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Arizona Suicide Prevention Training for School Mental Health Professionals  

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Arizona Suicide Prevention Training for School Mental Health Professionals  

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School mental health professionals play a critical role in keeping students safe, often being the first to identify when a student is at risk. Yet, their role is too often overlooked in safety planning. To address this need, The Jed Foundation (JED) and the Arizona Department of Education (ADE) have partnered to create a two-hour, eight-module online training that equips school counselors, social workers, psychologists, nurses, and other school personnel with the tools to support suicide prevention and early intervention.

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Register | The Jed Foundation Learning Platform for ADE

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JED Foundation: I want to help my students

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JED Foundation: I want to help my students

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The “Help My Students” page from The Jed Foundation (JED) is a dedicated resource for educators who want to support student mental health and emotional well-being. It empowers teachers, coaches, and school staff with practical tools, guides, and strategies to recognize signs of distress, start meaningful conversations, and connect students to appropriate support.

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Essential Resources

Set to Go

Over 100 resources, tips, and tools to help students, caregivers, and educators manage the transition from high school to college, the working world, or whatever is up next with less stress and more confidence.

Bring JED to Your Community

School and District Programs and Resources

The Jed Foundation equips school communities across the country with evidence-based resources to create a culture of care in which all students feel seen and supported. We offer our flagship JED High School program as well as a variety of trainings, research, guidance, and classroom tools for administrators, educators, and students to create healthy and connected school communities.

Higher Education Programs and Resources

The Jed Foundation partners with colleges and universities to put systems, programs, and policies in place to create a culture of caring that protects student mental health and prevents suicide. We offer our flagship JED Campus programs, as well as a variety of training, research, guidance, and tools for administrators, faculty, and students to create healthy and connected school communities.

Want to get updates? Sign up for our newsletter.

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I Want to Help My Students | The Jed Foundation

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If you’re in emotional distress there are options available to help you. You can also contact the 988 Lifeline at any time to connect with a skilled, caring counselor and get support. Confidential support is available 24/7 for everyone in the United States and its territories.

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If you’re in emotional distress there are options available to help you. You can also contact the 988 Lifeline at any time to connect with a skilled, caring counselor and get support.

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SOS Signs of Suicide is an affordable, evidence-based suicide prevention program that. SOS is an evidence-based youth suicide prevention program that teaches middle and high school students how to identify warning signs of suicide and depression. Signs of Suicide has been shown to reduce suicide attempts by 64%. SOS can be delivered in a single class period and encourages students to ACT® (Acknowledge, Care, Tell) if they are worried about themselves or a friend.

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Suicide Prevention | SOS Signs of Suicide by MindWise Innovations

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SOS Signs of Suicide is an affordable, evidence-based youth suicide prevention program for middle and high school students.

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Erika's Lighthouse aims to break down the stigma surrounding mental health and provide free depression education and suicide prevention programs to any school, anywhere. They make mental health education and resources 100% free of cost and accessible all with the click of a button. Providing evidence-informed mental health, depression education and suicide prevention curriculum can help us ensure that every school can equip its students with the tools they need to thrive.

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Suicide Awareness Voices of Education (SAVE)

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Suicide Awareness Voices of Education (SAVE)

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SAVE – Suicide Awareness Voices of Education is a national nonprofit working to prevent the tragedy of suicide through education, advocacy, lethal means safety efforts, and support for suicide loss survivors. Their work is based on the belief that suicide is preventable. Through raising public awareness, educating communities, training key stakeholders, advocating for systemic change, and providing unwavering support for loss survivors, we know we can SAVE lives.

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SAVE | Suicide Prevention | Suicide Information | Suicide Awareness

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The mission of SAVE is to prevent suicide through public awareness and education, reduce stigma and serve as a resource to those touched by suicide.

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The Arizona Suicide Prevention Coalition is a dedicated community-based organization committed to preventing suicide and promoting mental health and well-being throughout Arizona.

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Welcome to the Arizona Suicide Prevention Coalition
​
The Arizona Suicide Prevention Coalition is a dedicated community-based organization committed to preventing suicide and promoting mental health and well-being throughout Arizona. We provide essential resources and education to support individuals, families, and communities impacted by suicide.

Every life matters. Together, we can prevent suicide and build a community of hope.
​

The Arizona Suicide Prevention Coalition (AZSPC) is dedicated to reducing suicide in Arizona through public discourse, education, and awareness. Recognizing the signs of suicide is crucial for prevention, as most suicides are preventable.

Our coalition comprises a diverse group of mental health leaders, educators, healthcare professionals, survivors, and concerned citizens, all committed to making a positive impact on suicide prevention.

We invite survivors, professionals, supporters, and anyone interested in suicide prevention to join AZSPC and contribute to our mission.

The Arizona Suicide Prevention Coalition holds meetings on the second Tuesday of every even month.

For more information about our meetings, please click here:Coalition Meetings & Training Opportunities

​ IF YOU ARE IN CRISIS

The AZSPC webpage and email are not monitored for those in crisis.

If you are in need of immediate help within Arizona, please call EMPACT at:
(480) 784-1500 or 1-866-205-5229

If you are a teenager within Arizona and in crisis, please call or text Teen Lifeline at:
(602) 248-TEEN (8336) or 1-800-248-TEEN

988 Suicide and Crisis Lifeline (988) provides access to trained telephone counselors (and text/chat) 24 hours a day, 7 days a week.

If you have lost someone to suicide, you are not alone. Please visit for more information.​
​

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Welcome to the Arizona Suicide Prevention Coalition ​ The Arizona Suicide Prevention Coalition is a dedicated community-based organization committed to preventing suicide and promoting mental...

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The mission of Teen Lifeline is to prevent teen suicide in Arizona through enhancing resiliency in youth and fostering supportive communities.

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Teen Lifeline is a suicide prevention nonprofit & 24/7 crisis peer hotline for teens. We work to prevent teen suicide in AZ through enhancing resiliency in youth & fostering supportive communities.

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NAMI Arizona is an organization of families, friends and individuals whose lives have been affected by mental illness. Together, we advocate for better lives for those individuals who have a mental illness.

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NAMI Arizona | National Alliance on Mental Illness

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NAMI Arizona is a statewide grassroots organization dedicated to serving individuals and families affected by mental illness to improve their quality of life and achieve recovery. NAMI Arizona promotes activities, in partnership with local NAMI affiliates, through education, advocacy, research, and support.

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A Comprehensive Approach to Suicide Prevention 

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A Comprehensive Approach to Suicide Prevention 

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Effective suicide prevention is comprehensive: it requires a combination of efforts that work together to address different aspects of the problem.

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Strategies, Programs, and Practices to Consider

Effective suicide prevention is comprehensive: it requires a combination of efforts that work together to address different aspects of the problem.

The model above shows nine strategies that form a comprehensive approach to suicide prevention and mental health promotion. Each strategy is a broad goal that can be advanced through an array of possible activities (i.e., programs, policies, practices, and services). This model of a comprehensive approach was adapted from a model developed for campuses by SPRC and the Jed Foundation, drawing on the U.S. Air Force Suicide Prevention Program.

Many people in distress don't seek help or support on their own. Identifying people at risk for suicide can help you reach those in the greatest need and connect them to care and support. Examples of activities in this strategy include gatekeeper training, suicide screening, and teaching warning signs.

By teaching people to recognize when they need support-and helping them to find it-you can enable them to reduce their suicide risk. Self-help tools and outreach campaigns are examples of ways to lower an individual's barriers to obtaining help, such as not knowing what services exist or believing that help won't be effective. Other interventions might address the social and structural environment by, for example, fostering peer norms that support help-seeking or making services more convenient and culturally appropriate.

