The Four Steps to
Help Programme
Schools
&
Colleges Edition
MENTAL HEALTH AWARENESS
AND SUICIDE PREVENTION
Presentaon Notes
YOUTH SUICIDE PREVENTION IRELAND
All informaon in this leaflet is provided as an informaon resource about suicide prevenon and research acvies
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care advice.
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The material contained in this leaflet is provided for general informaon purposes only and does not constute care,
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© Copyright Youth Suicide Prevenon Ireland Publicaons Limited 2018. All Rights Reserved. E&OE.
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FOUR STEPS TO HELP PROGRAMME
SUICIDE WARNING SIGNS
If someone is seriously depressed and thinking of aempng suicide there are
oen warning signs that family and friends can pick up on. Nocing and acng
upon these warning signs could save a life. Most people who are considering
suicide are willing to talk about their problems if someone shows they care. Don’t
be afraid of discussing the subject with someone you think may be suicidal. Talking
about suicide won’t ‘plant the idea’ in someone’s head. This is a myth. If you are
wrong, you’re at least showing a friend you care. If you are right, you could save
their life.
Somemes stress or a traumac event like bereavement can trigger suicidal
thoughts in a vulnerable person. For this reason it’s important to ask a friend who
is going through a tough me how they are coping and if they need some support.
Having someone to talk with can make all the difference.
Warning signs can include but are not limited to:
Withdrawing from family and friends.
Having difficulty concentrang and thinking clearly.
Sleeping too much or too lile.
Feeling red most of the me.
Gaining or losing a significant amount of weight.
Talking about feeling hopeless or guilty.
Talking about suicide or death.
Self-destrucve behaviour like drinking too much or abusing drugs.
Losing interest in favourite things or acvies.
Giving away prized possessions.
Mood swings.
IMPORTANT
If a friend menons suicide, take it seriously. If they have expressed an immediate
plan, or have access to prescripon medicaon or other potenally deadly means,
do not leave them alone. Get help immediately.
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YOUTH SUICIDE PREVENTION IRELAND
About the Four Steps to Help Programme
The Four Steps to Help Programme for Schools has been developed and approved by our
Advisory Panel which includes a consultant child and adolescent psychiatrist and has been
deemed to be age appropriate for ages 16+.
These school visits are fully funded by the YSPI School Visits Programme as part of our
outreach work and there is no cost to the school or organisaon to book and host a talk.
The talks we present are based on our own “Four Steps to Help Programme” which is
designed to increase awareness of suicide prevenon and to provide informaon on the
support and resources available to anyone who is concerned about suicide or is concerned
about a friend or family member.
The Four Steps to Help Programme for Schools focuses on providing simple, factual guidance
for suicide awareness and prevenon.
The programme emphasises:
the importance of awareness of sudden changes in behaviour in friends, family or
acquaintances;
Understanding how to recognise the suicide warning signs, as well as signs of other
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FOUR STEPS TO HELP PROGRAMME
mental health issues;
promoon of ‘acve listening’, giving simple listening skills and exercises which can be
used in everyday situaons;
emphasis on making appropriate family members or other adults aware of concerns so
that acon can be taken;
Praccal informaon on dealing with a crisis situaon and how to respond.
We all need to know and understand
that there is always someone that we
can turn to in our life and talk about
the issues facing us without fear of
rejecon if we are prepared to take
the first step.
What is much more challenging is
being prepared to take that first step
for someone else; to face possible
rejecon or ridicule by being
prepared to use the Four Step
Programme to potenally save a life.
But there are so many other problems, surely suicide and mental health
aren’t a priority anymore?
And yet all these crises can increase the chances of mental health issues developing AND
increase the risk of suicide
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YOUTH SUICIDE PREVENTION IRELAND
Ireland has the fourth highest teen suicide rate in the EU/OECD
Well-being of Young People 2017 - UNICEF
Youth Suicide Prevenon Ireland has been working for over 11 years to provide free educaon
and training services to schools and colleges around Ireland. According to the World Health
Organisaon's 2016 report suicide is the 2nd highest cause of death amongst young people
across the World. Sadly Ireland is not spared from this problem which affects almost every
community in the country.
