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Table 2 Statements accepted as mental health first aid guidelines

From: Development of mental health first aid guidelines for suicidal ideation and behaviour: A Delphi study

Item:

Round:

Section 1: Identification of suicide risk

 

If the first aider thinks someone might be having suicidal thoughts, they should ask that person directly.

1

The first aider should be aware that if a person is not suicidal, asking them will not the idea of suicide in their head.

1

The first aider should not avoid using the word 'suicide'. It is important to discuss the issue directly, without dread or expressing negative judgement.

1

The first aider should understand that the threat of suicide may indicate that a person is trying to communicate to the first aider how badly he or she feels.

1

If the first aider appears confident in the face of a suicide crisis, it may have a reassuring effect for the suicidal person.

1

The first aider should allow the suicidal person to discuss their feelings. A suicidal person may feel relief at being able to do so.

1

If the first aider clearly states that thoughts of suicide may be associated with a treatable disorder, this may instil a sense of hope for the suicidal person.

2

The first aider should be able to recognise the warning signs of suicide.

2

Section 2: assessing seriousness of the suicide risk

 

The first aider should establish whether the person has definite plans and intentions to take his life as opposed to vague suicidal notions such as "what's the point," or "I can't be bothered going on".

1

The first aider should ask the suicidal person if they have a plan for suicide.

1

The first aider should ask the suicidal person how they intend to suicide.

1

The first aider should find out if the suicidal person has already taken steps to secure the means to end their life.

1

The first aider should ask the suicidal person if they have decided when they will carry out their plan.

1

The first aider should ask the suicidal person if they have been using drugs or alcohol.

1

The first aider should ask the suicidal person if they have ever made a suicide attempt in the past.

1

The first aider should take all thoughts of suicide seriously. The lack of a plan for suicide is not sufficient to ensure safety.

3

Section 3: initial assistance.

 

The first aider must not leave someone who is feeling suicidal on their own.

1

The first aider must keep in mind that they may not be successful in preventing suicide.

3

Section 4: Talking with a suicidal person

 

The first aider should tell the suicidal person that they care and want to help.

1

The first aider needs to allow the suicidal person to talk about their reasons for wanting to die.

1

The first aider should remind the suicidal person that these thoughts need not be acted on.

1

Suicidal thoughts are often a plea for help and a desperate attempt to escape from problems and distressing feelings. The first aider should therefore allow the suicidal person to talk about those feelings.

1

By discussing specific problems, the first aider can help the person work out ways of dealing with the difficulties that seem insurmountable.

1

The first aider needs to find out what has supported the suicidal person in the past, and whether these supports are still available.

1

The first aider should encourage the suicidal person to do most of the talking.

2

The first aider should express empathy for the suicidal person.

2

Section 5: No-suicide contracts

 

The first aider should try to develop a contract with the suicidal person to ensure their safety.

1

Contracts should include 24 hour safety contacts in case the suicidal person feels unable to continue with the agreement not to attempt suicide (such as a suicide helpline, professional helper or family member).

1

Section 6: Ensuring safety

 

No items endorsed.

 

Section 7: Confidentiality

 

The suicidal person needs to be involved in decisions about who else knows about the suicidal crisis.

2

A first aider must never agree to keep the suicidal person's suicidal plans a secret.

2

Section 8: Passing time during the crisis

 

No items endorsed.

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