A key element of suicide prevention is ensuring that individuals with suicide risk have timely access to evidence-based treatments, suicide prevention interventions, and coordinated systems of care. Suicide prevention interventions such as safety planning and evidence-based treatments and therapies delivered by trained providers can lead to significant improvement and recovery. SPRC encourages health and behavioral health care systems to adopt the Zero Suicide framework for integrating these approaches into their systems. Reducing financial, cultural, and logistical barriers to care is another important strategy for ensuring access to effective mental health and suicide care treatment.

You can reduce patients' suicide risk by ensuring that they have an uninterrupted transition of care and by facilitating the exchange of information among the various individuals and organizations that contribute to their care. Individuals at risk for suicide and their support networks (e.g., families) must also be part of the communication process. Tools and practices that support continuity of care include formal referral protocols, interagency agreements, cross-training, follow-up contacts, rapid referrals, and patient and family education.

Individuals in your school, organization, or community who are experiencing severe emotional distress may need a range of services. A full continuum of care includes not only hotlines and helplines but also mobile crisis teams, walk-in crisis clinics, hospital-based psychiatric emergency services, and peer-support programs. Crisis services directly address suicide risk by providing evaluation, stabilization, and referrals to ongoing care.

A postvention plan is a set of protocols to help your organization or community respond effectively and compassionately to a suicide death. Immediate responses focus on supporting those affected by the suicide death and reducing risk to other vulnerable individuals. Postvention efforts should also include intermediate and long-term supports for people bereaved by suicide.

One important way to reduce the risk of death by suicide is to prevent individuals in suicidal crisis from obtaining and using lethal methods of self-harm. Examples of actions to reduce access to lethal means include educating the families of those in crisis about safely storing medications and firearms, distributing gun safety locks, changing medication packaging, and installing barriers on bridges.

By helping people build life skills, such as critical thinking, stress management, and coping, you can prepare them to safely address challenges such as economic stress, divorce, physical illness, and aging. Resilience-the ability to cope with adversity and adapt to change-is a protective factor against suicide risk. While it has some overlap with life skills, resilience also encompasses other attributes such as optimism, positive self-concept, and the ability to remain hopeful. Skills training, mobile apps, and self-help materials are examples of ways to increase life skills and build resilience.

Supportive relationships and community connectedness can help protect individuals against suicide despite the presence of risk factors in their lives. You can enhance connectedness through social programs for specific population groups (such as older adults or LGBT youth) and through other activities that reduce isolation, promote a sense of belonging, and foster emotionally supportive relationships.

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A Comprehensive Approach to Suicide Prevention

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Effective suicide prevention is comprehensive: it requires a combination of efforts that work together to address different aspects of the problem. The model above shows nine strategies that form a comprehensive approach to suicide prevention and mental health promotion. Each strategy is a broad goal that can be advanced through an array of possible activities (i.e., programs, policies, practices, and services).

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Safety Planning for Youth Suicide Prevention

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Safety Planning for Youth Suicide Prevention

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Safety Planning for Youth Suicide Prevention is a one-hour, self- paced online course designed for licensed health and behavioral health professionals and students in clinical training programs. Participants will review the core elements of the Safety Planning Intervention, explore strategies for effective collaboration with young people and their family members, and consider ways to overcome common challenges to delivering the intervention with fidelity.

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JED Foundation: I want to help my friend 

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JED Foundation: I want to help my friend 

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The “Help My Friend” page from The Jed Foundation (JED) is a supportive and practical resource designed to help young people recognize when a friend may be struggling emotionally and take meaningful steps to support them.

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I want to help...

Friendship is all about looking out for each other.
We're in a unique position to notice when our friends are having a hard time, and to take action to support them. If you're worried that a friend is struggling emotionally, trust that instinct. Use the tips and tools below to help you recognize a problem, start a conversation, and follow through with your support.
If you or someone you know is feeling hopeless or having thoughts of suicide, text HOME to 741-741 or call or text 988 now.

JED Programs

Seize the Awkward

There are different ways to start the conversation and yet, no wrong way. Developed in partnership with the Ad Council and the American Foundation for Suicide Prevention, JED's Seize the Awkward has videos, GIFs, conversation starters, and more to help make starting the conversation, well, less awkward.

JED Storytelling

Sharing stories is a powerful way to reduce shame, prejudice, and secrecy, and inspire us to be proactive about our mental health. JED has two video series that help shine a personal light on mental health. JED Voices features intimate conversations with notable and influential mental health advocates and JED Storytelling features personal experiences of real people who've struggled with their mental health.

Want to get updates? Sign up for our newsletter.

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I Want to Help My Friend | The Jed Foundation

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The “Help My Teen/Young Adult” page from The Jed Foundation (JED) is a comprehensive resource for parents and caregivers who want to support the mental health and emotional well-being of their teens or young adults. It provides practical tools, expert guidance, and conversation strategies to help families navigate the challenges of adolescence and early adulthood.

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Skip to content

I want to help...

Parenting a teen or young adult can be both rewarding and challenging.
Your young person is navigating the demands of school, work, and relationships while trying to figure life out - and you're trying to help them become a resilient young adult. Explore JED's resources to help you recognize mental health warning signs, start meaningful conversations, and know the difference between normal growing pains and distress so you can provide the support your child needs.

Bring JED to You

School and District Programs and Resources

JED equips school communities across the country with evidence-based resources to create a culture of care in which all students feel seen and supported. We offer our flagship JED High School program as well as a variety of trainings, research, guidance, and classroom tools for administrators, educators, and students to create healthy and connected school communities.

Higher Education Programs and Resources

JED partners with colleges and universities to put systems, programs, and policies in place to create a culture of caring that protects student mental health and prevents suicide. We offer our flagship JED Campus programs, as well as a variety of training, research, guidance, and tools for administrators, faculty, and students to create healthy and connected school communities.

Want to get updates? Sign up for our newsletter.

Notice: JavaScript is required for this content.

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I Want to Help My Teen/Young Adult | The Jed Foundation

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Healing Conversations is a one-time visit (phone, virtual, in-person)  that connects those who have lost a loved one to suicide with trained volunteers who are also survivors of suicide loss. The goal of this connection is to help recent survivors navigate this challenging journey by offering support, connection and resources.

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American Foundation for Suicide Prevention

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Healing Conversations gives those who have lost someone to suicide the opportunity to talk with our experienced volunteers. These AFSP volunteers, who are themselves survivors of suicide loss, offer understanding and guidance in the weeks and months following a suicide death.

Available in person, on the phone or by video chat, our volunteers are familiar with the isolation that so often accompanies a death of this kind, and are able to show suicide loss survivors a way forward into a world of support, by creating an opportunity for the newly bereaved to speak openly with, and ask questions of, someone who has been there, too, and truly gets it.

When someone contacts us to request a conversation, we will ask them some questions about their loss, so that we may match them with a suitable volunteer who has experienced a similar loss. Their peer support volunteer will contact them to schedule a conversation at a convenient time and, in the case of in-person visits, at a comfortable location of the person's choice.

Submit the short online form below to request a meeting in person, by phone or by video call.

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Healing Conversations: Personal Support for Survivors of Suicide Loss

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Healing Conversations gives survivors of suicide loss the opportunity to speak with volunteers, who are themselves loss survivors.

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After a Suicide: A Toolkit for Schools assists schools in implementing a coordinated response to the suicide death of a student.

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American Foundation for Suicide Prevention (AFSP) and Suicide Prevention Resource Center (SPRC)

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After a Suicide: A Toolkit for Schools, Second Edition – Suicide Prevention Resource Center

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StandBy is a suicide postvention program dedicated to assisting people and communities bereaved or impacted by suicide.

