your treatmentin the emergency department. Retrieved from https://store.samhsa.gov/
shin/content//SMA08-4355/SMA08-4355.pdf
SuicideLine Victoria (2018). How to make a suicide safety plan.
Retrieved from https://www.suicideline.org.au/resource/makingsuicide-safety-plan/
Back to Table of Contents

Toolkit for people who have been impacted by a suicide attempt|10How to support a loved one who is having
thoughts of suicide

the distress centre to see what resources they might have that could

HOW TO TALK ABOUT SUICIDE IN AN HONEST, SAFE AND
AGE‑APPROPRIATE WAY

too. Want me to come with you?” (Centre for Suicide Prevention, 2016).

•

Supporting someone after a suicide attempt by SuicideLine Victoria
offers tips on some helpful and unhelpful things to say to someone
who has experienced a suicide attempt.

•

Suggestions of how to talk to and support someone can be foundon pages 16-18 of the After a suicide attempt: A handbook forfamily and friends by the Klinic Community Health and Canadian
Association for Suicide Prevention.

•

How to talk to a child about a suicide attempt in your familyby the Rocky Mountain Mental Illness Research, Education andClinical Centers (MIRECC). It breaks the conversations down for
pre-schoolers, school-age children and teenagers.

Sample script of how to talk to a friend (youth talking to another youth)
who may be having thoughts of suicide:“I’m sorry to hear you’re going through such a rough time, and I’m here

help. I’m so glad you told me how you’re feeling, I’ve been reallyworried about you! I feel like it’s a good idea to talk to your parents,•

Tips on how to talk to a family member or a friend on
Preventing Suicide by the Canadian Mental Health Association(CMHA) Toronto.

•

How to talk to a child about a suicide attempt in your family by
the Rocky Mountain Mental Illness Research, Education and ClinicalCenters (MIRECC) breaks the conversations down for pre-schoolers,
school-age children and teenagers.

RISK OF SUICIDALITY FOR FAMILY AND FRIENDS OF AN
ATTEMPT SURVIVOR OR DEATH BY SUICIDE
There is always a potential risk that vulnerable family members orfriends who have been exposed to a suicide attempt or a death bysuicide may develop or have thoughts of suicide themselves.
Suggested readings:•

Familial transmission of suicidal behavior (2008) by Brent Melhem.
This paper looks at the effects of exposure to suicidal behaviours
can have on family members.

•

The continuum of “survivorship”: Defnitional issues in the aftermathof suicide (2009) by Cerel et al. This paper looks at the impact that
suicide has on survivors.

for you. But we need to tell someone else how you’re feeling. I cancome with you to see the school counsellor if you want?” (Centre for
Suicide Prevention, 2016).
Sample script on how to text a friend (youth talking to another youth)
who may be having thoughts of suicide:“It sounds like things are really hard for you right now. I can’t imagine
what you’re going through, but I know things will get better! Let’s text

Toolkit for people who have been impacted by a suicide attempt|

11

REFERENCES
Brent & Melhem, N. (2008). Familial transmission of suicidal behavior.
Psychiatric Clinics of North America, 31(2), 157-177.
Canadian Mental Health Association, Toronto (2018). Preventing suicide.
Retrieved from https://toronto.cmha.ca/mental-health-2/fnd-help/
crisis-support/
Centre for Suicide Prevention (2016). Youth at risk. Retrieved fromhttps://www.suicideinfo.ca/resource/youthatrisk/
Cerel, J., McIntosh, J., Neimeyer, R., Maple, M. & Marshall, D. (2014).
The continuum of “survivorship”: Defnitional issues in the aftermathof suicide. Suicide and Life-Threatening Behavior, 44(6), 591-600.
Klinic Community Health & Canadian Association for Suicide Prevention(n.d.). After a suicide attempt: A handbook for family and friends.
Retrieved from: http://www.togethertolive.ca/sites/default/fles/
waterloo_after_a_suicide_attempt_for_family.pdf
Rocky Mountain Mental Illness Research, Education and Clinical Centers(2017). How to talk to a child about a suicide attempt in your family.
Retrieved from https://www.mirecc.va.gov/visn19/talk2kids/index.asp
Shneidman, E. (1973). On the nature of suicide. San Francisco:
Jossey-Bass.
SuicideLine Victoria (2018). Supporting someone after a suicide attempt.
Retrieved from https://www.suicideline.org.au/resource/supportingsomeone-after-suicide-attempt/
Back to Table of Contents

