Our Core Beliefs
Our core beliefs about suicide and its prevention have guided us throughout our history. These core beliefs have evolved through research and experience, and they underpin all LivingWorks philosophy and training. We hope that sharing them will prompt others to examine their own attitudes toward suicide. Beliefs about the nature of suicide and how to prevent it are diverse, and our workshops reflect this by providing flexibility to explore and validate individual attitudes and experiences.
Here are LivingWorks Education’s core beliefs about suicide and its prevention. Click on each one to jump to the detailed description and learn more:
1) Suicide is a community health problem
We believe that suicide is an issue for the entire community. We invite those with social, public, and mental health perspectives to join this broader approach. Everyone who wants to help is should be welcome. Throughout modern times, many so-called "ordinary" people have made anything-but-ordinary contributions to suicide prevention. We don’t believe that suicide prevention should be an exclusionary activity limited to any one group. To make suicide one group’s territory is to further stigmatize it by implying that suicide is so special, dangerous, or unusual that only some can deal with it. Such a restriction also reduces the range and number of people who could help prevent suicide. As a universal human problem, suicide should not be the domain of any one discipline or viewpoint—we need everyone, working together, to prevent suicide in the community.
2) Thoughts of suicide are understandable, complex, and personal
Virtually all people will think about suicide at some point in their lives. All indications suggest that it is simply part of being human. At LivingWorks we do not see suicide as abnormal, nor do we regard it as an illness. However, our view that thoughts of suicide are understandable does not mean that we accept suicide as just another way humans can die. We also believe that part of being human means wanting to prevent understandable thoughts from becoming tragic actions.
Suicide is also very complex. We are biological creatures who think. Neither the body nor the mind is well understood, and the interaction between the two is even less so. It is clear that the two influence each other in various ways, and that thoughts of suicide are surrounded by feelings and often impacted by chemical changes.
Suicide is complex in another way: individual people have thoughts of suicide—people with unique lives, influences, disappointments, reactions, hopes, and dreams. They all have different stories to tell. We believe that there are as many reasons for suicide as there are people who are thinking about suicide, and this means that each situation is unique and deserving of its own consideration.
3) Suicide can be prevented
Thoughts of suicide are dangerous, and everyone who experiences them should be taken seriously. Regarding one person’s thoughts of suicide as more serious than another’s are almost as dangerous as suicide itself. This does not mean that everyone at risk needs the same help—safety plans should be tailored to minimize the risk factors that apply to the particular person at risk.
We are optimistic about the prevention of suicide. While preventing thoughts of suicide may be difficult if not impossible, preventing those thoughts from becoming suicide actions is achievable. We believe that almost all people at risk actively invite help and retain a desire to live, even if they feel out of touch with the goals and forces that inspire them to keep living. In other words, people at risk are ambivalent about suicide.
We also believe that a person’s capacity to actively hold suicide as an immediate option is almost always temporary. Once a caregiver has prevented the immediate risk of suicide, it is often averted for a long time—maybe for a lifetime. To have thought about suicide and turned away from it can make it clear that everyone has a choice, including the choice to live life fully.
4) Help-seeking is encouraged by open, direct, and honest talk about suicide
We believe that all forms of help-seeking about suicide need to be encouraged. A person at risk is far more likely to reach a decision to live when they are in the company of a caregiver who is comfortable talking about suicide. The simple yet profound first approach to anyone at risk should be “let’s talk.” That fundamental message establishes the disclosure of suicide thoughts as a potential new beginning, a place where turning points can be found.
Help-seeking is also supported by awareness of, and access to, the many kinds of resources that can provide help. Crisis hotlines, caregivers whose roles are recognized by the community, and people with effective suicide intervention skills are some of the key resources needed to make help-seeking credible and worthwhile. People who inform or teach others about suicide—such as LivingWorks trainers—should also be able to engage in open, direct, and honest talk about suicide. This is important in case someone attending the training is at risk of suicide or knows someone who is.
It is also important to keep in mind that punishment as a means of preventing suicide has not worked, either historically or in modern times. Removing or restricting someone’s privileges, except in the specific context of a suicide intervention, is ineffective as a prevention measure. Similarly, linking suicide with mental illness further stigmatizes both of them and implies a link that is not always accurate. Finally, if someone does die by suicide, there is no reason their life cannot be celebrated as a whole, apart from the suicide itself. Punitive and stigmatizing attitudes about suicide only undermine the open, direct, and honest talk that encourages help-seeking.
5) Relationships are the context of suicide intervention
Relationships are central to understanding and preventing suicide. Measures that account for all of the most common “warning signs” known to be associated with suicide continue to falsely identify many people who are not at risk (false positives) and miss many of those who are (false negatives). The best way to identify individuals at risk is to ask them directly: “Are you thinking about suicide?” Having a relationship with a person at risk, or creating one through open talk about suicide, builds the trust that makes it possible to find out in no uncertain terms if that person is experiencing suicide thoughts.
Why people think about suicide or act upon those thoughts is far more likely to differ among individuals than it is to be similar. Establishing a relationship with a person at risk is the best way to more fully understand what their reasons are. By allowing a person at risk to talk openly about suicide with someone who cares, these relationships also counteract the most consistently dangerous risk factor: being alone with thoughts of suicide.
6) Intervention should be the main prevention focus
There are many important components of an overall suicide prevention strategy, including prevention (aiming to avert thoughts of suicide or prepare for them in the future), intervention (aiming to prevent suicidal thoughts from becoming suicidal actions), and postvention (aiming to prevent future suicidal thoughts or acts for those impacted by suicide).