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Resources to help promote resilient parenting for parents and caregivers of bereaved children and for service providers who help them on their journey.

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RPBF - Resilient Parenting for Bereaved Families

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RPBF - Resilient Parenting for Bereaved Families

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This course is about how to reduce access to the methods people use to kill themselves. It covers who needs lethal means counseling and how to work with people at risk for suicide—and their families—to reduce access.

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Course Description

Reducing access to lethal means, such as firearms and medication, can determine whether a person at risk for suicide lives or dies.

This course is about how to reduce access to the methods people use to kill themselves. It covers who needs lethal means counseling and how to work with people at risk for suicide-and their families-to reduce access.

This course earned two awards in 2019:

Bronze Digital Health Award

Bronze Omni Award

After completing this course you will be able to:

Explain that reducing access to lethal means is an evidence-based strategy for suicide prevention.

Explain how reducing access to lethal means can prevent suicide.

Identify clients for whom lethal means counseling is appropriate.

Describe strategies for raising the topic of lethal means, and feel more comfortable and competent applying these strategies with clients.

Advise clients on specific off-site and in-home secure storage options for firearms and strategies to limit access to dangerous medications.

Work with your clients and their families to develop a specific plan to reduce access to lethal means and follow up on the plan over time.

Audience
While this course is primarily designed for mental health professionals, others who work with people at risk for suicide, such as health care providers and social service professionals, may also benefit.
Course Length
This course can be completed in approximately two hours. You do not have to complete the course in one session. You can exit the course at any time and return later to the place where you left off.
Certificate of Completion
To receive a certificate of completion, you must do the following online: complete each lesson, pass the posttest (passing score is 80% or higher), and answer the feedback survey questions.

You can earn a certificate of completion once per year for each course. We do not offer continuing education credits for any of our courses.

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Reducing access to lethal means, such as firearms and medication, can determine whether a person at risk for suicide lives or dies. This course is about how to reduce access to the methods people use to kill themselves. It covers who needs lethal means counseling and how to work with people at risk for suicide-and their families-to reduce access.

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Transforming Tribal Communities: Indigenous Perspectives on Suicide Prevention

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Transforming Tribal Communities: Indigenous Perspectives on Suicide Prevention

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Culturally relevant suicide prevention strategies that are endorsed by community members can lead to long-lasting change. The following six-to-eight-minute webinar clips, adapted from SPRC’s Tribal Community of Learning Series, feature expert advice on addressing the root causes of mental health issues and suicide in American Indian and Alaska Native (AI/AN) communities by drawing on community strengths.

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Transforming Tribal Communities: Indigenous Perspectives on Suicide Prevention – Suicide Prevention Resource Center

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This site will help provide you some of the information, tools, and resources to help you identify at-risk youth and know how to assist them in getting help before a tragedy occurs. Prevention begins with education.

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An uprising of teens to help other teens. We’ve made it our mission to stop the suicide epidemic that’s taking the lives of our friends

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Dismiss

We are a movement. An uprising of teens to help other teens. We've made it our mission to stop the suicide epidemic that's taking the lives of our friends.

Help us cut teen suicide rates in half by 2028.

So...

How are you feeling today?

Know someone who needs help?
Text "TALK" to 38255, call Colorado Crisis Services at 1-844-493-8255, or call the National Suicide Prevention Lifeline at 1-800-273-8255

Welp,

You're not the only one.

So, let's do something about it. Together! Robbie's Hope Ambassadors are teen volunteers across the country bringing our programs to local communities to help us combat teen depression and suicide. Want to put your passion to work or know someone who should? Apply today and help us end the epidemic of teen suicide.

Whatever you feel,

we bet you're not alone.

So, let's do something about it. Together! Robbie's Hope Ambassadors are teen volunteers across the country bringing our programs to local communities to help us combat teen depression and suicide. Want to put your passion to work or know someone who should? Apply today and help us end the epidemic of teen suicide.

Thank you for downloading! We'd like to know where we are making an impact, if you could please share some information below. We will not share your information. We will only email you our newsletter if you check the box below.

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We are a movement. An uprising of teens to help other teens. We've made it our mission to stop the suicide epidemic that's taking the lives of our friends.

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Starting a conversation about mental health does not need to be uncomfortable, and it can make all the difference. Check out these resources to learn how to support a friend – or get help for yourself.

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Seize the Awkward | Talk With A Friend About Mental Health

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Having a conversation about mental health might be uncomfortable, but it can make all the difference. Check out these tools - from conversation guides to tips -that can help you help those in need.

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Teen Line provides support, resources, and hope to young people through a hotline of professionally trained teen counselors, and outreach programs that de-stigmatize and normalize mental health.

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Teen Line | Teens Support hotline - Connect, talk, get help!

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If you have a problem or just want to talk with another teen who understands, this is the place for you! Support, resources, and hope to any teen struggling.

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Teen Lifeline’s School ID Initiative ensures that this vital connection to hope is in the pocket of students statewide.

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Arizona law requires high schools to include hotline info on student IDs. Teen Lifeline’s School ID Initiative works with schools to put our hotline on IDs.

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Most teens who attempt or die by suicide have given some type of warning to loved ones ahead of time. It’s important for parents to know the warning signs so that youth who might be suicidal can get the help they need.

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We’re here to help. Know the warning signs of suicide so that youth who might be suicidal can get the help they need.

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Fostering resilience in youth takes all-around support and well-informed communities—something we support through our suicide prevention, intervention, and postvention services

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Suicide Prevention for All Arizona Youth

Fostering resilience in youth takes all-around support and well-informed communities-something we support through our suicide prevention, intervention, and postvention services. Provided by master's level clinicians and adhering to best practice standards, our free prevention trainings decrease risk, increase protective factors, and create resiliency in schools and across communities.

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Prevention Education Services | Teen Lifeline

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Fostering resilience in youth takes all-around support and well-informed communities-something we support through our suicide prevention, intervention, and postvention services. Provided by master's level clinicians and adhering to best practice standards, our free prevention trainings decrease risk, increase protective factors, and create resiliency in schools and across communities.

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The AHCCCS Suicide Prevention page is a comprehensive resource provided by the Arizona Health Care Cost Containment System (AHCCCS) to support suicide prevention efforts across the state. It offers vital information, tools, and crisis resources for individuals at risk, their families, and behavioral health professionals.

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Governor Doug Ducey proclaimed September 2022 Suicide Prevention Awareness Month.

Arizona ranks 20th in the nation for deaths by suicide,

Suicide is the 10th leading cause of death in Arizona,

1,359 Arizonans died by suicide in 2020,

Suicide is the second leading cause of death for Arizonans ages 10-34

On average, one person in Arizona dies by suicide every six and a half hours.

National Suicide Prevention Lifeline: 988

Nacional de Prevencion del Suicidio: 1-888-628-9454

Chat: Suicide Prevention Lifeline Chat

For more information and resources visit azhealth.gov/suicide

Priority Populations:

LGBTQ+ suicide rates are unknown because sexual and gender identity are not reported on death records ¹. Given this gap in data, much of what is known about LGBTQ+ people and suicidal behavior results from self-reported experiences. Many studies report an elevated risk of suicidality among LGBTQ+ individuals regardless of age; however, the risk of suicidal behaviors is highest among teens and young adults 1,2,3. The elevation of suicidal behavior is in part due to bias, discrimination, isolation, and other pressures associated with minority stress ⁴.
Supporting our LGBTQ+ peers can include, but is not limited to:

Advocating for anti-discriminatory policies and laws

Fighting stigma

Providing safe and supportive environments

Improving data collection

Increasing awareness and social acceptance

Learn more here: Find LGBTQ+ Resources here:

Arizona Specific Resources

The Trevor Project

24-hour, toll-free, crisis intervention phone line: 1.866.488.7386

Online, a social networking community for LGBTQ youth (13 to 24 years) and allies

Educational programs for schools

Peer Listening Line

Anonymous and confidential helpline for accessing support from other LGBTQ youth (not specific to suicide): 800.399.PEER

Offers LGBTQ young people a safe place to call for information, referrals, and support with coming out, locating LGBTQ groups and services, safer sex and relationships, and HIV/AIDS.