Toolkit for people who have been impacted by a suicide attempt|12Telling your story safely
Telling your story can be scary. Just like every story related to suicide is personal, the decision to tell your story is equally as personal,
and the way you decide to tell that story is up to you. Telling your story can bring great strength; however, be mindful that you tell yourstory safely, ensuring your safety and the safety of the person(s) learning from you. The following resources are suggestions that haveresonated with the people who flled out our online survey and additional resources from a literature review. This is not intended to be
an exhaustive list.
HOW TO FIND HOPEFUL MESSAGES FOR OTHERS WITHINYOUR EXPERIENCES

families and friends in the individual’s treatment and interventions.”“Telling your story is a huge decision so allow time to heal and only•

Supporting suicide attempt survivors (2009) by Suicide Prevention
Australia, is a position statement that advocates for work that
supports suicide attempt survivors.

•

The Way Forward: Pathways to hope, recovery, and wellness withinsights from lived experience (2014) is a resource devoted to
advocacy of suicide attempt survivors.

(Suicide Prevention Australia, 2009, pp. 11-13).

consider telling your story if you are ready and willing. Know that
there is a difference between healing yourself and helping others as
both of them are not mutually exclusive but are also hugely important.
Consider consultation with a mentor or peer before making the decisionto speak (Only tell your story if you want to—Make sure you are readyto tell your story; the length of time to heal varies greatly from person
to person—There is a difference between healing yourself and helping
others.” (American Association of Suicidology, 2012).
••

Special considerations for telling your story: Best practices bysuicide loss and suicide attempt survivors (2012) is a guide forattempt and loss survivors on telling their story by the American
Association of Suicidology.
Four keys to sharing suicide survival stories safely is an easy to read
infographic by the Canadian Association for Suicide Prevention.

The National Action Alliance for Suicide Prevention in The Way forward:
Pathways to hope, recovery, and wellness with insights from lived
experience urges attempt survivors to get more involved in suicide
prevention initiatives and advocacy. They need:•“to join crisis centers as members of boards of directors, leaders,and staff/volunteers•

to participate in oversight or advising behavioral healthsystems change•

to review communications campaigns or social marketing endeavors
aimed at consumer/individuals who are suicidal•

to act as spokespersons, advocates, or resources for legislative
hearings/testimony•

to be partners in the development of research/evaluation for suicide
prevention initiatives.”

ADVOCACY FOR ATTEMPT SURVIVORS“[People who have experienced suicide attempts] need to be able to live
stigma-free; the voices of suicide attempt survivors need to be included
in understandings of and interventions for suicide attempt survivors;
prevention strategies need to address the issue of those who do notseek help; with the suicide attempt survivor’s consent, the inclusion of(National Action Alliance for Suicide Prevention, 2014, p. 30).

Toolkit for people who have been impacted by a suicide attempt|

13

REFERENCES
American Association of Suicidology (2012). Special considerations fortelling your story: Best practices by suicide loss and suicide attempt
survivors. Retrieved from https://www.sprc.org/sites/default/fles/
migrate/library/Best%20Practices%20for%20Presentations%20by%20
Suicide%20Loss%20and%20Suicide%20Attempt%20Survivors%20-%20
FINAL%202012.1.pdf
Canadian Association for Suicide Prevention (n.d.). Four keys tosharing suicide survival stories safely. Retrieved from https://www.
mentalhealthcommission.ca/sites/default/fles/CASPinfographic_4KEYS_
fnal%2525202_0.pdf
National Action Alliance for Suicide Prevention: Suicide Attempt
Survivors Task Force (2014). The Way Forward: Pathways to hope,recovery, and wellness with insights from lived experience. Washington,
DC: Author.
Suicide Prevention Australia (2009). Position Statement– Supporting Suicide Attempt Survivors. Retrieved fromhttps://suicideprevention.ca/Im-a-Suicide-Attempt-Survivor?locale=en
Back to Table of Contents