Given the current base of knowledge about reducing suicidal behaviors, we believe intervention should be a community’s main suicide prevention focus. A one-on-one relationship between a person at risk and competent helper represents the best chance of creating a life-saving or life-altering change. This is because people who are at risk of suicide are the ones with the most interest in staying alive, even if they do not immediately recognize it. Once they do recognize that they may want to live, their need to do something to protect life is immediate. It is not about something that might happen in the future. It is literally about saving their lives right now.
We believe that the intervention context provides the right moment to help people at risk discover new energy and protect themselves against the life-threatening danger of suicide. We can hope for a time when our collective knowledge of suicide prevention and life-promotion will mean that suicide thoughts hardly ever occur and interventions are rarely needed. For now, a more realistic hope is that effective suicide interventions are available to people at risk.
7) Cooperation is the essence of intervention
We believe that, for a person at risk, involvement in decision-making is critical to the success of an intervention. If the person doing the intervention knows how to provide the leadership and direction to uncover it, there is a wealth of potential for cooperation in those at risk. Every attempt should be made to obtain the consent and cooperation of the person at risk. When a person at risk lets a caregiver know or find out about their suicide thoughts they are, in effect, giving the caregiver permission to help them stay alive. In this way, almost all of a caregiver’s actions are those of cooperation and consent with the person at risk.
8) Intervention skills are known and can be learned
We believe that effective intervention processes can be documented, practiced, and taught to others. At the same time, community members in various roles need different sets of skills to ensure that all people at risk can receive help. It is also important that these community members be able to communicate effectively with one another. To prepare such a community of helpers requires more than one learning experience about suicide intervention, and these experiences need to be integrated so that participants have a shared vocabulary.
Currently, LivingWorks offers five interrelated programs. safeTALK, ASIST, and suicideCare each offer a unique intervention skill set, linked by a common framework and layered to address increasing levels of helping competency. suicideTALK and esuicideTALK are suicide awareness programs that encourage participants to take further steps toward suicide prevention activities.
All of our learning experiences share common learning elements:
- Theory and content consistent with leading knowledge of education and suicide
- Opportunities to explore experiences and attitudes about suicide in a respectful and reflective atmosphere
- Exposure to a conceptual model that is comprehensive, elegant, easy to use, flexible, and practical
- Opportunities to examine and practice using the model in an atmosphere that is both challenging and safe
Designing learning technologies that share a common intervention framework, include layered participant outcomes, and incorporate active learning processes is not simple. We don’t believe that it is enough to simply illustrate an intervention model. Suicide awareness programs, trainings that are entirely media-based, or programs using largely lecture-style methods cannot produce caregivers who are willing, ready, and able to help prevent the risk of suicide. Opportunities to practice in an environment that encourages mastery and success without sacrificing realism are required.
9) Large numbers of people can be taught intervention skills
We believe that with the right approach and learning technology, almost everyone, regardless of professional qualifications or experience, can learn intervention skills. This means that there is potentially a very large pool of people who could help to save lives from suicide.
To keep the costs of teaching manageable, local trainers are taught the various programs through Training for Trainers (T4T) and they then cascade intervention skills into the community. To ensure that these “cascaded” presentations provide the same skills to the different groups of participants attending them, the programs need to be standardized. To ensure communication among caregivers, training should also feature meaningful language and concepts understandable by everyone. There must also be standards of quality, and periodically the material must be updated to reflect new developments. LivingWorks exists to fulfill all of these roles, providing a central agency that supports efforts to bring intervention skills to large numbers of people around the world.
10) Evidence of effectiveness should be broadly defined
The evidence-based approach to informing policy decisions and best practices is making its way to suicide prevention. On the one hand, we welcome the new research efforts that such a view might encourage and the new information that might result. On the other hand, we hold that the evidence-based movement must be tempered by one fundamental caveat: many important questions regarding complex social problems are unlikely to be testable using even the most rigorous research approaches. A broad view of evidence and effectiveness is needed.
It is possible to evaluate the results of individual programs, and numerous studies have found that LivingWorks programs are effective at preparing caregivers and improving outcomes for those at risk. It is even possible to track suicide rates in a certain area or community after the implementation of suicide prevention initiatives. Studies have shown that LivingWorks programs contribute to lower suicide rates in areas where they are widely implemented. Ultimately, however, when it comes to a phenomenon such as suicide—which means something different to each person, and which is underscored by countless social and cultural factors—it can be difficult to draw precise conclusions.
To fully understand the effectiveness of a program or prevention initiative, we believe a wide range of factors must be considered: effective dissemination of skills, program transferability, caregiver preparedness, retention of knowledge, and outcomes for people at risk are but a few. Anyone wishing to evaluate LivingWorks programs is encouraged to contact us for more details.
Beliefs and hopes
Our core beliefs sustain our hope that suicide-safer communities are possible. As these beliefs find expression in the community through our programs, we envision benefits that will live on:
- Suicide will be less of a community health problem.
- Suicide will be better understood.
- Suicidal behavior will be reduced.
- Help seeking will be more common.
- Relationships will be strengthened.
- More attention will be focused upon life preservation and promotion.
- Cooperation will grow. Intervention skills will be widely known and used.
- Large numbers of people will be taught intervention skills.
- More research funds will go toward exploring fundamental questions about suicide.