LGBT Helpline

Anonymous and confidential helpline for accessing support from other LGBTQ people (not specific to suicide): 888.340.4528

Offers information, referrals, and support with coming out, locating LGBTQ groups and services, safer sex and relationships, and HIV/AIDS.

Family Acceptance Project

A research, intervention, education, and policy initiative that works to prevent health and mental health risks for LGBTQ children and youth in the context of their families, cultures, and faith communities.

Provides training and consultation on an evidence-based family model of wellness and prevention and care to strengthen families and promote positive development.

References

1. Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D'Augelli, A. R., Silverman, M. M., Fisher, P. W., Hughes, T., Rosario, M., Russell, S. T., Malley, E., Reed, J., Litts, D. A., Haller, E., Sell, R. L., Remafedi, G., Bradford, J., Beautrais, A. L., Brown, G. K., ... Clayton, P. J. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. Journal of homosexuality, 58(1), 10-51. https://doi.org/10.1080/00918369.2011.534038

2. Mathy, R. M. (2002). Suicidality and sexual orientation in five continents: Asia, Australia, Europe, North America, and South America. International Journal of Sexuality & Gender Studies, 7(2-3), 215-225. https://doi.org/10.1023/A:1015853302054

3. Fredriksen-Goldsen, K. I., & Muraco, A. (2010). Aging and Sexual Orientation: A 25-Year Review of the Literature. Research on aging, 32(3), 372-413. https://doi.org/10.1177/0164027509360355

4. Haas, A., & Lane, A. (2017). Suicide & LGBT Populations (Rep.). Retrieved https://www.datocms-assets.com/12810/1576937561-talking-about-suicide-and-lgbt-populations-2nd-edition.pdf

The majority of those who die by suicide in Arizona are age 65 and older. While there is no one cause of suicide, hopelessness and isolation are often factors. The Area Agency on Aging has an Eldervention Program, including a 24-hour senior help line - 602-264-4357.

For more information: Eldervention Program

What you can do:

Depression is not a normal symptom of aging. If someone in your life is experiencing depression or increased substance use, have a courageous conversation and ask if he/she is considering suicide. Learn the warning signs and how to refer a person to care: How we can all prevent suicide

Check on your neighbors. If you haven't seen an older neighbor or friend lately, stop by and see how he/she is.

Volunteer with seniors in your community. Connectedness and friendship are protective factors against suicide.

Suicide rates are higher for all individuals who served in the military. A US Department of Veteran Affairs report in 2016 found the suicide rate among those who served in the military was significantly higher than the national rate, with the most deaths among those aged 55-74.

Be Connected is a collaborative effort among multiple partners, including AHCCCS and the Arizona Department of Veteran Services, to connect Arizona service members, veterans, families and helpers to information, support, and resources, including a 24-hour help line: 1-866-4AZ-VETS. For more information visit Be Connected.

What you can do:

Recognize those in your life who served in the military are at higher risk for suicide. Learn the warning signs and how to refer a person to care: How we can all prevent suicide

A protective factor for suicide prevention is family and community support. Reach out to those in your life who served in the military.

Volunteer with a veteran service organization. A directory can be found here: ADVS Veterans Service Organization VSO Directory

Resources:

Recognizing depression in teenagers can be difficult. Abnormal sleep patterns and changes in mood are common in teens, but both can be warning signs for suicidal thoughts. Depression in teenagers varies from adult depression. Teenage symptoms that are more common include:

Irritable moods

Unexplained aches and pains

Extreme sensitivity to criticism

Withdrawing from some aspects of social life

Teen Lifeline is an Arizona-based nonprofit that provides a safe, confidential crisis service where teens help other teens to make health decisions: 800-248-8336. Teen Lifeline has resources for teens, parents, and educators on what to do if a teen is thinking about suicide: My teen needs help

LGBTQ teens can speak with a peer through The Trevor Project: 1-866-488-7386. The national organizations provides crisis intervention and suicide preventions services to LGBTQ youth younger than 25. Chat and text features are also available.

AHCCCS has partnered with the Arizona Department of Education on a five-year Project AWARE grant. This project works with school districts and educators to promote mental health and suicide prevention trainings. More information about the project can be found on the Arizona Department of Education Project Aware web page.

What you can do:

Learn the warning signs for suicide among teens and how to refer a person to care: How we can all prevent suicide Volunteer for a community-based organizations working with youth. A strong relationship with an adult can be a protective factor against suicide. Ask your school to participate in the free Teen LifeLine school ID initiative:Arizona School ID Initiative

According to data from the Centers for Disease Control and Prevention (CDC), American Indian/Alaska Natives (AI/AN) have the highest rates of suicide of any racial/ethnic group in the United States. The rates of suicide in this population have been increasing since 2003. i The National Indian Council on Aging reports for AI/AN youth ages 10 to 24, suicide is the second leading cause of death; and the AI/AN youth suicide rate is 2.5 times higher than the overall national average. ii

Arizona is home to 22 diverse tribal nations, and a significant urban American Indian population. We strive to walk alongside tribal partners in their suicide prevention activities.

AHCCCS staff has compiled a list of suicide prevention programs.

The Suicide Prevention Resource Center has a comprehensive approach to preventing suicides among American Indians. This includes:

Promoting culturally competent practices.

Connecting a community or tribe's resources to a shared vision of wellness.

Gathering information from Elders and community members to understand suicide among the community.

What you can do:

Know the cultural risk factors for suicide among AI/AN, a how to refer a person to care: How we can all prevent suicide

Consider making a safety plan for if/when you feel depressed or suicidal. A protective factor for suicide includes having a strong support network. Knowing who to call when you feel depressed or suicidal can help in crisis.

Practice active listening; listening to someone who is depressed or having suicidal thoughts, without offering advice or judgment, is courageous.

Advocate for the importance of suicide surveillance systems, including building relationships with respected community members.

Speak with tribal councils, school boards, and other community leaders about the need for suicide prevention resources.

i https://www.cdc.gov/mmwr/volumes/67/wr/mm6708a1.htm
ii https://www.nicoa.org/national-american-indian-and-alaska-native-hope-for-life-day

Resources by County

Other Tools and Resources:

The foundational belief of Zero Suicide is that suicide deaths for individuals under the care of health and behavioral health systems are preventable. Zero Suicide presents an aspirational challenge and practical framework for system-wide transformation toward safer suicide care. For more information see the Zero Suicide one pager.

Postvention is an intervention that happens after a suicide to provide support for the bereaved. Family and friends of the individual who died by suicide may be at increased risk for suicide as a result. Postvention has been shown to be a successful model of helping provide immediate help and services to those mourning.

For more information: SPRC Comprehensive Approach Postvention
AHCCCS Postvention Guide

Means Reduction:

Additional Resources

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Governor Doug Ducey proclaimed September 2022 Suicide Prevention Awareness Month. Arizona ranks 20th in the nation for deaths by suicide, Suicide is the 10th leading cause of death in Arizona, 1,359 Arizonans died by suicide in 2020, Suicide is the second leading cause of death for Arizonans ages 10-34 On average, one person in Arizona dies by suicide every six and a half hours.