Toolkit for people who have been impacted by a suicide attempt|14Hopeful messages
Knowing that you are not alone and being able to share hope can be incredibly healing. This section of the toolkit is intended to be asafe space to read and to share online messages of hope with other people. The following hopeful messages were gathered from theresponses of people with lived experience related to suicide who answered the online survey. There was a tremendous amount of hopethat fowed from these responses. Unfortunately, we were unable to incorporate everyone’s messages.

suicide or distressing thoughts, consider reaching out to your local

FOR PEOPLE WHO ARE SUPPORTING SOMEONE WHO HASATTEMPTED SUICIDE

distress centre.

When we released the survey, we asked people, “If you could giveIf you or someone you know is currently experiencing thoughts of

FOR PEOPLE WHO HAVE THOUGHTS OF SUICIDE

one message to other people who are supporting someone who has
attempted suicide, what would it be?” Here are a few of the messages

When we released the survey, we asked people, “If you could give one

we received:

message to other people who have suicidal thoughts or attempts, what•

“Be patient. Be hopeful. Be there.”

would it be?” Here are a few of the messages we received:••“It will get better! One step at a time, one minute at a time - you
got this.”“Always take the person seriously, listen and ask them what theyneed to be safe.”••“Honestly, it won’t always feel this bad and it WILL get better.
You are worth it, please keep going.”“Appreciate that it is not an attention seeking act. Their pain is real do not minimize their thoughts.”•“Ask them - what is the most helpful thing I can do for you?”•“If you are looking for a sign not to kill yourself, THIS IS IT.”•“Be non-judgemental. Be supportive. Be kind.”•“It is temporary. Do what you need to do to cope and get throughthis. Sleep if you must, cry if you must, just hold on for another day,hour, or minute.”•“Be strong. Look after yourself and never give up fghting for yourloved ones.”•“Please reach out for help, you are not alone and YOU MATTER.”•“Do not blame yourself for not seeing the signs.”•“Your illness does not defne you.”•“Get support and talk about it. Supporters need help too and the loveand comfort of knowing they are not living this alone.”•“Breathe.”•“Don’t forget to take care of yourself too.”•“Don’t ever lose hope! Recovery is possible!”•“Find one thing to wake up for every day whether it’s a pet, a child,spouse, parent, etc.”•“Find someone you trust who is supportive and reliable and put
them on speed dial!”•“HOPE (Hold On, Pain Ends).”

SHARE YOUR OWN MESSAGE OF HOPE!
Share your own message of hope today by using #sharehope on yoursocial media platform of choice and watch it go live here!
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Toolkit for people who have been impacted by a suicide attempt|

15About suicide
For some people, knowing the basic statistics and other important information about suicide can be very helpful. This section of thetoolkit helps remind people that suicide affects everyone, and that you are not alone. The following resources provide details aboutsuicide that both resonated with the people who flled out our online survey or came to our attention from a literature review.
This is not intended to be an exhaustive list.

Background and context

SAFE LANGUAGE AROUND SUICIDE
Traditional language around suicide has negative connotations and,

WHAT IS SUICIDE?

as a result, unintentionally perpetuates stigma. Some examples include

Suicide is defned as the act or instance of taking one’s own life

“committed suicide” (implying criminality), “successful suicide” orvoluntarily and intentionally.

“completed suicide” (implying being unsuccessful or incomplete before)or “failed suicide attempt” (implying a failure).

BASIC STATISTICS ON SUICIDE IN CANADA

More neutral, compassionate words should be used when talking

Canada tracks suicide by age, sex and geography. Unlike in theabout suicide. The following are a few recommendations to fnd more

United States, we do not record ethnicity or method of death.

information:•

Statistics Canada provides a breakdown by age and sex.

