December 18, 2025 • 22 mins
Not every crisis looks like a breakdown. Learn how to spot subtle signs someone’s struggling, and how to respond without overreacting or brushing it off.
You’re sitting in the car after a long shift when a coworker quietly says, “I don’t know how much longer I can do this. Sometimes I wonder if everyone would be better off without me.”
Your heart drops. Are they just venting… or are they really thinking about ending their life?
This is one of the most critical moments you’ll face as a peer supporter or as a trusted coworker. You don’t want to overreact, but you also can’t ignore what you just heard.
In this episode, we’ll break down exactly what to do when a peer mentions suicide, so you’re not stuck guessing or hoping you say the right thing.
BY THE TIME YOU FINISH LISTENING, YOU’LL LEARN:
- The most important warning signs and risk factors for suicide in high-stress professions
- How to ask directly about suicide using clear, honest language (without making things worse)
- How to persuade a peer to stay safe and accept help when they feel like giving up
- Practical referral options and how to make a “warm handoff” so they’re not left alone in the process
You don’t have to be a clinician to save a life. You just need to notice, ask the hard question, and care enough to stay with them while you connect them to help.
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OTHER LINKS MENTIONED IN THIS EPISODE:
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https://stresscaredoc.com/consultation
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LinkedIn: linkedin.com/in/bartleger
Facebook Page: facebook.com/survivingyourshift
Website: www.survivingyourshift.com
Want to find out how I can help you build a peer support program in your organization or provide training? Schedule a no-obligation call or Zoom meeting with me here.
Mentioned in this episode:
Houston Area CISM GRIN Training
This 3-day course, hosted by the Atascocita Fire Department, will teach you how to support your peers through effective communication, emotional resilience, and understanding the psychological impact of crises. Register for this training. https://stresscaredoc.com/atascocita-grin Dates: January 6-8, 2026 Times: 8:30 AM - 5:00 PM each day Location: Atascocita Fire Admin Building
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Track 1 (00:01):
You're sitting in the break room after a rough shift
and just you and a co-workerwho's been quieter than usual.
You're both staring at the wall,just chilling out when they say
almost under their breath (00:11):
"I don't know how much longer I can
do this. Sometimes I wonder ifeverybody would be better off
without me." And then, yourstomach drops. You think: "Are
they just venting? Or are theyreally thinking about ending
their life?" You don't want tooverreact and you don't want to
say the wrong thing, but youalso don't want to walk away and
(00:32):
find out later this was youronly chance to step in. In
today's episode, we're going totalk about what to do in that
exact moment, when a peermentions suicide or... just
hints at it. It raises a redflag and it's enough that you
start to wonder. We're going towalk through how to recognize
the warning signs and the riskfactors, how to ask directly
(00:56):
about suicide without makingthings worse, and how to
persuade them to receive help.What we'll be doing is using the
QPR model
that stands for Question,Persuade and Refer. If you're a
peer supporter, a supervisor orjust the person everyone seems
to come to when things are ausual way. This episode's for
(01:17):
you.
Track 2 (01:20):
Welcome to Surviving Your Shift, your go-to resource
for building strong, peersupport teams in high-stress
professions. I'm your host, BartLeger, board-certified in
traumatic stress with over 25years of experience supporting
and training professionals infrontline and emergency roles.
Whether you're looking to starta peer support team, learn new
(01:42):
skills, or bring training toyour organization, this show
will equip you with practicaltools to save lives and careers.
Track 1 (01:52):
Let's talk about the moment when someone you work
with crosses the line from justventing into something that
sounds a whole lot more serious.If you work in a high-stress
profession long enough, you'lleventually run into a coworker
who's suicidal or at leastthinking about it. You might
hear it in a dark joke, ordarker than usual. You might see
(02:15):
it in a change in their behavior,or you might just hear it
straight out. "I'm thinkingabout cashing it in" or "I'm
thinking about ending my life."In that moment, you don't have
to be a therapist, and let metake the pressure off, you don't
have to fix everything. But youdo need to know how to respond.
That's where the QPR suicidegatekeeper model comes in. QPR
(02:40):
stands for Question, Persuadeand Refer. What it is, is a
simple, practical framework thatequips everyday people to
recognize the warning signs of asuicidal crisis, ask the
question directly, and thenconnect that person to help.
We're going to use QPR as ourbackbone today, and then just
(03:03):
flesh it out as we go. We'llstart with what usually leads up
to that critical moment.
So this is part one: Recognizing the Warning Signs:
Risks and Factors. Suicidealmost never comes out of the
blue. There are usually somewarning signs and some risk
factors that show up ahead oftime. As peer supporters and
(03:24):
co-workers, our job is to noticewhen something feels off, and to
take it seriously. We'll startoff with the behavioral signs.