In the European Union during 2015, according to Eurostat, there were approximately 56,000
reported deaths by suicide making it one of the leading causes of death. Males accounted for
43,000 of those deaths or 76%.
According to research by UNICEF published in 2017 Ireland has the fourth highest teen suicide
rate in the EU/OECD region. The organisaon's latest report card on well-being of young people
found that Ireland's suicide rate amongst adolescents aged 15 to 19 was 10.3 per 100,000
populaon and ranks well above the naonal country average of 6.1 per 100,000.
Schools and teachers are so important to the development of personality, social skills and selfworth
in a young person. The WHO states that among the six most important ways of reducing
suicide rates is through School-based Intervenons.
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FOUR STEPS TO HELP PROGRAMME
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YOUTH SUICIDE PREVENTION IRELAND
The Four Steps to Help Programme is a simple introducon to suicide prevenon and mental
health awareness informaon. The talks focus on four steps:
Step 1: Watching
This step focusses on raising awareness of the suicide warning signs and encouraging
parcipants to watch out for sudden behaviour changes in their friends and family members.
Step 2: Showing
This step focusses on showing friends and family members that they can discuss any concerns
with their friend or sibling, and they can turn to parents and trusted adults for support and
advice. This step introduces the Acve Listening skillset and provides techniques and
examples.
Step 3: Asking
This step focusses on simple techniques for asking someone how they are feeling and
encouraging them to talk about their concerns. This step builds on the techniques
introduced in step 2
Step 4: Helping
This step provides guidance on how to help someone you are concerned about and focusses
on geng assistance from a trusted adult or directly from a medical professional. This step
also introduces a crisis scenario and provides informaon on how to deal with the need to get
immediate assistance. This step links to the YSPI FreeText Crisis Informaon service detailed
on the back page of this leaflet.
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FOUR STEPS TO HELP PROGRAMME
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YOUTH SUICIDE PREVENTION IRELAND
PRE-SUICIDAL INDICATORS
Talking about suicide Any talk about suicide, dying, or self-harm, such as "I
wish I hadn't been born," "If I see you again..." and "I'd
be beer off dead."
Seeking out lethal means
Preoccupaon with death
No hope for the future
Self-loathing, self-hatred
Geng affairs in order
Saying goodbye
Withdrawing from others
Self-destrucve behaviour
Sudden sense of calm
Seeking access to guns, pills, knives, or other objects
that could be used in a suicide aempt.
Unusual focus on death, dying, or violence. Wring
poems or stories about death.
Feelings of helplessness, hopelessness, and being
trapped ("There's no way out"). Belief that things will
never get beer or change.
Feelings of worthlessness, guilt, shame, and self-hatred.
Feeling like a burden ("Everyone would be beer off
without me").
Making out a will. Giving away prized possessions.
Making arrangements for family members.
Unusual or unexpected visits or calls to family and
friends. Saying goodbye to people as if they won't be
seen again.
Withdrawing from friends and family. Increasing social
isolaon. Desire to be le alone.
Increased alcohol or drug use, reckless driving, unsafe
sex. Taking unnecessary risks as if they have a "death
wish."
A sudden sense of calm and happiness aer being
extremely depressed can mean that the person has
made a decision to die by suicide.
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FOUR STEPS TO HELP PROGRAMME
SPECIFIC RISK FACTORS IN TEENAGERS
Teenage suicide is a serious and growing problem. The teenage years can be emoonally
turbulent and stressful. Teenagers face pressures to succeed and fit in. They may struggle
with self-esteem issues, self-doubt, and feelings of alienaon. For some, this leads to
suicide. Depression is also a major risk factor for teen suicide.
Other risk factors for teenage suicide include:
Childhood abuse
Recent traumac event
Lack of a support network
Availability of means of suicide
Hosle social or school environment
Exposure to other teen suicides
SPECIFIC SUICIDE WARNING SIGNS IN TEENAGERS
Addional warning signs that a teen may be considering suicide:
Change in eang and sleeping habits
Withdrawal from friends, family, and regular acvies
Violent or rebellious behaviour, running away
Drug or alcohol abuse
Unusual neglect of personal appearance
Persistent boredom, difficulty concentrang, or a decline in the quality of schoolwork
Frequent complaints about physical symptoms, oen related to emoons, such as
stomach-aches, headaches, fague, etc.