•

The power of words: the language of suicide by Bonny Ball (2005).

•

Health Canada’s infographic provides statistics on the current
context of suicide in Canada.

•

What’s in a word? The language around suicide by Alberta HealthServices (2005).

•

The Centre for Suicide Prevention has a resource that provides
suicide rates across provinces and territories.

•

Glossary of inappropriate or “unacceptable” terms by the Centers of
Disease Control and Prevention (2011).

•

Additional reading: The power of 41%: A glimpse into the life ofa statistic by Tanis (2016). The paper explores statistics aroundtransgender people and suicide and the impacts of these statistics
on transgender people.

•

Find specifc recommendations tailored for people with lived
experience related to a suicide attempt with The Way Forward:
Pathways to hope, recovery, and wellness with insights from lived
experience (2014) by the Suicide Attempt Survivors Task Force of
the National Action Alliance for Suicide Prevention.

Toolkit for people who have been impacted by a suicide attempt|

16

MYTHS AND FACTS ABOUT SUICIDEREFERENCES

Stigma is perpetuated by misinformation and myths about suicide.

Alberta Health Services (2005). What’s in a word: the language ofSome myths are more embedded in society than others and may

suicide. Alberta Mental Health Board. Retrieved from http://www.

be harmful for people who have been impacted by suicide. To help

portcares.on.ca/folder-resources-adult/Language%20of%20Suicide%20

distinguish myth from fact, here are some helpful resources:-%20Alberta%20Health%20Services.pdf•••

Preventing suicide: A global imperative: Myths by the World
Health Organisation (2014).

Ball, P. (2005). The Power of words. Retrieved from

Suicide prevention primer by the Centre for Suicide
Prevention (2013).

Centre for Suicide Prevention (2013). Suicide Prevention primer.

Myths about suicide by the Tennessee Suicide Prevention
Network (2016).

prevention-primer-facts-myths/

Helpful literature:•

Myths about Suicide (2011) by Thomas Joiner sharply debunks
myths such as “suicide is selfsh” to “if people want to dieby suicide, we cannot stop them” to “it’s just a cry for help”.
This exemplifes why he is considered one of the leading thinkers
in contemporary suicidology.

https://www.suicideinfo.ca/resource/suicideandlanguage/
Retrieved from https://www.suicideinfo.ca/resource/suicideCrosby, A., Ortega, L. & Melanson, C. (2011). Self-directed violence
surveillance: Uniform defnitions and recommended data elements.
Atlanta, GA.: Centers for Disease Control and Prevention. Retrieved
from https://www.cdc.gov/violenceprevention/pdf/Self-DirectedViolence-a.pdf
Centre for Suicide Prevention. (2018). Cross-Canada comparison
statistics. Retrieved from https://www.suicideinfo.ca/resource/crosscanada-comparison-statistics/
Goldney, R. (2008). Suicide prevention. New York. Oxford University
Press. 105 p.
Health Canada (2016). Suicide in Canada: An infographic. Retrieved fromhttp://healthycanadians.gc.ca/publications/healthy-living-vie-saine/suicide-canada-infographic/alt/infographic-infographique-eng.pdf
Joiner, T. (2010). Myths about suicide. Cambridge, MA.: Harvard
University Press.

Toolkit for people who have been impacted by a suicide attempt|17King, K. (1999). Fifteen prevalent myths concerning adolescent suicide.

Segal, D. (2000). Levels of knowledge about suicide facts and myths

Journal of School Health, 69(4), 159-161.

among younger and older adults. Clinical Gerontologist, 22(2), 71-80.

MacDonald, M. (2004). Teachers’ knowledge of facts and myths about

Silverman, Morton (2006). The Language of suicidology. Suicide andsuicide. Psychological Reports, 95(2), 651-656.

Life-threatening Behavior, 36(5), 519-532.