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American Foundation for Suicide Prevention

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American Foundation for Suicide Prevention

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The American Foundation for Suicide Prevention (AFSP) is a national nonprofit organization dedicated to saving lives and bringing hope to those affected by suicide. The website serves as a central hub for education, support, advocacy, and community engagement around suicide prevention.

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American Foundation for Suicide Prevention

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Learn about suicide, how you can help prevent it, and resources for those affected, from the American Foundation for Suicide Prevention. Our mission: save lives and bring hope to those affected by suicide

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The Suicide in Schools (SiS) Model of suicide assessment and management takes you through all the applied steps to conduct ethical suicide risk screenings (universal or targeted), complete comprehensive suicide risk assessments (SRAs), and facilitate appropriate follow up and intervention.

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Suicide In Schools Model - Public Consulting Group

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The SiS Model outlines clear processes that will help schools and districts develop clear and consistent suicide prevention protocols and procedures. The SiS Model was developed based upon extensive research and provides a tool for schools to ensure standardized practices across a school district. The SiS Model has been utilized nationally and internationally by schools and practitioners.

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Columbia-Suicide Severity Rating Scale (C-SSRS)

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Columbia-Suicide Severity Rating Scale (C-SSRS)

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The Columbia Suicide Severity Rating Scale (C-SSRS) website is the official home of the Columbia Protocol, a globally recognized suicide risk assessment tool developed by researchers at Columbia University and affiliated institutions. The site is managed by the Columbia Lighthouse Project and serves as a central hub for information, training, and implementation support for the C-SSRS.

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Just Ask. You Can Save a Life.

The Columbia-Suicide Severity Rating Scale (C-SSRS), the most evidence-supported tool of its kind, is a simple series of questions that anyone can use anywhere in the world to prevent suicide.

Get the Questions

Effective For Everyone

The C-SSRS can be used by anyone, anywhere. The Columbia Lighthouse Project provides the scale in more than 100 country-specific languages for use by:

"The advent of the C-SSRS and its dissemination could be seen as really a watershed moment, like the introduction of antibiotics. [The C-SSRS] has played a comparable role when it comes to mental illness and perhaps its most tragic consequence, suicide."

Former President, American Psychiatric Association

IF YOU OR SOMEONE YOU KNOW IS IN CRISIS, CALL 988

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The Lighthouse Project The Columbia Lighthouse Project

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The Columbia-Suicide Severity Rating Scale (C-SSRS), the most evidence-supported tool of its kind, is a simple series of questions that anyone can use anywhere in the world to prevent suicide. Get the Questions The C-SSRS can be used by anyone, anywhere.

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Advancing policies impacting chronic disease risk factors in AZ and promoting a tobacco free future.

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Solari Crisis Response Network - Arizona Dashboard

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Solari Crisis Response Network - Arizona Dashboard

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American Foundation for Suicide Prevention - Arizona Chapter

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American Foundation for Suicide Prevention - Arizona Chapter

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The Arizona chapter of the American Foundation for Suicide Prevention (AFSP) is a nonprofit organization dedicated to providing education, resources, and support to individuals and families affected by suicide.

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American Foundation for Suicide Prevention

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We bring together people from all backgrounds who want to prevent suicide in our communities. Families and friends who have lost someone to suicide, vulnerable individuals, mental health professionals, clergy, educators, students, community/business leaders, and many others energize our chapter.

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When a teen needs to talk, they often turn to a friend for support. That’s why Teen Lifeline trains teens to talk to other teens about their problems. Our peer-to-peer hotline gives them a safe place to connect with someone they can relate to. Teen Lifeline is a free, confidential, anonymous hotline for teens. Peer Counselors are available by call or text from 3-9pm every day. Thanks to a partnership with Solari, our hotline remains open 24/7.

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Free, confidential, anonymous hotline for teens, answered by teen peer counselors. The hotline is open 24/7/365, with texting & peer counseling 3-9pm daily.

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At Tu Nidito, care, empathy and hope take flight. Their support services are free of charge and available for children, teens, young adults and families who are impacted by a serious medical condition or a death.

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where children, teens, young adults and families find comfort, hope and support while they are grieving the diagnosis of a serious medical condition or the death of a loved one. All programs are offered in English and Spanish, at no cost to children and families.

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Tu Nidito is a safe place where children and families find comfort, hope and support while they are grieving the diagnosis of a serious medical condition or the death of a loved one. Each year we support hundreds of individuals on their grief journey.

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The Mental Health Intercept Model (MHIM) is adapted from the Sequential Intercept Model to focus on mental health and Implements the Mental Health Continuum. The Substance Abuse and Mental Health Services (SAMHSA) created this model to help communities find gaps and resources for those with substance use and mental disorders, and how they encounter the criminal justice system.

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HH4Y MHIM/Toolkit | AZ Youth Partnership

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This page is designed to explain AZYP's Help & Hope for YOUth's Mental Health Intercept Model and ways it can be implemented into communities that need it. According to The State of Mental Health in America 2022, we are currently one of the worst ranked states in America for mental health.

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Billy’s Place is a community in the West Valley that provides comfort and companionship to kids and families experiencing grief—no matter where they are on their journey. Through support groups, special events, and a community of people who ‘get it,’ we help families rediscover moments of happiness without guilt. We nurture these moments as signs of hope for more promising days ahead.

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🧡💜 HIKE FOR HOPE, ROCKING THROUGH GRIEF 2022 REGISTRATION HERE 🏔️🚶🏽‍♀️

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Understanding the issues concerning suicide and mental health is an important way to take part in suicide prevention and help others in crisis. Evidence shows that providing support services, talking about suicide, reducing access to means of self-harm, and following up with loved ones are just some of the actions we can all take to help others.

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Suicide Prevention | Maricopa County, AZ

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Information and resources for suicide prevention in Maricopa County.

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Arizona's Mental Health’s Awakening Website and Resource Hub

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Arizona's Mental Health’s Awakening Website and Resource Hub

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This page provides tools and resources to highlight how you can support mental health and different aspects of wellness that contribute to your overall mental health- like your relationships, school or work environment, physical health, and more.

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Laws Relating to Suicide and its Prevention

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Laws Relating to Suicide and its Prevention

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This page provides an overview of key suicide-related laws in Arizona. These laws are designed to support individuals at risk, provide essential training for educators and mental health professionals, and ensure access to necessary mental health services.

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Arizona is committed to preventing suicide through comprehensive legislation that addresses mental health awareness, education, and access to care. This page provides an overview of key…

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Suicide In Arizona currently ranks 10th among the leading causes of death, down from 8th in 2019. Arizona ranks 35th of 50 states in rate of suicide per 100k of population, up from 42nd in 2020.

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Advancing policies impacting chronic disease risk factors in AZ and promoting a tobacco free future.

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The video resource offers resources to caregivers whose child is struggling with mental health challenges or concerns

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About the Video

Right after a child makes a suicide attempt can be a deeply confusing, scary, and emotional time for parents and families. Understandably, parents may have a lot of questions or concerns. While health care professionals, school leaders, and others may have addressed many questions, often hearing directly from parents who have been there can be especially supportive.

Parents to Parents: After Your Child's Suicide Attempt

For Parents

Hearing that your child is having thoughts of suicide or has made an attempt can be overwhelming. But you are not alone. The parents interviewed for this video have been there and understand. We hope this video offers some practical guidance for the days and weeks to come, but-more importantly-hope. People do get better, recover, and create lives worth living.