Not tolerang praise or rewards
DANGEROUS CALM
Somemes when someone is under tremendous stress they can make very bad decisions,
including the decision to end their own life. In some people making this decision takes away
their pain and anxiety so their behaviours quickly return to normal. BUT their decision is sll
made and that decision can stay dormant for weeks or months!
SO if you are concerned about someone and they seem to recover very quickly, and perhaps
suddenly become very happy and enthusiasc, remember the dangerous calm. Let
someone know you are sll concerned and tell your friends so you can all be vigilant and
supporve.
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YOUTH SUICIDE PREVENTION IRELAND
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FOUR STEPS TO HELP PROGRAMME
TRUE OR FALSE?
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
TRUE OR FALSE
1. People who talk about suicide seldom mean it and can, in fact, be
regarded as low risk to aempt suicide.
2. The fact that someone has aempted suicide once greatly reduces
the risk of a second aempt.
3. Women aempt suicide more oen than men.
4. Suicide now ranks among the leading causes of youth death in the
European Union.
5. Most suicides occur "out of the blue" without any warning signs.
6. Asking someone if they are thinking about suicide will put the idea in
their head.
7. Teenagers rarely aempt suicide, although they may frequently think
about it.
8. Suicide aempts mean a person has ambivalent feelings toward life
and death.
9. Improvement following a suicidal crisis means that the suicidal risk is
over.
10. Suicide is inherited or runs in the family.
11. All suicidal individuals are mentally ill and suicide always is the act of
a psychoc person.
12. The incidence of suicide among the poor and deprived is
substanally higher than among the advantaged.
13. At least half of all people who complete suicide leave notes
explaining their acon.
14. The elderly have the highest rate of suicide for any age group.
Answers are on page 23
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YOUTH SUICIDE PREVENTION IRELAND
SOME MYTHS ABOUT SUICIDE
If I talk to people about their suicidal feelings, it will put the idea into their
heads.
If a person talks about wanng to die that is a sure sign that no suicide
aempt will be made.
If you think about suicide or suicide aempts, you will eventually die by
suicide.
People who think about suicide, aempt suicide or kill themselves are always
mentally ill.
When a person talks about suicide, it's just for aenon and the best thing to
do is to ignore the words.
FALSE !!
FALSE !!
FALSE !!
FALSE !!
FALSE !!
Suicide occurs without warning so there is no way to prevent it. FALSE !!
We can relax once the suicidal person is geng professional help. FALSE !!
The depression has lied and the person seems to be much beer and
happier. This is an indicaon that the person is out of danger.
FALSE !!
People who talk about suicide don't kill themselves. FALSE !!
When teenagers talk about suicide, change the subject and try to get their
minds off of it.
FALSE !!
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FOUR STEPS TO HELP PROGRAMME
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YOUTH SUICIDE PREVENTION IRELAND
WHAT IS “ACTIVE LISTENING”?
"Acve Listening" is simply the offering of friendship by one ordinary human being to
another at a me of crisis or loneliness. An Acve Listener has no professional status or
authority, but is simply a fellow human being who cares. The purpose of Acve Listening is to
listen, accept, care and empathise.
LISTEN
Allowing the person with a problem to express and to talk without being judged.
ACCEPT
Allowing the person to stay in neutral and accept feelings as they are.
CARE
Allowing one human being to reach out to another human being with respect.
EMPATHISE
Allowing the listener to hear where the speaker is coming from and allows us to be sensive
to another's feelings or ideas even when we don’t agree.
The purpose of Acve Listening is not to give advice, instruct, solve problems, or judge. It is
to respect the worth and value of another human being through Listening, Accepng, Caring,
and Empathising.
A GUIDE TO “ACTIVE LISTENING”
It's hard to know what to do when someone you care about is feeling depressed or upset.