Marusic, A. (2004). Toward a new defnition of suicidality? Are we prone

Statistics Canada (2017). Suicides and suicide rate, by sex and by age

to Fregoli’s illusion? Crisis, 25(4), 145-146.

group (Both sexes rate). Retrieved from https://www.statcan.gc.ca/

National Action Alliance for Suicide Prevention: Suicide Attempttables-tableaux/sum-som/l01/cst01/hlth66d-eng.htm

Survivors Task Force (2014). The Way Forward: Pathways to hope,Sommer – Rottenburg, D. (1998). Suicide and language. Canadian Medical

recovery, and wellness with insights from lived experience. Washington,

Association Journal, 159(3), 239-240.

DC: Author. Retrieved from https://theactionalliance.org/resource/
way-forward-pathways-hope-recovery-and-wellness-insights-livedexperience
National Strategy for Suicide Prevention. Glossary of suicide prevention
terms. Retrieved from http://www.sprc.org/sites/default/fles/migrate/
library/glossary.pdf
O’Carroll, P. W., Berman, A. L., Maris, R. W., Moscicki, E. K., Tanney, B. L.,& Silverman, M. M. (1996). Beyond the Tower of Babel: A nomenclaturefor suicidology. Suicide and Life-Threatening Behavior, 26(3), 237–252.
Rettersol, N. (1993). Suicide - a European perspective. Cambridge:
Cambridge University Press.
Schurtz, D., Cerel, J. & Rodgers, P. (2010). Myths and facts aboutsuicide from individuals involved in suicide prevention. Suicide andLife-Threatening Behavior, 40(4), 346-352.

Tanis, J. (2016). The power of 41%: A glimpse into the life of a statistic.
American Journal of Orthopsychiatry, 86(4), 373-377.
Tennessee Suicide Prevention Network (2016). Myths about suicide.
Retrieved from http://tspn.org/myths-about-suicideWasserman, D. & Wasserman, C. (eds.). (2009). Oxford textbook ofsuicide and suicidology. New York. 872 p.
World Health Organization (1998). Primary prevention of mental,
neurological and psychological disorders. Geneva, Switzerland.
World Health Organization (2014). Preventing Suicide: A global
imperative: Myths. Geneva, Switzerland. Retrieved fromhttp://www.who.int/mental_health/suicide-prevention/myths.pdf
Back to Table of Contents

Toolkit for people who have been impacted by a suicide attempt|18Why do people attempt to die by suicide?

The social and economic determinants of suicide in Canadian provinces

Suicide is complex. Why some people die by suicide is puzzling anddeterminants and suicide, especially the determinants of unemployment

some academics spend their entire working lives trying to learn why.
“No single factor is suffcient to explain why a person died by suicide:suicidal behaviour is a complex phenomenon that is infuenced byseveral factors- personal, social, psychological, cultural, biological andenvironment.” (The World Health Organisation, 2014, p. 15)(Jalles & Andresen, 2015) found a distinct correlation between theseand gender.

RISK AND PROTECTIVE FACTORSThe Suicide Prevention Resource Center defnes these two groupings
simply and straightforwardly: “Risk factors are characteristics that•

Suicide: Statistics, warning signs and prevention

make it more likely that individuals will consider, attempt, or die by•

Why do people kill themselves: New warning signs

suicide. Protective factors are characteristics that make it less likely that

SOCIAL DETERMINANTS OF HEALTH•

According to Mikkonnen and Raphael in their infuential publication,
Social determinants of health: The Canadian Facts (2010), there are
14 determinants which have a greater bearing on an individual’s
health than all other factors. They include:– Aboriginal status– Disability– Early life

individuals will consider, attempt, or die by suicide.” (Suicide Prevention
Resource Center, 2011). Please note that despite protective factors, thisdoes not mean that a person will not move on to attempt suicide.
•

Understanding risk and protective factors: A primer for preventing
suicide (Suicide Prevention Resource Center)•

Suicide prevention and assessment handbook (Centre for Addiction
and Mental Health, 2015, pp. 6-8)•

Risk and protective factors for suicide and suicidal behaviour:
A literature review– Education– Employment and working conditions

WARNING SIGNS– Food insecurity“One of the key distinctions between a warning sign and a risk factor is– Health services

time. Risk factors are typically static, longstanding and speak to suicide– Genderrisk in the long term. In contrast, warning signs usually are dynamic,– Housingtemporary, and indicate acute escalation of suicide risk now or in the– Income and income distribution

very near future.” (Freedenthal, 2018, p. 69).