These are changes in what they do. Pulling away from
the crew, sitting alone insteadof with the group. It could be
they're calling in sick more, orshowing up late. Or they just
(03:45):
seem like they're checked out.Maybe they're giving away
personal items, talking likethey're wrapping things up.
Maybe they're taking more riskson calls or on the road. There
could be more drinking or druguse, using substances to numb
themselves. Maybe they'retalking a lot about death or
(04:06):
dying. Or it could be as simpleas just wishing they didn't wake
up. In our kind of work, I knowdark humor is normal, but you
know your people. When somethingshifts from the usual jokes to
something heavier and morepersonal, I want you to trust
your gut.
Secondly, there's emotional and verbal signs. I
(04:26):
want you to listen forstatements like, "I'm done. I
can't do this anymore. Everyonewould be better off without me.
I just want it all to stop." Or,"What's the point? Nobody would
even miss me." Sometimes they'lladd, "I'm just kidding. Don't
worry, I'm not really going todo it." But, I want you to know,
it still matters. Any talk aboutwanting to die or not wanting to
(04:49):
be here anymore is a bigflashing warning light.
And then there's situational or work-related risk
factors. These are thesituations that increase the
suicidal risk, especially inhigh-stress professions. It
could be a recent criticalincident. It could be a child
death, a mass casualty, anofficer-involved shooting, a
(05:12):
gruesome scene, or maybe apatient they can't stop thinking
about. It could be cumulativestress-not the one big call or
the one big thing in their life,but maybe months or years of
constant exposure to trauma orpressure. It could come after
disciplinary issues-maybethere's an IA investigation or
(05:35):
complaints, potentially a jobloss or loss of certification or
license. There could also be asignificant loss in their life,
a divorce or breakup, custodybattles, death of a loved one,
or a financial crisis. It couldbe chronic pain or medical
issues, especially if itthreatens their career or their
(05:57):
identity. When more than one ofthese starts stacking up and
then you hear suicidal comments,that's when your peer support
radar should be on high alert.
Then we have access to means. We often have easy access
to lethal means. Most of us havefirearms or medications or other
(06:17):
tools or environments where asuicide attempt could be carried
out quickly. You don't have tointerrogate them about this
right away, but knowing thataccess is part of the picture
helps you understand the levelof risk. The bottom line in this
first stage is, if your guttells you that something's off,
please don't ignore it. It'sbetter to ask and be wrong than
(06:39):
to stay silent and wish you'dspoken up.
So here's part two: asking the question about
suicide. This is the part thatmost people are scared of.
They're afraid if they say theword "suicide" it will put the
ID in the person's head. Let metell you: It will not. You won't
cause someone to become suicidalby asking if they're thinking
(07:02):
about suicide. If they're notsuicidal, they'll usually say so
and now they know you're a safeperson to talk to. they were
living with. If they aresuicidal, asking the question
can come as a relief. Becausesomeone finally sees how much
(07:25):
they're struggling. We shouldask the question clearly and
directly. Don't beat around thebush. Because many avoid the
question. We avoid asking (07:33):
Are you thinking about killing
yourself? Because, I mean, itreally does feel too direct and
probably the main reason manypeople are afraid to ask.
Because we're afraid of theanswer. We don't know what to do
if they say yes. We don't wantto make them angry or lose their
trust. But if we dance around it,we risk missing what's really
(07:56):
going on. So, how do you ask thequestion? Depending upon your
relationship or your style orhow they've been talking, it
might sound like you've beenthrough a lot lately and you
just said you're done. I need toask you straight: Are you
thinking about killing yourself?Or when you say they'd be better
(08:17):
off without you... Do you meanyou're thinking about suicide?
Or, "I care about you. I'm nothere to judge." Are you thinking
about ending your life? Notice afew things. You're calm and
you're direct. And when you'regeneral... You use clear words
like killing yourself, endingyour life, suicide. You're not
accusing. What you're doingis... You're checking in because
(08:38):
you care. Even if it feelsuncomfortable, we stick with the
direct language about dying orsuicide. We don't soften it into
hurting yourself. I've heardmany people ask, "Are you
considering hurting yourself?"Or... Are you thinking of doing
something crazy? Well, in theirmind, they're not looking to
hurt themselves and they don'tsee it as being crazy. You might
(09:03):
give yourself a short lead in tohelp you say it. So, this may
sound blunt, but it's importantthat I ask. Or... I'd rather be
a little awkward than staysilent. So, let me ask you
directly. And then follow itwith... Are you thinking about
killing yourself? Have you beenthinking about suicide? Or...
