Hundreds of teachers descended Thursday on Skyview High for the annual MEA-MFT Educators' Conference, an annual training built around two days off of school around the state.
Some learned about teaching science or math. Some examined issues within the profession, like burnout. And some learned about how to help keep students alive.
Montana's suicide rate is shockingly high, almost twice the national average. Those statistics extend to teenagers. In Billings, several high school and middle school students have died by suicide in recent years.
On Thursday, educators learned about a research-based approach known as QPR — question, persuade, refer. The acronym is intentionally patterned after CPR.
“It is meant to be a life-saving intervention, and anyone can do it," said Fredricka Gilje, a former psychiatric nurse and professor.
Both Gilje and Joan Nye are board members of the Montana chapter of the American Foundation for Suicide Prevention and are certified QPR gatekeeper trainers.
Thursday's program is similar to training that some Billings school staffers have received. It started with dispelling some common myths about suicide.
Perhaps most importantly for prevention efforts is creating a widespread knowledge that a suicide attempt can be averted, even if someone's mind appears made up.
"That may be hard for people to believe if they haven't had a program like this," Nye said.
Nor will asking about suicide make anything worse. Research shows that asking someone about suicide makes it more likely they'll eventually get help.
Another myth — that only experts can prevent suicide — has also been proven false, in part by methods like QPR targeted at people without formal training.
"Suicide prevention is everybody's business," Nye said.
How the question is asked matters less than asking it. But there are some tips.
"You set up that question by prefacing it with what you know," Nye said. Reflecting on any warning signs can provide an avenue toward asking about suicide.
For example: "Have you been unhappy lately? So unhappy that you've been thinking about ending your life?"
There is one question structure to avoid — phrasing a question to which "no" seems like the correct answer. For example: "You're not suicidal, are you?"
Several educators shared experiences when they've asked about suicide and struggled to get a clear answer. That's common, Gilje said.
"Both of those impulses (to live and to die) are strong at the same time," when someone is considering suicide, she said.
"What you want from the answer to a question is a clear yes or a clear no. ... You ask the question again and again and again, maybe in different ways."
It's a good idea to practice questions before having the conversation with someone who may show signs of considering suicide, they said. And if you can't ask, find someone else who can.
More than anything, listen to someone who is considering suicide. Don't rush to judgement; listen to problems; and though it may seem counterintuitive, don't list reasons a person has to live.
"This is not a debate with the person," Nye said. "This is about listening to what's going on in their lives and giving them hope."
Persuasion should focus on trying to "get some good-faith commitments" from someone considering suicide, Gilje said.
"It's not easy to persuade somebody to get help," she said.
Any willingness to accept help is a good thing. But some options are better than others.
The best scenario is to physically accompany someone to a place to seek help, perhaps a counselor or hospital emergency department.
The next-best option is to get a commitment from someone that they will accept help in the future.
Getting a commitment from someone that they won't attempt suicide is still a step forward.
One of the most easily available resources is a crisis and suicide prevention hotline and text line. The latter option is especially important for teenagers.
"They're probably more likely to text than call," Nye said.
Cities in Montana are more likely to have physical resources and specialists that can help address suicidal ideations, while rural areas might not have easy access.
“What’s important there is that you form your own teams,” Gilje told educators.
In any case, it's a good idea to follow up with a phone call or visit after a conversation with someone considering suicide.
Educators also should recognize that even with training, they won't stop every attempt or death by suicide.
“Don’t beat yourself up," Nye said, "Unless you didn’t try when you saw something.”
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