Editor's note: This story appears in the February edition of LO Monthly.
This story discusses self-harm. If you or people you know are at risk of self-harm, the National Suicide Prevention Lifeline provides 24-hour support at 988."
Question, Persuade, Refer.
These are the three intervention steps in the QPR suicide prevention training.
An intrinsic part of the Lake Oswego School District’s suicide prevention education for all staff, QPR training is also available to Lake Oswego community members and caregivers who wish to learn more about suicide prevention and intervention.
“Mental health is just as important as physical health. As a matter of fact, I firmly believe that if our mental health isn’t OK, we can’t learn; we can’t function,” said Kirsten Guelsdorf, elementary school social worker for the Lake Oswego School District.
The district’s mental health resiliency education programming, LOSD Cares, hosted two QPR sessions in the fall and added another session in January because of a growing waitlist. QPR is just one component of the district’s mental health education work, alongside partnerships with Clackamas County Behavioral Health and the National Alliance on Mental Health Clackamas.
“Kids are out in the community, whether at school, where they spend a majority of their time, or on a sports team. A lot of times it is those teachers, parents, friends of parents or staff that are like, ‘Hey, something’s going on,’” said Guelsdorf.
Starting with a questionThe QPR Institute was founded in 1999 in Washington to spread QPR training as an emergency mental health intervention, much like CPR is an emergency medical intervention. Both are geared toward “gatekeepers,” or individuals situated to recognize a crisis. By giving as many community members as possible the tools and strength to intervene, awareness for suicide intervention and prevention grows.
QPR training aims to fill that need by building a network inside a community that isn’t afraid to ask the question: “Are you thinking about suicide?”
“I think all of the parts are incredibly important, but you can’t get to the ‘persuade’ or ‘respond’ (aspects) without the question. Being very direct with it and recognizing how hard of a question it is and that, anytime you have to ask it, you are going to feel anxious — but we can’t get to where we need to get unless that question is asked,” said Guelsdorf. “QPR is great because it goes over all the myths of suicide. I think I grew up thinking, ‘Well, if you ask somebody if they want to kill themselves that means that you’ve given them the idea.’ That is absolutely not true. What it does is it makes a person pause to get mental health support.”
By unpacking myths surrounding suicide, educating more of the community about mental health resources and preparing those who interact with students daily, QPR training builds an interconnected web of support.
“The more people we have who are comfortable asking that question, the more lives we can save without a doubt,” said Guelsdorf.
However, the question is only the first step of QPR. Finding the “seeds of hope” in someone’s lived experience drives the second step, “persuade.” The final step is “refer,” which puts continued intervention in the hands of a mental health professional.
LOSD Cares provides resources to mental health professionals in Clackamas County and beyond, but the district’s mental health and social work team also offers intervention, prevention and “post-vention” for students.
‘I’m not alone’
The need for further education and wellness promotion comes at a time when many students are struggling with greater mental health challenges. According to Mental Health America, Oregon ranked 49th in the United States in terms of access to mental health services for adults and children.
Promoting mental health development and sharing strategies for coping with these challenges are key responsibilities for the district’s student services team. The district social workers work with counselors and educators to foster community and a sense of belonging.
“I think the schools really try to build a feeling of community and safety-ness. I think we often think that we have to have a magic bullet, but I think sometimes there are just fun activities that kids can do and be a part of,” said Guelsdorf. “We can think that a building has a strong community to it and then when you ask the kids you realize, ‘Oh, I guess not.’ So the kids are the biggest voice and the ones that I think need to be listened to the most.”
QPR training sessions are relatively small, with a maximum of 32 participants. For the fidelity of the program and the privacy of session participants, all QPR training sessions are confidential; there’s no recording or sharing of what was discussed during the training.
“I was really impressed, afterward, by how supportive the parents who were there were. I think it often surprises me how much people are willing to share with people they don’t know. It was like the community that was there in that classroom just wrapped their arms around each other. It brought up more sharing and it created such a vulnerable but safe environment,” added Guelsdorf. “It makes people feel like, ‘I’m not alone.’ I think that’s another really important thing in QPR because I think people tend to feel, with mental health and then with suicide, so isolated.
Like learning the steps of CPR, participants should feel like they have the tools to save a life after attending a QPR training session. That doesn’t make mental health intervention easy, but it does mean there’s one more group of people who understand how important simply asking the question really is.
“It just takes one person, and it doesn’t have to be somebody that that individual knows,” said Guelsdorf. “One person to ask, ‘Are you OK?’”
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