(09:24):
Are you thinking about endingyour life? You're not trying to
be dramatic. You're trying to beclear. Because vague questions
are easy to dodge. Clearquestions? Open the door. If
they say no, but you still thinkthey're having thoughts of
suicide, what you can do is, youcan come back around and ask the
(09:45):
question indirectly. often havethoughts of suicide.
This lets them know they're notthe only ones struggling with
something and considering apermanent way out.
Track 1 (10:02):
So, you should choose what to do when they say yes.
Let's say you ask the questionand they say, "Yeah, I've
thought about it. Honestly, morethan I want to admit." Or maybe,
"I don't have a plan, but yeah,the thought crosses my mind a
lot." Well, first of all, what Iwant you to do is I want you to
(10:23):
take a breath. You did the hardpart. You opened the
conversation. Now, what I wantyou to do is slow things down
and stay present. This is notthe time to panic, lecture, or
jump into fix-it mode. What youmight say is something like,
"Thank you for being honest withI'm really glad you told me
(10:45):
that." Or, "That has to feelreally heavy to carry all by
yourself." What your goal isright now is to keep them
talking. Help them feel heardand not judged, and then gather
enough information to understandthe level of risk. Then secondly,
get a sense of how serious it is.You're not doing a full clinical
(11:07):
assessment, but you can gentlyexplore, "Have you thought about
how you would do it?" Or, "Doyou have access to what you'd
use to kill yourself?" "Have youever tried to end your life
before?" Maybe, "Are youthinking about doing something
today?" Or, "Are these moreongoing thoughts?" In general,
the more specific the plan, themore immediate the time frame
(11:29):
and the easier access to lethalmeans, it means the higher the
risk. If they say, "I've thoughtabout using my duty weapon, and
I've been thinking a lot aboutit lately," you treat that as
very serious. If they say, "No,I don't have a plan. I just feel
like I wouldn't mind if I didn'twake up." That's still serious,
(11:51):
but you have a little more roomto work with in the moment.
Either way, any yes to suicidalthinking is a signal to move to
the next step.
And that's where the "P" comes in. You're trying to
persuade them to stay and gethelp. Now, we're not talking
about coercion here. You're nottalking about talking them out
of their feelings. You're tryingto persuade them to stay alive
(12:12):
for now, to accept help andsupport, and to let you connect
them through resources. Thefirst thing you will do is
communicate that you care andoffer them hope. This is where
your relationship matters. Youmight say, "I'm really glad you
told me. You matter to this teammore than you know." "I don't
(12:33):
want you going through thisalone." Or, "People in our line
of work feel this way more oftenthan you think. You're not the
only one, and there is help." Or,"What can we do right now to
keep you alive?" I want you totry to avoid things like, "You
shouldn't feel that way." Or,"You've got so much to live
for." Or, "Think of your kids.How could you do that to them?"
(12:56):
Those may be well-intentioned,but they can add to guilt and
they can shut the person down.Then, you can ask for a
short-term commitment. Someexamples might be, "Would you be
willing to let me walk with youthrough this, at least for today,
and not act on those thoughtswhile we get you some help?" Or,
"Can you agree with me that youwon't try to kill yourself
(13:18):
before we talk to someone whocan help?" Like a chaplain or
maybe a counselor whounderstands us. Could "Will you
let me help you find someone whocan support you through this and
stay alive while we do that?" Ifyou're not asking for them to
promise they'll never feel thatway again. You're asking them to
let you bridge the gap to thenext level of support. And if
(13:38):
they agree, that really is a bigstep. If they say, "I don't
know," or, "What's the point?"You keep listening. Reflecting
back their pain and gentlyreturning to, "I hear how bad it
feels." And I still want you toget help instead of going
through this alone.
Then the next step is, "R," refer to help. This is the
(14:01):
third part of QPR. This is wheremany peer supporters get stuck.
They think, "Okay, I asked and Ilistened. Now what?" Remember,
you're not the endpoint. You'rethe bridge. The right referral
depends on their level of risk,what resources your agency has,
and what the person is willingto accept in the moment. The
(14:22):
referral options might includepeer support team leader or
coordinator. It could be achaplain who understands the
culture or, better yet, aculturally competent therapist
or psychologist. It could beyour employee assistance program
with someone who gets firstresponders or medical work or
whatever line of work thatyou're in. Or it could be the
(14:44):
local crisis line or nationallifeline. Emergency department
or urgent psychiatric evaluation,if the risk is high. It could be
a supervisor or command staffwhen agency policy requires it
for safety. In the United States,you can always say something
like, "We can call the 988Suicide and Crisis Lifeline
together." Because it'savailable 24 hours a day, 7 days
(15:07):
a week. And adapt to whatevercrisis resources exist in your
area. And then, make it a warmhandoff, not a cold referral.
