Twenty-one Missouri National Guardsmen participated in Applied Suicide Intervention Skills Training at the Missouri Baptist Convention Center in Jefferson City recently.
ASIST is a two-day course designed to help recognize and intervene to prevent the immediate risk of suicide. It provides an opportunity for service members to explore their experiences and attitudes about suicide, to have a better understanding of the needs of a person at risk of suicide and how to use suicide first-aid to meet those needs.
"The focus during this course is to learn to be a caregiver when someone is already thinking about suicide," said 1st Lt. Joe Pence, a chaplain candidate and ASIST instructor.
During the training, Guardsmen broke up into small groups to discuss their attitudes about suicide and to understand the concerns of people at risk. They also learned about the suicide-intervention model.
The suicide-intervention model has three phases: understanding, assisting and connecting. Within these categories, caregivers try to ask and identify six concerns.
"It's important to ask if someone is thinking about suicide," said Capt. Robin Markham, an ASIST instructor and the suicide-prevention program manager for the Missouri National Guard. "That's one of the six risk concerns we teach caregivers to address. The other five concerns are: exploring invitations, listing reasons, reviewing risks, contracting a safe plan and follow-up on commitments."
Actions, thoughts and feelings could be an invitation that can identify an at-risk individual. Sometimes people who are thinking about suicide will give away possessions; think they can't do anything right; and feel desperate, angry, sad or hopeless.
Reasons for causing self-harm might include events, the meaning the events have to a person at risk and their reactions to those events. Reasons for living may include both internal and external things. Internally, they might be feelings, hopes, beliefs, values, attitudes or skills that help a person stay alive. Externally, they might be resource people who the person at risk feels are helping, caring and supportive organizations to which the person belongs. Economic assets, recreational activities and hobbies can also be resources. Family, friends, pets and organizations that a person cares about and wants to support can be important resources as well.
In reviewing a person's risk, a caregiver should find out if there is a current suicide plan, if the person experiences pain they feel is unbearable, if they feel they have any resources, previous suicidal behavior, and if they have ever received mental health care. From there, a caregiver can develop a safe plan.
A safe plan strives to keep an at-risk individual safe. It should list safety contacts, like a chaplain, and links to resources.
"Going through this training, I felt like ASIST is the next level of urgent care beyond the Army's Ask, Care and Escort suicide prevention training," said Master Sgt. Tim Riley. "It's improved awareness training. It helps break through the discomfort of addressing suicide or self-harm with someone who might be at risk."
When caregivers explore invitations and ask about suicide, they meet the at-risk person's need for recognition and permission. The person at risk feels valued and relieved, and they are more likely to answer honestly about thoughts of suicide and talk openly about suicide.
"One of the big things we learned is how to take an at-risk person and get them to reach ambivalence," Riley said.
Ambivalence involves simultaneous and contradictory attitudes or feelings. In ASIST, ambivalence involves both life and death feelings. Caregivers can use ambivalence to show that they understand the person at risk. They can help the individual by listening to the reasons for dying while reinforcing reasons to live.
The Missouri National Guard actively focuses on suicide awareness and prevention.
"This training is beneficial because it trains our soldiers on how to recognize when and how an intervention can unfold in response to the needs of a person at risk," said Markham. "Soldiers shouldn't be afraid to ask how their buddies are doing just because they don't know how to respond to a suicidal soldier."
The Missouri National Guard hopes to hold ASIST workshops quarterly throughout the calendar year.
"I hope that people who receive this training will be ready and willing to reach out to their fellow buddies and share with them what they have learned from this training," said Markham.
For more information on the Applied Suicide Intervention Skills Training, contact Markham at 638-9602 or [email protected].