ASIST - Applied Suicide Intervention Skills Training

Last week I went on a two day ASIST course. ASIST stands for Applied Suicide Intervention Skills Training and was developed by a Canadian company called Living Works. It is now delivered by over 3000 trainers worldwide, 102 of which are in Ireland. I did the course in Donegal, but they are run all over the country and organised by ASIST Coordinators (usually, but not always a HSE employee). It is funded by the National Office for Suicide Prevention.

The ASIST training consists of two days of practical training in what they call "suicide first aid". This is not like emergency first aid for physical problems. This first aid is for a different type of emergency - when and how to intervene when someone may be contemplating suicide.

Image from www.livingworks.net

As the image shows, activities that come before suicidal thoughts are “suicide prevention”.

 One-on-one contact with persons at risk of suicide is “suicide intervention”. This comes between thoughts of suicide and suicidal acts.  Activities for those who are impacted by suicidal acts is “suicide postvention”. "Community coordination" is ongoing preventative work including education, public awareness and co-ordination of resources so people know where to get approachable and effective help. 

The ASIST course focuses on suicide intervention. It is analogous to regular first aid in that the "care-giver's" role is to help keep the person at risk alive or "safe" until they can access further help. I will write about this in more detail in my next blog post. 

Over the two days we saw some sample interventions happen on film and then practised it through various role plays. At the end of the course we were each given a detailed handbook, a shorter workbook and a small card which fits into your wallet which outlines the key steps of the process. Our trainers told us that well over half the people who have completed the course use this card successfully within 18 months. They know this because they ask at refresher courses (3 hours) which take place 18 months after the initial ASIST course.

I found the course practical, realistic, well structured and not nearly as emotional as I had expected. Our trainers in Donegal kept it light so although the topic was heavy the atmosphere was not. I can't say if it's like this in other areas. This course allowed the other participants and I the time and space to look at our attitudes to suicide without getting into personal experiences. At the beginning of the course we each filled in an anonymous questionnaire and the results showed that 37% of us had considered suicide at some time in our lives. This really reinforced that reality we all know that "normal" people consider and go through with suicide. The sad fact is that thoughts of suicide are normal but in the vast majority of cases, it can be prevented. 

I would highly recommend doing an ASIST course. To find out about courses in your area and if you are eligible to apply, contact your local ASIST coordinator. If you are working with people, either paid or voluntary, you should be eligible. In some areas, there are waiting lists so the sooner you add your name, the sooner you can get trained up. Depending on the Coordinator in your area, you may also have the option of organising a three hour SafeTALK course in your group or in your workplace. SafeTALK stands for Tell, Ask, Listen and Keepsafe, and is suitable for the general public who want to learn more about suicide prevention. It is aimed at adults and teenagers over 15 and can be also run in schools.