Where if possible, don't justhand them a phone number and
walk away. Instead, offer to sitwith them while they make the
call. Offer to walk with them tothe chaplain or the supervisor
or emergency room if necessary.Offer to stay while they talk to
(15:31):
the clinician for their firsttime if they would like you to.
You might say something like,"I'll stay with you while you
make the call." Or, "I can goover there with you right now.
Let's walk down there together."That warm handoff communicates,
"I'm still with you, I'm notdumping you on someone else." If
(15:53):
they have a clear plan.Immediate access to lethal means.
Or, the intent to act soon. Then,we're in immediate safety
territory. In those cases, youmay need to make sure they're
not left alone. You may want tosecure or remove access to
lethal means, if possible, insafe and within policy. Or,
please, follow your agency'sprotocol for emergency mental
(16:14):
health intervention. In somecases, help them get to an
emergency room or contactemergency services. This is
where your agency policies andyour local laws come into play.
Your job as a peer is not tobecome law enforcement or a
clinician. And, to help them getthe right help as safely as
possible.
(16:34):
Now, let's talk about some real-world challenges
you're likely to face. The firstone is, "Don't tell anyone."
When you ask the question, theyadmit suicidal thoughts. And
then, they say, "I'll talk toyou, but you can't tell anyone.
Promise me." This one's tough.Because, trust is the foundation
of peer support. "I'm notlooking to broadcast your
(17:00):
business, but..." "I'm reallyworried that your life's in
danger." "I can't promise tokeep that a secret. I care too
much about you to do that. WhatI can promise is that I'll walk
with you and we'll get helptogether." "I won't just hand
you off and disappear." You'rebeing honest about the limit of
confidentiality while reassuringthem they won't be alone in the
(17:20):
process. The next one is, "Angeror defensiveness." Sometimes,
when you ask directly aboutsuicide, the person might say,
"What? You think I'm crazy? Iwould never do that. I'm just
blowing off steam." "Or back off.I don't need this." Or, "If I'm
interested..." Or, "If I'minterested..." Or, "If I'm
(17:49):
misunderstood..." I'm glad. And,if that ever changes, even a
little bit, you can talk to me.I'd rather you reach out than
stay alone with it. Sometimes,that first conversation just
plants a seed. They may comeback to you later when the
defenses come down. Then barriernumber three. You're off-duty or
away from work. Maybe they textyou late at night. Or, they call
(18:12):
you on your day off. Or, "Thisconversation happens away from
the station or the hospital."Your response doesn't magically
change just because you'reoff-the-clock. can still ask the
direct question, listen andvalidate, and then persuade them
to stay safe and get help. Andthen, refer, if needed, loop in
appropriate support. You mightsay something like, "I'm glad
(18:35):
you reached out, even off-duty.Let's figure out what support we
can get you right now." Ifthey're in immediate danger, you
may need to consider contactingthe local emergency services,
where they are, not where youare.
And then, next thing, how do you take care of yourself
afterward? We focus a lot on theperson in crisis, and we should.
(18:56):
But, if you're the one havingthese conversations, you need to
recognize this too. When a peertells you they're thinking about
killing themselves, that's aload. Even if it ends well, and
they get help, you carry part ofthat weight. So, after the
immediate situation isstabilized, number one, I want
you to debrief with someone youtrust. This might be another
(19:19):
peer supporter. It could be yourteam leader, or a chaplain. Or a
trusted clinician who supportsyour team. You don't have to
share names or specificidentifiers, but you do need a
place to say, "Man, that wasintense," or "I'm shaken up. I'm
worried I might have missedsomething." You're not weak for
needing that debrief, becauseyou're human. I want you to
(19:41):
watch your own stress reactions.After a high-stakes conversation
like that, you might notice youhave trouble sleeping, or you're
replaying the conversation inyour head. You may be irritable,
or have a short fuse. You mighthave an increased urge to
overwork, over-eat, drink more,or to numb out yourself. I want
(20:02):
you to pay attention to that.And then, give yourself
permission to rest when you can,and step back from extra
responsibilities, if possible.And talk it through with someone
who understands this kind ofwork. Because you matter too.
well if you're completelydrained yourself. to remember:
(20:30):
changes in behavior, talk ofhopelessness, big stressors at
work or home, or any talk aboutwanting to die are red flags.
Use QPR as your roadmap.Question. Ask directly about
suicide. Are you thinking aboutkilling yourself? Then persuade.