The video was created to:

Describe what parents can expect in the days and weeks following a child's suicide-related crisis

Provide information on how to access effective treatment

Offer insights on how parents can best support their child and family

Validate the feelings that can accompany a child's suicide-related crisis

Direct caregivers to additional supportive resources

Making the Most of the Video

The video is approximately one hour. You may want to watch the video in its entirety the first time. However, it is available in chapters for you to return to after that to re-watch specific sections. If you would like to return to specific sections, a playlist of the video that includes chapters is available at the link below.

Post-Viewing Survey

After viewing the video, please complete the survey using the link below. Your responses can help inform us as we work to improve this resource or any future resources. All survey responses gathered here are confidential and will only be shared in aggregate without identifying information when presented anywhere publicly. The survey will take approximately 5 minutes to complete. Thank you in advance for your participation.

For Health Care Professionals and School and Community Leaders

Families, understandably, will have many questions in the days and weeks following a suicide attempt of their child. It can be hard to process and retain all that is being told to them and available resources will vary community by community. This video captures many of the questions raised by parents and describes best practices in suicide care so that parents can best navigate a complex health care system.

By hearing from parents whose child has made a suicide attempt as well as national experts in suicide prevention, parent's feelings are validated and they can be directed to quality care that best supports their child. This video is not meant to replace any care provided in the community, rather, will hopefully serve to augment care provided by health care professionals as parents can return to it again and again.

Making the Most of the Video

Who can disseminate this video?

Emergency departments, inpatient hospitals, residential care, crisis services, mobile crisis units, community mental health providers, pediatricians, schools, substance misuse professionals, peer advocates, faith leaders, anyone who has encountered a family whose child has recently made a suicide attempt or talked about suicide. Add the video link to discharge paperwork and planning or share the link with parents as part of medical or behavioral health care.

Below, we have provided a curated list of supplemental resources for additional support.

Resources

Immediate Services

Crisis Services

If you or someone you know is in suicidal crisis, please call 988. The 988 Lifeline provides 24/7, free and confidential support for people in distress. Assistance is available through this Lifeline number and their website www.988lifeline.org.

The Trevor Hotline provides support for LGBTQ young people. Their trained counselors understand the challenges LGBTQ young people face and are available for support 24/7. Text "Start" to 678-678 or Call 866-488-7386.

Crisis Text Line provides free, 24/7, high- quality text-based mental health support and crisis intervention by empowering a community of trained volunteers to support people in their moments of need. Text "Home" to 741741.

Teen Line provides support, resources, and hope to young people through a hotline of professionally trained teen counselors. Available from 6PM-10PM PST, Call 800-852-8336 or Text "Teen" to 839863.

Resources For Developing a Safety Plan

Stanley- Brown Safety Plan

The Stanley- Brown Safety Plan is a form developed by Stanley- Brown Safety Planning Intervention intended to help individuals develop a plan of action when thoughts of suicide occur. This action plan has users identify triggers, coping strategies, people to help distract them from suicidal thoughts, people to contact in a crisis, professional agencies to contact in a crisis, and plans for lethal means safety.

Pause to Protect

Managing access to lethal means is an important step in developing a safety plan. The Pause to Protect website includes a national map of firearm businesses willing to consider voluntary, temporary firearm storage, along with materials for businesses and customers.

Resources to Support Families After a Child's Suicide Attempt

Suicide Prevention Resources and Support for Friends & Family

Sorting through available articles and research on suicide can be overwhelming. To alleviate some of this burden, CAMS- care has created a collection of articles as a starting point. These articles touch on topics such as identifying risk factors and warning signs, what to expect from calling 988, how to find the right therapist, and tips for parents with struggling children.

After an Attempt: A Guide

From Substance Abuse Mental Health Services, this guide gives families information on what happens during Emergency Department treatment, and how to take care of their loved one after treatment.

Guiding Their Way Back

Beyond Blue, Australia's guide provides resources specifically tailored to support everyday people following a suicide attempt. This resource acts as a starting point for working through the difficult, and at times overwhelming, questions that can arise following an attempt.

Family Life After Attempt

This article by Pepperdine University offers statistics and recommendations aimed to help families navigate life after an attempt. This article addresses topics including ensuring a safe return home, understanding the emotional toll on family members, communicating with your child or teen after an attempt, and getting back to "regular life".

Talking About Suicide With Your Child Under Age 12

This article, written by Dr. John Ackerman, presents parents with steps on how to create a safe place to talk about suicide with their young child. Included is a video of Dr. Ackerman identifying and addressing suicidal behavior in children 12 and under

Loving Someone With Suicidal Thoughts

Written by Dr. Stacey Freedenthal, this book provides guidance on supporting your loved one while also looking out for your own mental health. The book tackles questions such as "What are signs and clues of risk?", "What do I say and do after an attempt?" and "What can I do to cope better?".

Speaking of Suicide

Speaking of Suicide is a curated website dedicated to addressing the complexity of suicide through a variety of posts and resources. Topics covered include what to do if you are thinking of suicide, friends and family support, survivor stories, and professional recommendations.

What to do, What to say

Written by Anne Moss Rogers, this eBook focuses on how to manage conversations regarding suicide, and how to navigate the emotions that come with supporting a suicidal child. The eBook provides script examples on how to initiate a conversation about suicide, what questions to ask the child, and how to build resiliency as you provide support.

Teen Suicide Prevention

In this video from the Mayo Clinic, teens describe common warning signs of suicidal ideation among their peers and encourage direct communication and immediate support and safety.

Helping Kids Who Are Thinking of Suicide

Experts from Nationwide's Children's Hospital's Center for Suicide Prevention Research have compiled a list of things to remember when supporting a child who is thinking about suicide. This resource includes statistics, suggestions for initiating conversation, and tips on how to preserve your own mental health while supporting your loved one.

10 Things to Say to a Suicidal Person

Written by Dr. Stacey Freedenthal and posted to National Alliance on Mental Illness Queens/ Nassau, this post provides ten statements you can say to a person considering suicide, along with the context and rational behind them.

Ideas of How to Talk to Your Child About Suicide

This resource by Anne Moss Rogers highlights important steps and considerations for supporting someone who has shared their suicidal ideation with you. The resource acknowledges the complexities of providing support, and provides tactical and emotional support for the caregiver.

Prevent Suicide: Ask the Question

This article from Seattle Children's Hospital highlights the importance of asking the question "are you thinking about suicide?" and provides parents with knowledge to help them identify warning signs, contact support services, and prevent suicide attempts for their child.

The Adolescent Safety and Coping Plan

The Adolescent Safety and Coping Plan (ASCP) is a safety planning intervention designed for adolescents at risk for suicide and their families. Developed by Kimberly McManama O'Brien and colleagues, the ASCP is tailored for adolescents returning home from hospital level of care (but can be used at any level of care).

Family Connections™ - Managing Suicidality & Trauma Recovery Program

This free course, developed by the National Education Alliance for Borderline Personality Disorder, provides skills and support for parents of children dealing with self-harm or suicidal behaviors. Through this program, parents learn to manage the stress and trauma they experience while supporting their child, as well as how to respond to the child's crisis behavior.

Holding Onto Life Toolkit

Developed by Macomb County Suicide Prevention Coalition, this free toolkit supplies parents with data and best practices for supporting an adolescent with suicidal ideation. This resource addresses the mentality behind suicidal ideation, as well as how to identify signs of suicidality, and how to have conversations about mental health with adolescents.

Resources For The Person Who Made The Attempt

After An Attempt

The American Foundation for Suicide Prevention offers this resource to help people navigate and process their emotions following their suicide attempt. Included are safety plan resources, tips on interacting with family and friends, and reassurance that the attempt survivor is not alone.

