About QPR Institute Australia
QPR Institute Australia is the Australian subsidiary of the QPR Institute in the U.S. A key objective of QPR Institute Australia is to increase the uptake of QPR on-line and face-to-face training programs in Australia, thereby equipping Australians with the skills and confidence that will enable them to intervene appropriately to the save the lives of those at risk of suicide.
To save lives and reduce suicidal behaviours by providing innovative, practical and proven suicide prevention training. We believe that quality education empowers all people, regardless of their background, to make a positive difference in the life of someone they know.
The four primary goals of QPR Institute Australia are:
- Raise public awareness about suicide and its prevention.
- Provide low-cost, high-tech, effective, basic gatekeeper and intervention skills training to lay persons who may be able to prevent suicide.
- Provide suicide prevention, intervention and postvention training programs for a variety of professionals and for undergraduate, graduate and post-graduate students preparing for careers in the helping professions.
- Reduce morbidity and mortality of suicide patients, students, and employees through a systems approach to suicide risk reduction that enhances detection of suicide behaviours and those clinical competencies necessary to assess, manage, monitor, and treat patients known to be at elevated risk for suicide behaviours.
What does QPR Mean?
QPR stands for Question, Persuade, and Refer — the 3 simple steps anyone can learn to help save a life from suicide. Just as people trained in CPR and the Heimlich Manoeuvre help save thousands of lives each year, people trained in QPR learn how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help. Each year thousands of Australians, like you, are saying "Yes" to saving the life of a friend, colleague, sibling, or neighbour. QPR can be learned in our Gatekeeper course in as little as one hour, but 90 minutes to two hours is preferred. QPR Gatekeeper Training for Suicide Prevention is listed in the National Registry of Evidence-based Practices and Policies as published by the U.S. Department of Health and Human Service Substance Abuse and Mental Health Services Administration at: www.samhsa.gov.
What is a Gatekeeper?
According to the Surgeon General’s National Strategy for Suicide Prevention (2001), a gatekeeper is someone in a position to recognise a crisis and the warning signs that someone may be contemplating suicide.
Gatekeepers can be anyone, but include parents, friends, neighbours, teachers, ministers, doctors, nurses, office supervisors, squad leaders, foremen, police officers, advisors, caseworkers, firefighters, and many others who are strategically positioned to recognise and refer someone at risk of suicide.
As a QPR-trained Gatekeeper you will learn to:
- Recognize the warning signs of suicide
- Know how to offer hope
- Know how to get help and save a life
How is QPR like CPR?
Both are life-saving interventions
Much of the world is familiar with CPR — short for cardiopulmonary resuscitation — an emergency medical intervention created in 1957 by Peter Safar. The process is designed to stabilize people who aren’t breathing or breathing intermittently and who may be in cardiac arrest until the person can reach a hospital or other care.
Similarly, QPR is an emergency mental health intervention for suicidal persons created in 1995 by Paul Quinnett. An abbreviation for Question, Persuade and Refer, the intent is also to identify and interrupt the crisis and direct that person to the proper care.
Both are part of a "Chain of Survival"
Both CPR and QPR are part of systems designed to increase the chance of survival in the event of a crisis.
In the Chain of Survival model of emergency cardiac care, the likelihood that a victim will survive a cardiac arrest increases when each of the following four links is connected:
- Early Recognition and Early access | The sooner 9-1-1 or your local emergency number is called the sooner early advanced life support arrives.
- Early CPR | This helps maintain blood flow to the vital organs.
- External Defibrillator | A device ready for use when advanced medical personnel arrive.
- Early Advanced Life Support | Administered by trained medical personnel who provide further care and transport to hospital facilities.
Similarly, with QPR, the following Chain of Survival elements must also be in place:
- Early Recognition of suicide | The sooner warning signs are detected and help sought, the better the outcome of a suicidal crisis will be.
- Early QPR | Asking someone about the presence of suicidal thoughts and feelings opens up a conversation that may lead to a referral for help.
- Early intervention and referral | Referral to local resources or calling 1-800-Suicide for evaluation and possible referral is critical.
- Early Advanced Life Support | As with any illness, early detection and treatment results in better outcomes.
We cannot overemphasize the need for early recognition of suicide warning signs.