Communicate care, listen, askthem to agree to stay safe while
(20:53):
you get help, and then refer.You're not the endpoint. Walk
with them to the next layer ofsupport. You can be a team
leader, a chaplain, a clinician,EAP, a crisis line, or the
emergency room. Whatever'sappropriate and available. Then
be honest about confidentiality.You can't promise to keep it
secret if you believe theirlife's in danger. But you can
(21:15):
promise not to abandon them inthe process. And then take care
of yourself afterward. Be brief.Watch your own reactions. You're
doing important, heavy work. Youdon't have to get every word
perfect. Take the pressure off.You just have to be willing to
show up, ask a hard question,and stay with them long enough
to connect them to help. And ifthis episode was helpful, please
(21:38):
share it with another person onyour team or another agency. If
you're happy about how youshould be following us through
the more people who know how tohelp talk to others about
suicide, the safer your agencybecomes. In the next episode,
we're going to talk about whatto do after a suicide attempt or
death in your agency. How tosupport the team. How to honor
the person. And navigate theripple effects without causing
(22:01):
more harm. make sure you'refollowing the show so you don't
miss it. Thanks for listening toSurviving Your Shift. Until next
time, God bless and have a greatday.
You're sitting in the break room after a rough shift
and just you and a co-workerwho's been quieter than usual.
You're both staring at the wall,just chilling out when they say
almost under their breath (00:11):
"I don't know how much longer I can
do this. Sometimes I wonder ifeverybody would be better off
without me." And then, yourstomach drops. You think: "Are
they just venting? Or are theyreally thinking about ending
their life?" You don't want tooverreact and you don't want to
say the wrong thing, but youalso don't want to walk away and
(00:32):
find out later this was youronly chance to step in. In
today's episode, we're going totalk about what to do in that
exact moment, when a peermentions suicide or... just
hints at it. It raises a redflag and it's enough that you
start to wonder. We're going towalk through how to recognize
the warning signs and the riskfactors, how to ask directly
(00:56):
about suicide without makingthings worse, and how to
persuade them to receive help.What we'll be doing is using the
QPR model
that stands for Question,Persuade and Refer. If you're a
peer supporter, a supervisor orjust the person everyone seems
to come to when things are ausual way. This episode's for
(01:17):
you.
Track 2 (01:20):
Welcome to Surviving Your Shift, your go-to resource
for building strong, peersupport teams in high-stress
professions. I'm your host, BartLeger, board-certified in
traumatic stress with over 25years of experience supporting
and training professionals infrontline and emergency roles.
Whether you're looking to starta peer support team, learn new
(01:42):
skills, or bring training toyour organization, this show
will equip you with practicaltools to save lives and careers.
Track 1 (01:52):
Let's talk about the moment when someone you work
with crosses the line from justventing into something that
sounds a whole lot more serious.If you work in a high-stress
profession long enough, you'lleventually run into a coworker
who's suicidal or at leastthinking about it. You might
hear it in a dark joke, ordarker than usual. You might see
(02:15):
it in a change in their behavior,or you might just hear it
straight out. "I'm thinkingabout cashing it in" or "I'm
thinking about ending my life."In that moment, you don't have
to be a therapist, and let metake the pressure off, you don't
have to fix everything. But youdo need to know how to respond.
That's where the QPR suicidegatekeeper model comes in. QPR
(02:40):
stands for Question, Persuadeand Refer. What it is, is a
simple, practical framework thatequips everyday people to
recognize the warning signs of asuicidal crisis, ask the
question directly, and thenconnect that person to help.
We're going to use QPR as ourbackbone today, and then just
(03:03):
flesh it out as we go. We'llstart with what usually leads up
to that critical moment.
So this is part one: Recognizing the Warning Signs:
Risks and Factors. Suicidealmost never comes out of the
blue. There are usually somewarning signs and some risk
factors that show up ahead oftime. As peer supporters and
(03:24):
co-workers, our job is to noticewhen something feels off, and to
take it seriously. We'll startoff with the behavioral signs.
These are changes in what they do. Pulling away from
the crew, sitting alone insteadof with the group. It could be
they're calling in sick more, orshowing up late. Or they just
(03:45):
seem like they're checked out.Maybe they're giving away
personal items, talking likethey're wrapping things up.
Maybe they're taking more riskson calls or on the road. There
could be more drinking or druguse, using substances to numb
themselves. Maybe they'retalking a lot about death or
(04:06):
dying. Or it could be as simpleas just wishing they didn't wake
up. In our kind of work, I knowdark humor is normal, but you
know your people. When somethingshifts from the usual jokes to
something heavier and morepersonal, I want you to trust
your gut.
Secondly, there's emotional and verbal signs. I
(04:26):
want you to listen forstatements like, "I'm done. I
can't do this anymore. Everyonewould be better off without me.