– Race•– Social exclusion

IS PATH WARM - The American Association of Suicidology (2018):
Educational tool to present the concept of warning signs.

– Social safety net– Unemployment and job security

Toolkit for people who have been impacted by a suicide attempt|19THE ROLE OF TRAUMA AND CHILDHOOD EXPERIENCESREFERENCES

What is Trauma:

American Psychiatric Association (2013). Diagnostic and statistical“Trauma results from an event, series of events, or set of circumstances

manual of mental disorders (5th ed.). Washington, DC: Author.

that is experienced by an individual as physically or emotionallyharmful or threatening and that has lasting adverse effects on theindividual’s functioning and physical, social, emotional, or spiritualwell-being.” (The Substance Abuse and Mental Health Services
Administration, 2012, p. 2).
Unresolved trauma in childhood and adolescence is linked to anincreased risk of suicide ideation and if unaddressed, can escalate
with age — potentially leading to suicide attempts or death by suicide.
Early intervention post-trauma is crucial. (Herba, et al., 2007; Dube,et al., 2001).

American Association of Suicidology (2018). Know the warning signsof suicide. Retrieved from http://www.suicidology.org/resources/
warning-signs
Baumeister, R. (1990). Suicide as escape from self. Psychological Review,
97(1), 90-113.
Botskwick, J., Pabbatti, C., et al. (2016). Suicide attempt as a risk factor
for completed suicide: Even more lethal than we knew. The American
Journal of Psychiatry, 173(11), 1094-1100.
Centre for Addiction and Mental Health (2012). Trauma. Retrieved fromhttps://www.camh.ca/en/health-info/mental-illness-and-addictionindex/trauma
Centre for Addiction and Mental Health (2015). CAMH suicide prevention
and assessment handbook. Retrieved from http://otgateway.com/
articles/sp_handbook_fnal_feb_2011.pdf
Dube, S., Anda, R., Felitti, V., Chapman, D., Williamson, D., & Giles,
W. (2001). Childhood abuse, household dysfunction, and the riskof attempted suicide throughout the life span: Findings from theadverse childhood experiences study. Journal of the American Medical
Association, 286(24), 3089-3096.
Enns, M., Cox, B., Afti, B., De Graaf, R., Ten Have, M. & Sareen, J. (2006).
Childhood adversities and risk for suicidal ideation and attempts:
A longitudinal population-based study. Psychological Medicine, 36(12),1769-1778.
Freedenthal, S. (2018). Helping the suicidal person: Tips and techniques
for professionals. New York: Routledge.

Toolkit for people who have been impacted by a suicide attempt|20

Greenwald, R. (2007). EMDR: Within a phase model of trauma-informed

Rudd, M., Joiner, T., Nock, M., Silverman, M., Mandrusiak, M., et al.

treatment. New York: Routledge.

(2006). Warning signs for suicide: Theory, research, and clinical

Herba, C., Ferdinand, R., van der Ende, J., & Verhulst, F. (2007).

applications. Suicide and Life-Threatening Behavior, 36(3), 255-262.

Long-term associations of childhood suicide ideation. Journal ofRudd, M. (2008). Suicide warning signs in clinical practice.

the American Academy of Child and Adolescent Psychiatry, 46(11),Current Psychiatry Reports, 10, 87-90.

1473-1481.

Russell, D., Turner, R. & Joiner, T. (2009). Physical disability and suicidal

Jalles, J. & Andresen, M. (2015). The social and economic determinants

ideation: A Community-based study of risk/protective factors forof suicide in Canadian provinces. Health and Economic Review, 5(1). DOI:

suicidal thoughts. Suicide and Life-Threatening Behavior, 39(4), 440-451.