Resources for Returning to School

How to Help a Youth Return to School After an Attempt

Created by the University of North Carolina at Chapel Hill Research, this infographic depicts key statistics on youth suicide and offers data driven solutions on how school systems can support returning students.

Emotionally Naked

This book by Anne Moss Rogers and Kimberly H McManama O'Brien, initially intended for school personnel, can serve to inform parents on what schools can and should be doing to held children with suicidal thoughts.

Parent Support Groups and Resources

NAMI Family Support Groups

The National Alliance on Mental Illness (NAMI) provides free, confidential family support groups for families living with mental health challenges. These groups help families support other families in their area through collective lived experience and learned group wisdom.

AFSP Support Groups

The American Foundation for Suicide Prevention (AFSP) has local chapters in all 50 states. These chapters aim to create an informed mental health culture through community programs, educational opportunities, research, advocacy, and support.

Supporting Marriage When a Child Has Major Mental Illness(es)

In this article, the Newport Academy highlights difficulties in a marriage that may come from supporting a child that is suicidal. This resource offers explanations, validations, and solutions to possible problems, and provides tips on how to keep your partnership strong as you support your loved one.

Talking With Children About Their Sibling's Suicide Attempt

Talking to Kids About a Sibling Suicide Attempt by Age Appropriateness

This resource from the United States Department of Veterans Affairs provides age-specific guidance on discussing a sibling's suicide attempt. Divided into "preschool age", "school age", and "teenage" sections, this resource addresses the nuances of suicide discussions based on age and offers helpful tips to ensure that the sibling of the suicide survivor is properly supported.

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Right after a child makes a suicide attempt can be a deeply confusing, scary, and emotional time for parents and families. Understandably, parents may have a lot of questions or concerns. While health care professionals, school leaders, and others may have addressed many questions, often hearing directly from parents who have been there can be especially supportive.

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In 2019, the Arizona State legislature passed ARS 15-120, known as the Mitch Warnock Act, mandating all public school staff be trained in suicide prevention. The statute states that AHCCCS will annually post approved suicide prevention training materials.The law went into effect at the beginning of the 2020-2021 school year and mandates that all school staff who interact with students in grades 6 through 12 must receive suicide prevention training at least once every three years.

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In 2019, the Arizona State legislature passed ARS 15-120, known as the Mitch Warnock Act, mandating all public school staff be trained in suicide prevention. The statute states that AHCCCS will annually post approved suicide prevention training materials.

The law went into effect at the beginning of the 2020-2021 school year and mandates that all school staff who interact with students in grades 6 through 12 must receive suicide prevention training at least once every three years. Per the statute, the training must include:

1. Training in suicide prevention,

2. Training to identify the warning signs of suicidal behavior in adolescents and teens, and

3. Appropriate intervention and referral techniques.

AHCCCS, in coordination with the Arizona Department of Education (ADE) and Arizona Department of Health Services (ADHS), have selected the following school suicide prevention training options for this school year, 2022-2023. School administrators can choose from these suicide prevention training materials as they work toward meeting the statute's requirements.

Additionally, the Mitch Warnock Act stipulates that each school must provide its staff with information on its specific intervention and referral procedures. Jake's Law requires that schools have a policy for behavioral health referrals and a process for obtaining parental consent, and post it on their website. The Arizona School Board Association has created a policy with assistance from AHCCCS and ADE to assist school districts with the statutory requirements for Jake's Law. Once suicide prevention training is provided, school administrators shall provide staff with specific processes and procedures, outlined in their school policy, for crisis intervention and behavioral health referral. Once school staff have been trained in identifying the warning signs of suicidal behavior, it's critical that they know the appropriate next steps to take per each schools unique process. School administrators should also provide information for local resources such as crisis line numbers. Information about the school's referral process and important numbers should be displayed in common areas, such as a teacher lounge, as a constant reminder.

The methodology used to select these materials include the review of The Substance Abuse and Mental Health Services Administration's (SAMHSA) Suicide Prevention Toolkit for High Schools, review of the Suicide Prevention Resource Center for additional gateway trainings, and review of articles addressing cultural considerations, particularly for tribal nations, in suicide prevention. This work was conducted by a third-party contractor.

AHCCCS, ADE and ADHS are currently evaluating additional suicide prevention training materials to exapand this list for the 2023-2024 school year. The updated list is scheduled to be posted here by January 2023. For submissions of curriculum for consideration, BHInSchools@azahcccs.gov.

The Arizona Department of Education provides suicide prevention training for school staff and community members. While the Arizona Department of Education will prioritize the training of school staff, ADE also offers training to community members across the state. If your school or district is interested in receiving training, please utilize the Google Form.

More resources for schools:

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In 2019, the Arizona State legislature passed ARS 15-120, known as the Mitch Warnock Act, mandating all public school staff be trained in suicide prevention. The statute states that AHCCCS will annually post approved suicide prevention training materials.

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The Suicide Prevention Resource Center (SPRC) is the only federally supported resource center in the U.S. solely dedicated to advancing the National Strategy for Suicide Prevention. It provides a wide range of tools, training, and technical assistance to help individuals and organizations develop effective suicide prevention programs and policies.

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The Suicide Prevention Resource Center at the University of Oklahoma Health Sciences Center is supported by a grant from the U.S. Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), under Grant No. 1H79SM083028-03

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We Matter is an Indigenous youth-led and nationally registered organization dedicated to Indigenous youth support, hope and life promotion.

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We Matter is an Indigenous youth-led and nationally registered organization dedicated to Indigenous youth support, hope and life promotion.

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Text HOME to 741741 from anywhere in the United States – 24/7, free, confidential. Crisis Text Line (CTL) is here for you. A live, trained volunteer Crisis Counselor receives the text and responds, all from our secure online platform

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Crisis Text Line | Text HOME To 741741 free, 24/7 Crisis Counseling

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Crisis Text Line provides free, 24/7 support via text message. We're here for everything: anxiety, depression, suicide, school. Text HOME to 741741.

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Ask Suicide-Screening Questions (ASQ) Tool and Toolkit

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Ask Suicide-Screening Questions (ASQ) Tool and Toolkit

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The Ask Suicide-Screening Questions (ASQ) tool is a brief validated tool for use among both youth and adults. Additional materials to help with suicide risk screening implementation are available in The Ask Suicide-Screening Questions (ASQ) Toolkit, a free resource that can help providers successfully identify individuals at risk for suicide. The ASQ toolkit consists of youth and adult versions as some of the materials take into account developmental considerations.

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National Institute of Mental Health (NIMH)

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Overview

The Ask Suicide-Screening Questions (ASQ) tool is a brief validated tool for use among both youth and adults. The Joint Commission approves the use of the ASQ for all ages. Additional materials to help with suicide risk screening implementation are available in The Ask Suicide-Screening Questions (ASQ) Toolkit, a free resource for use in medical settings (emergency department, inpatient medical/surgical units, outpatient clinics/primary care) that can help providers successfully identify individuals at risk for suicide . The ASQ toolkit consists of youth and adult versions as some of the materials take into account developmental considerations.

The ASQ is a set of four screening questions that takes 20 seconds to administer. In an NIMH study , a "yes" response to one or more of the four questions identified 97% of youth (aged 10 to 21 years) at risk for suicide. Led by the NIMH, a multisite research study has now demonstrated that the ASQ is also a valid screening tool for adult medical patients. By enabling early identification and assessment of medical patients at high risk for suicide, the ASQ toolkit can play a key role in suicide prevention.