I just want it all to stop." Or,"What's the point? Nobody would
even miss me." Sometimes they'lladd, "I'm just kidding. Don't
worry, I'm not really going todo it." But, I want you to know,
it still matters. Any talk aboutwanting to die or not wanting to
(04:49):
be here anymore is a bigflashing warning light.
And then there's situational or work-related risk
factors. These are thesituations that increase the
suicidal risk, especially inhigh-stress professions. It
could be a recent criticalincident. It could be a child
death, a mass casualty, anofficer-involved shooting, a
(05:12):
gruesome scene, or maybe apatient they can't stop thinking
about. It could be cumulativestress-not the one big call or
the one big thing in their life,but maybe months or years of
constant exposure to trauma orpressure. It could come after
disciplinary issues-maybethere's an IA investigation or
(05:35):
complaints, potentially a jobloss or loss of certification or
license. There could also be asignificant loss in their life,
a divorce or breakup, custodybattles, death of a loved one,
or a financial crisis. It couldbe chronic pain or medical
issues, especially if itthreatens their career or their
(05:57):
identity. When more than one ofthese starts stacking up and
then you hear suicidal comments,that's when your peer support
radar should be on high alert.
Then we have access to means. We often have easy access
to lethal means. Most of us havefirearms or medications or other
(06:17):
tools or environments where asuicide attempt could be carried
out quickly. You don't have tointerrogate them about this
right away, but knowing thataccess is part of the picture
helps you understand the levelof risk. The bottom line in this
first stage is, if your guttells you that something's off,
please don't ignore it. It'sbetter to ask and be wrong than
(06:39):
to stay silent and wish you'dspoken up.
So here's part two: asking the question about
suicide. This is the part thatmost people are scared of.
They're afraid if they say theword "suicide" it will put the
ID in the person's head. Let metell you: It will not. You won't
cause someone to become suicidalby asking if they're thinking
(07:02):
about suicide. If they're notsuicidal, they'll usually say so
and now they know you're a safeperson to talk to. they were
living with. If they aresuicidal, asking the question
can come as a relief. Becausesomeone finally sees how much
(07:25):
they're struggling. We shouldask the question clearly and
directly. Don't beat around thebush. Because many avoid the
question. We avoid asking (07:33):
Are you thinking about killing
yourself? Because, I mean, itreally does feel too direct and
probably the main reason manypeople are afraid to ask.
Because we're afraid of theanswer. We don't know what to do
if they say yes. We don't wantto make them angry or lose their
trust. But if we dance around it,we risk missing what's really
(07:56):
going on. So, how do you ask thequestion? Depending upon your
relationship or your style orhow they've been talking, it
might sound like you've beenthrough a lot lately and you
just said you're done. I need toask you straight: Are you
thinking about killing yourself?Or when you say they'd be better
(08:17):
off without you... Do you meanyou're thinking about suicide?
Or, "I care about you. I'm nothere to judge." Are you thinking
about ending your life? Notice afew things. You're calm and
you're direct. And when you'regeneral... You use clear words
like killing yourself, endingyour life, suicide. You're not
accusing. What you're doingis... You're checking in because
(08:38):
you care. Even if it feelsuncomfortable, we stick with the
direct language about dying orsuicide. We don't soften it into
hurting yourself. I've heardmany people ask, "Are you
considering hurting yourself?"Or... Are you thinking of doing
something crazy? Well, in theirmind, they're not looking to
hurt themselves and they don'tsee it as being crazy. You might
(09:03):
give yourself a short lead in tohelp you say it. So, this may
sound blunt, but it's importantthat I ask. Or... I'd rather be
a little awkward than staysilent. So, let me ask you
directly. And then follow itwith... Are you thinking about
killing yourself? Have you beenthinking about suicide? Or...
(09:24):
Are you thinking about endingyour life? You're not trying to
be dramatic. You're trying to beclear. Because vague questions
are easy to dodge. Clearquestions? Open the door. If
they say no, but you still thinkthey're having thoughts of
suicide, what you can do is, youcan come back around and ask the
(09:45):
question indirectly. often havethoughts of suicide.
This lets them know they're notthe only ones struggling with
something and considering apermanent way out.
Track 1 (10:02):
So, you should choose what to do when they say yes.