10.1186/s13561-015-0041-y

Selby, E., Joiner, T. and Ribeiro, J. (2014). Comprehensive theories ofJoiner, T. (2005). Why people die by suicide. Cambridge, MA.: Harvard

suicidal behaviors. In Nock (Ed.), The Oxford Handbook of Suicide andUniversity Press.

Self-injury (286-305). New York: Oxford University Press.

Kashdan, T. (2014). Why do people kill themselves: New warning signs.

Shneidman. E. (1993). Suicide as psychache: A clinical approach to

Psychology Today. Retrieved from https://www.psychologytoday.

self-destructive behavior. Northvale, NJ.: Jason Aronson, Inc.

com/blog/curious/201405/why-do-people-kill-themselves-newwarning-signs

Substance Abuse and Mental Health Services Administration (2012).
Trauma and Justice Strategic Initiative. SAMHSA’s working defnition

McLean, J., Maxwell, M., Platt, S., Harris, F. & Jepson, R. (2008). Risk andof trauma and guidance for trauma-informed approach. Rockville, MD:protective factors for suicide and suicidal behaviour: A literature review.

Substance Abuse and Mental Health Services Administration.

Edinburgh, Scotland: Scottish Government Social Research.

Suicide Prevention Resource Center (n.d.). Understanding risk andMikkonen, J. & Rapheal, D. (2010). Social determinants of health:protective factors for suicide: A primer for preventing suicide risk.

The Canadian Facts. Retrieved from http://thecanadianfacts.org/the_

Newton, MA: Education Development Center, Inc. Retrieved

canadian_facts.pdf

from https://www.sprc.org/sites/default/fles/migrate/library/

Pappas, S. (2017). Suicide: Statistics, warning signs and prevention.

RiskProtectiveFactorsPrimer.pdf

Retrieved from https://www.livescience.com/44615-suicide-help.html

World Health Organization (2014). Preventing suicide:

Phillips, J. & Nugent, C. (2014). Suicide and the Great Recession of 2007-

A global imperative. Retrieved from http://apps.who.int/iris/

2009: The role of economic actors in the 50 U.S. states. Social Science

bitstream/10665/131056/8/9789241564878_eng.pdf?ua=1&ua=1

and Medicine, 116, 22-31.
Public Health Agency of Canada (2008). Canadian incidence study of

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reported child abuse and neglect. Retrieved from http://cwrp.ca/sites/
default/fles/publications/en/CIS-2008-rprt-eng.pdf

Toolkit for people who have been impacted by a suicide attempt|21Additional resources
For some people, immersing themselves in training and additional readings can be very healing. This section of the toolkit provides
some additional tools and resources to help people gain the knowledge and courage needed to have conversations about suicide.

Training and other suicide prevention programs••

Applied Suicide Intervention Skills Training (ASIST): “Applied Suicide
Intervention Skills Training (ASIST) is a two-day interactive workshop
in suicide frst aid. ASIST teaches participants to recognize whensomeone may have thoughts of suicide and work with them to createa plan that will support their immediate safety. Although ASIST is
widely used by healthcare providers, participants don’t need any
formal training to attend the workshop—anyone 16 or older can learn
and use the ASIST model.”SafeTALK is a half-day alertness training course that prepares
anyone 15 or older, regardless of prior experience or training, tobecome a suicide-alert helper. Most people with thoughts of suicide
don’t truly want to die, but are struggling with the pain in theirlives. Through their words and actions, they invite help to stay alive.
SafeTALK-trained helpers can recognize these invitations and takeaction by connecting them with life-saving intervention resources,
such as caregivers trained in ASIST.

•

Mental Health First Aid is the help provided to a person developinga mental health problem, experiencing the worsening of an existing
mental health problem or in a mental health crisis. The Basic Mental
Health First Aid course has been adapted for Adults Who Interact
with Youth, First Nations, Inuit, Northern Peoples, Seniors and theVeteran Community.