Background

Suicide is a global public health problem and a leading cause of death across age groups worldwide. Suicide is also a major public health concern in the United States, with suicide ranking as the second leading cause of death among young people ages 10-24. According to the Centers for Disease Control and Prevention (CDC), more than 47,000 individuals killed themselves in 2019 . Even more common than death by suicide are suicide attempts and suicidal thoughts.

Screening for Suicide Risk

Early detection is a critical prevention strategy. The majority of people who die by suicide visit a healthcare provider within months before their death. This represents a tremendous opportunity to identify those at risk and connect them with mental health resources. Yet, most healthcare settings do not screen for suicide risk. In February 2016, the Joint Commission, the accrediting organization for health care programs in hospitals throughout the United States, issued a Sentinel Event Alert recommending that all medical patients in all medical settings (inpatient hospital units, outpatient practices, emergency departments) be screened for suicide risk. Using valid suicide risk screening tools that have been tested in the medical setting and with youth, will help clinicians accurately detect who is at risk and who needs further intervention.

Using an evidence-based clinical pathway can guide the process of identifying patients at risk and managing those who screen positive. Having a pathway to follow will save time and resources when responding to a positive screen. The ASQ Toolkit has several suicide risk clinical pathways that are built on the following foundation:

About the Tool

Beginning in 2008, NIMH led a multisite study to develop and validate a suicide risk screening tool for youth in the medical setting called the Ask Suicide-Screening Questions (ASQ). In 2014 another multisite research study was launched to validate the ASQ among adults. The ASQ consists of four yes/no questions and takes only 20 seconds to administer. Screening identifies individuals that require further mental health/suicide safety assessment.

For medical settings, one of the biggest barriers to screening is how to effectively and efficiently manage the patients that screen positive. Prior to screening for suicide risk, each setting will need to have a plan in place to manage patients that screen positive. The ASQ Toolkit was developed to assist with this management plan and to aid implementation of suicide risk screening and provide tools for the management of patients who are found to be at risk.

Using the Toolkit

The Ask Suicide-Screening Questions (ASQ) toolkit is designed to screen medical patients ages 8 years and above for risk of suicide. As there are no tools validated for use in kids under the age of 8 years, if suicide risk is suspected in younger children a full mental health evaluation is recommended instead of screening. The ASQ is free of charge and available in multiple languages.

For screening youth, it is recommended that screening be conducted without the parent/guardian present. Refer to the nursing script for guidance on requesting that the parent/guardian leave the room during screening. If the parent/guardian refuses to leave or the child insists that they stay, conduct the screening with the parent/guardian present. For all patients, any other visitors in the room should be asked to leave the room during screening.

What happens if patients screen positive?

Patients who screen positive for suicide risk on the ASQ should receive a suicide safety assessment (BSSA) conducted by a trained clinician (e.g., social worker, nurse practitioner, physician assistant, physician, or other mental health clinicians) to determine if a more comprehensive mental health evaluation is needed. The BSSA should be brief and guides what happens next in each setting. Any patient that screens positive, regardless of disposition, should be given the Patient Resource List.

The ASQ toolkit is organized by the medical setting in which it will be used: emergency department, inpatient medical/surgical unit, and outpatient primary care and specialty clinics. For questions regarding toolkit materials or implementing suicide risk screening, please contact: Lisa Horowitz, PhD, MPH at horowitzl@mail.nih.gov or Debbie Snyder, MSW at DeborahSnyder@mail.nih.gov.
Youth Adults*Note: The following materials remain the same across all medical settings. These materials can be used in other settings with youth (e.g. school nursing office, juvenile detention centers).
Emergency Department (ED/ER)
Inpatient Medical/Surgical Unit National Institute of Mental Health Substance Abuse and Mental Health Services Administration
Outpatient Primary Care/Specialty Clinics
Emergency Department (ED/ER)
Inpatient Medical/Surgical Unit
Outpatient Primary Care/Specialty Clinics
Suicide Prevention Resources

National Suicide Prevention Lifeline
1-800-273-TALK (8255)
Spanish/español: 1-888-628-9454

Crisis Text Line
Text HOME to 741-741

Suicide Prevention Resource Center

References

Horowitz, L. M., Snyder, D. J., Boudreaux, E. D., He, J. P., Harrington, C. J., Cai, J., Claassen, C. A., Salhany, J. E., Dao, T., Chaves, J. F., Jobes, D. A., Merikangas, K. R., Bridge, J. A., Pao, M. (2020). Validation of the Ask Suicide-Screening Questions (ASQ) for adult medical inpatients: A brief tool for all ages. Psychosomatics, 61(6), 713-722.

Horowitz, L. M., Wharff, E. A., Mournet, A. M., Ross, A. M., McBee-Strayer, S., He, J., Lanzillo, E., White, E., Bergdoll, E., Powell, D. S., Merikangas, K. R., Pao, M., & Bridge, J. A. (2020). Validation and feasibility of the Ask Suicide-Screening Questions (ASQ) among pediatric medical/surgical inpatients. Hospital Pediatrics, 10(9), 750-757

Brahmbhatt, K., Kurtz, B. P., Afzal, K. I., Giles, L. L., Kowal, E. D., Johnson, K. P., ... & Workgroup, P. (2019). Suicide risk screening in pediatric hospitals: Clinical pathways to address a global health crisis . Psychosomatics, 60(1), 1-9.

Roaten, K., Horowitz, L. M., Bridge, J. A., Goans, C. R. R., McKintosh, C., Genzel, R., Johnson, C., & North, C. S. (2021). Universal pediatric suicide risk screening in a health care system: 90,000 patient encounters. Journal of the Academy of Consultation-Liaison Psychiatry.

Horowitz, L. M., Mournet, A. M., Lanzillo, E., He, J. P., Powell, D. S., Ross, A. M., Wharff, E. A., Bridge, J. A., & Pao, M. (2021). Screening pediatric medical patients for suicide risk: Is depression screening enough? Journal of Adolescent Health, S1054-139X(21)00060-4.

Mournet, A. M., Smith, J. T., Bridge, J. A., Boudreaux, E. D., Snyder, D. J., Claassen, C. A., Jobes, D. A, Pao, M., & Horowitz, L. M. (2021). Limitations of screening for depression as a proxy for suicide risk in adult medical inpatients. Journal of the Academy of Consultation-Liaison Psychiatry.

Thom, R., Hogan, C., & Hazen, E. (2020). Suicide Risk Screening in the Hospital Setting: A Review of Brief Validated Tools. Psychosomatics, 61(1), 1-7.

Lanzillo, E. C., Horowitz, L. M., Wharff, E. A., Sheftall, A. H., Pao, M., & Bridge, J. A. (2019). The importance of screening preteens for suicide risk in the emergency department. Hospital Pediatrics, 9(4), 305-307.

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Ask Suicide-Screening Questions (ASQ) Toolkit

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Ask Suicide-Screening Questions (ASQ) Toolkit

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La Frontera EMPACT is a community behavioral health organization that provides mental health, crisis intervention, suicide prevention, substance use treatment, and family support services to children, adolescents, adults, and families throughout Arizona. Their mission is to help build safer, stronger, and healthier communities by offering comprehensive, accessible services that support emotional well-being and recovery. Services include outpatient counseling, crisis hotlines, mobile crisis response, suicide prevention programs, family and children's services, trauma-informed care, and community education.

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Suicide Prevention Center offers comprehensive crisis and community behavioral health services to children, adults and families. We provide services in Maricopa and Pinal counties with office locations in Tempe, Phoenix, Glendale, Mesa, Apache Junction, San Tan Valley, and the city of Maricopa.