Let's say you ask the questionand they say, "Yeah, I've
thought about it. Honestly, morethan I want to admit." Or maybe,
"I don't have a plan, but yeah,the thought crosses my mind a
lot." Well, first of all, what Iwant you to do is I want you to
(10:23):
take a breath. You did the hardpart. You opened the
conversation. Now, what I wantyou to do is slow things down
and stay present. This is notthe time to panic, lecture, or
jump into fix-it mode. What youmight say is something like,
"Thank you for being honest withI'm really glad you told me
(10:45):
that." Or, "That has to feelreally heavy to carry all by
yourself." What your goal isright now is to keep them
talking. Help them feel heardand not judged, and then gather
enough information to understandthe level of risk. Then secondly,
get a sense of how serious it is.You're not doing a full clinical
(11:07):
assessment, but you can gentlyexplore, "Have you thought about
how you would do it?" Or, "Doyou have access to what you'd
use to kill yourself?" "Have youever tried to end your life
before?" Maybe, "Are youthinking about doing something
today?" Or, "Are these moreongoing thoughts?" In general,
the more specific the plan, themore immediate the time frame
(11:29):
and the easier access to lethalmeans, it means the higher the
risk. If they say, "I've thoughtabout using my duty weapon, and
I've been thinking a lot aboutit lately," you treat that as
very serious. If they say, "No,I don't have a plan. I just feel
like I wouldn't mind if I didn'twake up." That's still serious,
(11:51):
but you have a little more roomto work with in the moment.
Either way, any yes to suicidalthinking is a signal to move to
the next step.
And that's where the "P" comes in. You're trying to
persuade them to stay and gethelp. Now, we're not talking
about coercion here. You're nottalking about talking them out
of their feelings. You're tryingto persuade them to stay alive
(12:12):
for now, to accept help andsupport, and to let you connect
them through resources. Thefirst thing you will do is
communicate that you care andoffer them hope. This is where
your relationship matters. Youmight say, "I'm really glad you
told me. You matter to this teammore than you know." "I don't
(12:33):
want you going through thisalone." Or, "People in our line
of work feel this way more oftenthan you think. You're not the
only one, and there is help." Or,"What can we do right now to
keep you alive?" I want you totry to avoid things like, "You
shouldn't feel that way." Or,"You've got so much to live
for." Or, "Think of your kids.How could you do that to them?"
(12:56):
Those may be well-intentioned,but they can add to guilt and
they can shut the person down.Then, you can ask for a
short-term commitment. Someexamples might be, "Would you be
willing to let me walk with youthrough this, at least for today,
and not act on those thoughtswhile we get you some help?" Or,
"Can you agree with me that youwon't try to kill yourself
(13:18):
before we talk to someone whocan help?" Like a chaplain or
maybe a counselor whounderstands us. Could "Will you
let me help you find someone whocan support you through this and
stay alive while we do that?" Ifyou're not asking for them to
promise they'll never feel thatway again. You're asking them to
let you bridge the gap to thenext level of support. And if
(13:38):
they agree, that really is a bigstep. If they say, "I don't
know," or, "What's the point?"You keep listening. Reflecting
back their pain and gentlyreturning to, "I hear how bad it
feels." And I still want you toget help instead of going
through this alone.
Then the next step is, "R," refer to help. This is the
(14:01):
third part of QPR. This is wheremany peer supporters get stuck.
They think, "Okay, I asked and Ilistened. Now what?" Remember,
you're not the endpoint. You'rethe bridge. The right referral
depends on their level of risk,what resources your agency has,
and what the person is willingto accept in the moment. The
(14:22):
referral options might includepeer support team leader or
coordinator. It could be achaplain who understands the
culture or, better yet, aculturally competent therapist
or psychologist. It could beyour employee assistance program
with someone who gets firstresponders or medical work or
whatever line of work thatyou're in. Or it could be the
(14:44):
local crisis line or nationallifeline. Emergency department
or urgent psychiatric evaluation,if the risk is high. It could be
a supervisor or command staffwhen agency policy requires it
for safety. In the United States,you can always say something
like, "We can call the 988Suicide and Crisis Lifeline
together." Because it'savailable 24 hours a day, 7 days
(15:07):
a week. And adapt to whatevercrisis resources exist in your
area. And then, make it a warmhandoff, not a cold referral.
Where if possible, don't justhand them a phone number and
walk away. Instead, offer to sitwith them while they make the
call. Offer to walk with them tothe chaplain or the supervisor
or emergency room if necessary.Offer to stay while they talk to
(15:31):
the clinician for their firsttime if they would like you to.
You might say something like,"I'll stay with you while you
make the call." Or, "I can goover there with you right now.
Let's walk down there together."That warm handoff communicates,
"I'm still with you, I'm notdumping you on someone else." If
(15:53):
they have a clear plan.Immediate access to lethal means.
Or, the intent to act soon. Then,we're in immediate safety
territory. In those cases, youmay need to make sure they're
not left alone. You may want tosecure or remove access to
lethal means, if possible, insafe and within policy. Or,
please, follow your agency'sprotocol for emergency mental
(16:14):
health intervention. In somecases, help them get to an
emergency room or contactemergency services. This is
where your agency policies andyour local laws come into play.