You can use the following list as a guide to good Acve Listening:
DO:
Befriend
Consider the possibility of suicide
Focus on the pain
Ask if suicide is on their minds
Get involved
Allow the expression of feeling
LISTEN
Make life an opon
Be non-judgmental
Get help from responsible persons
Stay with the person at risk
Keep details of the story confidenal
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FOUR STEPS TO HELP PROGRAMME
DON'T:
× Lecture or moralise or give advice
× Think it is a passing phase
× Brush off feelings with inane remarks
× Be afraid that you will insl the idea
× Do nothing
× Trample on feelings
× TALK TOO MUCH
× Dare them to follow through with suicide
× React verbally or physically with shock
× Go it alone
× Leave the person alone
× Promise not to tell anyone
WHAT MAKES A GOOD “ACTIVE LISTENER”?
A good Acve Listener is someone who:
Does
listen more than talk
direct the conversaon to the painful
feelings
have compassion for sufferer
risk being foolish
aempt to be available at all mes
remain willing to share another person's
pain
respect confidences
listen
accept
empathise
Does not
× offer opinion or judgments
× belile or minimise concerns
× discuss one's own problems
× give advice
× express shock or surprise
× patronise or probe
× offer platudes and clichés
× make promises that cannot be kept
× interpret, lecture or diagnose
× Say "I know just how you feel."
× fail to pay aenon or care
Remember, a good friend will always tell a trusted adult about someone who is
struggling with a serious problem, is deeply depressed or considering suicide.
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YOUTH SUICIDE PREVENTION IRELAND
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FOUR STEPS TO HELP PROGRAMME
ASKING ABOUT SUICIDE
DO be yourself. Let the person know you care, that he/she is not alone. The right words
are oen unimportant. If you are concerned, your voice and manner will show it.
DO Listen. Let the suicidal person unload despair, venlate anger. No maer how
negave the conversaon seems, the fact that it exists is a posive sign.
DO be sympathec, non-judgmental, paent, calm, accepng. Your friend or family
member is doing the right thing by talking about his/her feelings.
DO offer hope. Reassure the person that help is available and that the suicidal feelings
are temporary. Let the person know that his or her life is important to you.
If the person says things like, “I’m so depressed, I can’t go on,” ask the queson: “Are
you having thoughts of suicide?” You are not pung ideas in their head; you are
showing that you are concerned, that you take them seriously, and that it’s OK for them
to share their pain with you.
DON’T argue with the suicidal person. Avoid saying things like: "You have so much to live
for," "Your suicide will hurt your family," or “Look on the bright side.”
DON’T act shocked, lecture on the value of life, or say that suicide is wrong.
DON’T promise confidenality. Refuse to be sworn to secrecy. A life is at stake and you
may need to speak to a mental health professional in order to keep the suicidal person
safe. If you promise to keep your discussions secret, you may have to break your word.
DON’T offer ways to fix their problems, or give advice, or make them feel like they have
to jusfy their suicidal feelings. It is not about how bad the problem is, but how badly it’s
hurng your friend or loved one.
DON’T blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness
or lack thereof, is not your responsibility.
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YOUTH SUICIDE PREVENTION IRELAND
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FOUR STEPS TO HELP PROGRAMME
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YOUTH SUICIDE PREVENTION IRELAND
What are they thinking? - A Parents’ Guide
This book gives a broad introducon to youth mental health awareness and suicide
prevenon and the state of youth mental health in Ireland today for parents and those
concerned about the welfare of young people in this fast paced, ever-changing world of 21st
Century Ireland.
Order online & we'll deliver to your door. We provide this book to you free of charge but we
do ask for a small voluntary donaon to cover the cost of postage. Your book will be
dispatched to you within 10 working days via An Post. All orders are dispatched in plain
envelopes with no charity informaon visible.
Order at parents.yspi.ie
PAGE 22
FOUR STEPS TO HELP PROGRAMME
www.saythesword.eu
True Or False Answers
1 False 2 False 3 True 4 True 5 False 6 False 7 False 8 True 9 False 10 False 11 False 12 False
13 False 14 True
PAGE 23
FreeText Crisis Assistance is a service of Youth Suicide Prevenon Ireland in associaon with NeonSMS. This
service is provided free of charge and without cost to the user. All informaon provided is in the public domain.
E&OE.
You can also visit ineedhelp.ie at anyme 24/7 for informaon on naonal and local helplines,
naonal and local support groups and safe places near you.
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