A well-executed, strong and positive response to the early warning signs of a pending suicide event may render subsequent links in the Chain of Survival unnecessary. Most people thinking about suicide are suffering from an undiagnosed and/or untreated mental illness or substance abuse disorder for which excellent treatments exist.
The prompt recognition of the scream of a smoke detector can eliminate the need to suppress a raging fire. In just that way, by recognizing early the warning signs of suicide, opening a supporting dialogue with a suicidal person and securing consultation a professional may prevent the need for an emergency room visit or psychiatric hospitalization.
Often times, the simple offering of hope and social and spiritual support can avert a suicide attempt entirely.
Different Crises, Different Warning Signs
In CPR, the general public is educated about the classic signs of a heart attack: pressure, fullness, squeezing and pain in the centre of the chest, sweating, and other symptoms, and then taught how to respond.
In QPR the general public is educated about the known warning signs of a suicide crisis: expressions of hopelessness, depression, giving away prized possessions, talking of suicide, securing lethal means, and then taught how to respond.
Who needs Training?
In short, the more people trained in QPR, the more lives saved.
Suicide is one of the most critical health concerns, both in Australia and on a global scale. In 2015, over 3000 Australians died by suicide. For every suicide death, as many as 25 individuals will attempt suicide, and for some communities, such as Aboriginal and Torres Strait Islanders and LGBTI people, rates of suicide attempts and deaths are even higher.
Over the past decade in Australia, there has been a 20% increase in the number of suicides and suicide is the leading cause of death for Australians aged 15-44.
We also know that suicide rates of Aboriginal and Torres Strait Islander people are at least twice that of non-Indigenous Australians, and that while women make more suicide attempts, 75% of suicides are by men.
Some people in the community are particularly vulnerable, for example men aged 18 to 24 who have previously served in the Australian Defence Forces are twice as likely to die by suicide as men of the same age in the general population. The bereaved by suicide are up to eight times greater the risk of suicide than the general population.
Other workforces with higher risk of suicide can include those working in agricultural, transport and construction and health sectors.
Clearly, the need for QPR training across the community is very high.
You may know someone who has made a suicide attempt, or may even know someone who died by suicide. It is likely you know someone who has thought, or is thinking, about suicide.
If you are a professional caregiver, police officer, fireman, coach, teacher, youth leader, paramedic, school counsellor, case manager, volunteer or paid staff in any of a hundred different kinds of organisations, you very likely have had first-hand contact with someone who has contemplated suicide. We can all become gatekeepers.
The city of Seattle, Washington and surrounding King County has trained more citizens in CPR per capita than any other region in the country. As result, CPR-trained citizens are more likely to respond to perceived medical emergencies in Seattle than in any other city in the United States, which leads to more favourable survival rates. The percentage of people who survive a non-hospital cardiac event in most cities in the world range from 5 to 10%. But in Seattle the survival rate is 62%.
According to Sanddal and his colleagues (Sanddal, 2003), "In the Seattle cardiac care system it is estimated that one in four persons has been exposed to CPR training. One can conjecture that the recognition of, and survival from, an acute suicide event would be more likely if one in four persons were trained as a suicide lay gatekeeper."
Because of the nature of suicidal warning signs, and who is most likely to recognize and respond to them, we at QPR Institute Australia strongly concur with the goal of one in four persons trained a basic gatekeeper role for suicide prevention in Australia. Because suicides happen in families – where emergency interventions are more likely to take place — we believe that at least one person per family unit should be trained in QPR.
How did QPR Institute begin?
Following a productive, three-year joint effort between Spokane Mental Health, Spokane Regional Health District, and the founder to launch a national suicide prevention training program, the Institute became an independent organization in July of 1999. In the early and developmental years, the QPR concept and associated training program that eventually lead to the founding of the Institute enjoyed considerable support and input from a wide variety of organizations and professional colleagues.
For moral support in the early going, we especially wish to honour, thank and recognize two groups of very special people who share our vision and mission. Both grassroots survivor of suicide organizations, Suicide AwarenessVoices of Education (SAVE) and the Suicide Prevention Advocacy Network (SPAN USA) provided that all essential spark of encouragement that keeps hope alive and all of us working even harder to bring about the reality of preventing suicide.
We also wish to thank members of the American Association of Suicidology for their contributions to the ideas, research and development of our suicide risk reduction tools and protocols.