•

Suicide to Hope “Suicide to Hope is a one-day workshop designed forclinicians and caregivers working with those recently at risk of andcurrently safe from suicide. It provides tools to help these caregivers
and persons with experiences of suicide work together to developachievable and signifcant recovery and growth goals.”•

Straight Talk: Preventing Suicide in Youth: “Straight Talk is aninteractive half-day workshop created for individuals working withyouth aged 12 to 18. Straight Talk encompasses the developmental,
cognitive, and emotional differences found within this age group inpresenting strategies to strengthen the protective factors of youth atrisk of suicide. Relevant intervention strategies are explored throughvideos and case studies.”•

Question Persuade and Refer (QPR): “We can all save lives. The QPR
mission is to reduce suicidal behaviors and save lives by providing
innovative, practical and proven suicide prevention training. The
signs of crisis are all around us. We believe that quality education
empowers all people, regardless of their background, to make apositive difference in the life of someone they know.”

Toolkit for people who have been impacted by a suicide attempt|22Books, directories, editorials andacademic studies

ACADEMIC STUDIES•

Bergmans, Y., Gordon, E. & Eynan, R. (2017). Surviving moment tomoment: The experience of living in a state of ambivalence for thosewith recurrent suicide attempts. Psychology and Psychotherapy:
Theory, Research and Practice, 90(4), 633-648.

•

Frey, L., Hans, J., & Cerel, J. (2016). Suicide disclosure in suicide
attempt survivors: Does family reaction moderate or mediate
disclosure’s effect on depression? Suicide and Life-Threating Behavior,
46(1), 96-105.

•

Hadland, S., Wood, E., Marshall, B., Kerr, T., Montaner, J. & Debeck, K.
(2015). Suicide attempts and childhood maltreatment among street
youth: A prospective cohort study. Pediatrics, 136(3), 1-10.

•

Klonsky, E., May, A. & Saffer, B. (2016). Suicide, suicide attempts, andsuicidal ideation. Annual Review of Clinical Psychology, 12(14).

•Lester, D. & Walker, R. (2006). The stigma for attempting suicide andthe loss to suicide prevention efforts. Crisis, 27(3), 147-148.

•

Sheehan, L., Corrigan, P., Al-Khouja, M. & Stigma of suicide researchteam (2016). Stakeholder perspectives on the stigma of suicide
attempt survivors. Crisis, 38(2), 73-81.

•

Shepard, D., Gurewich, D., et al. (2016). Suicide and suicidal attempts
in the United States: Costs and policy implications. Suicide andLife-Threatening Behavior, 46(3), 352-362.

BOOKS
•

Michel, K. & Gysin-Maillart, A. (2015). ASSIP Attempted Suicide
Short Intervention Program: A manual for clinicians. Boston, MA.:
Hogrefe Publishing.

•

Heckler, R. (2014). Waking Up, Alive: The Descent, The Suicide
Attempt... and the Return to Life. New York: Ballantine Books. 303.

DIRECTORIES•A directory of links pertinent for suicide attempt survivors:
International Association for Suicide Prevention (IASP) - Resources:
Suicide Attempt Survivors.

•

Directory of attempt survivor resources: American Association of
Suicidology. (2018). Suicide Attempt Survivors.

EDITORIALS•

Centre for Suicide Prevention. (2016). Suicide attempt survivors andthe value of lived experience.

•

Overcoming the shame of a suicide attempt. New York Times.
D4 (2016, May 30) Brickhouse, J.

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Toolkit for people who have been impacted by a suicide attempt|23

Mental Health Commission of Canada
Suite 1210, 350 Albert Street
Ottawa, ON K1R 1A4
Tel: 613.683.3755
Fax: 613.798.2989
mhccinfo@mentalhealthcommission.ca
www.mentalhealthcommission.ca/ theMHCC/1MHCC@MHCC_@theMHCC/Mental Health Commission of Canada