Your job as a peer is not tobecome law enforcement or a
clinician. And, to help them getthe right help as safely as
possible.
(16:34):
Now, let's talk about some real-world challenges
you're likely to face. The firstone is, "Don't tell anyone."
When you ask the question, theyadmit suicidal thoughts. And
then, they say, "I'll talk toyou, but you can't tell anyone.
Promise me." This one's tough.Because, trust is the foundation
of peer support. "I'm notlooking to broadcast your
(17:00):
business, but..." "I'm reallyworried that your life's in
danger." "I can't promise tokeep that a secret. I care too
much about you to do that. WhatI can promise is that I'll walk
with you and we'll get helptogether." "I won't just hand
you off and disappear." You'rebeing honest about the limit of
confidentiality while reassuringthem they won't be alone in the
(17:20):
process. The next one is, "Angeror defensiveness." Sometimes,
when you ask directly aboutsuicide, the person might say,
"What? You think I'm crazy? Iwould never do that. I'm just
blowing off steam." "Or back off.I don't need this." Or, "If I'm
interested..." Or, "If I'minterested..." Or, "If I'm
(17:49):
misunderstood..." I'm glad. And,if that ever changes, even a
little bit, you can talk to me.I'd rather you reach out than
stay alone with it. Sometimes,that first conversation just
plants a seed. They may comeback to you later when the
defenses come down. Then barriernumber three. You're off-duty or
away from work. Maybe they textyou late at night. Or, they call
(18:12):
you on your day off. Or, "Thisconversation happens away from
the station or the hospital."Your response doesn't magically
change just because you'reoff-the-clock. can still ask the
direct question, listen andvalidate, and then persuade them
to stay safe and get help. Andthen, refer, if needed, loop in
appropriate support. You mightsay something like, "I'm glad
(18:35):
you reached out, even off-duty.Let's figure out what support we
can get you right now." Ifthey're in immediate danger, you
may need to consider contactingthe local emergency services,
where they are, not where youare.
And then, next thing, how do you take care of yourself
afterward? We focus a lot on theperson in crisis, and we should.
(18:56):
But, if you're the one havingthese conversations, you need to
recognize this too. When a peertells you they're thinking about
killing themselves, that's aload. Even if it ends well, and
they get help, you carry part ofthat weight. So, after the
immediate situation isstabilized, number one, I want
you to debrief with someone youtrust. This might be another
(19:19):
peer supporter. It could be yourteam leader, or a chaplain. Or a
trusted clinician who supportsyour team. You don't have to
share names or specificidentifiers, but you do need a
place to say, "Man, that wasintense," or "I'm shaken up. I'm
worried I might have missedsomething." You're not weak for
needing that debrief, becauseyou're human. I want you to
(19:41):
watch your own stress reactions.After a high-stakes conversation
like that, you might notice youhave trouble sleeping, or you're
replaying the conversation inyour head. You may be irritable,
or have a short fuse. You mighthave an increased urge to
overwork, over-eat, drink more,or to numb out yourself. I want
(20:02):
you to pay attention to that.And then, give yourself
permission to rest when you can,and step back from extra
responsibilities, if possible.And talk it through with someone
who understands this kind ofwork. Because you matter too.
well if you're completelydrained yourself. to remember:
(20:30):
changes in behavior, talk ofhopelessness, big stressors at
work or home, or any talk aboutwanting to die are red flags.
Use QPR as your roadmap.Question. Ask directly about
suicide. Are you thinking aboutkilling yourself? Then persuade.
Communicate care, listen, askthem to agree to stay safe while
(20:53):
you get help, and then refer.You're not the endpoint. Walk
with them to the next layer ofsupport. You can be a team
leader, a chaplain, a clinician,EAP, a crisis line, or the
emergency room. Whatever'sappropriate and available. Then
be honest about confidentiality.You can't promise to keep it
secret if you believe theirlife's in danger. But you can
(21:15):
promise not to abandon them inthe process. And then take care
of yourself afterward. Be brief.Watch your own reactions. You're
doing important, heavy work. Youdon't have to get every word
perfect. Take the pressure off.You just have to be willing to
show up, ask a hard question,and stay with them long enough
to connect them to help. And ifthis episode was helpful, please
(21:38):
share it with another person onyour team or another agency. If
you're happy about how youshould be following us through
the more people who know how tohelp talk to others about
suicide, the safer your agencybecomes. In the next episode,
we're going to talk about whatto do after a suicide attempt or
death in your agency. How tosupport the team. How to honor
the person. And navigate theripple effects without causing
(22:01):
more harm. make sure you'refollowing the show so you don't
miss it. Thanks for listening toSurviving Your Shift. Until next
time, God bless and have a greatday.
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