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Each year, September is designated National Suicide Prevention Awareness Month, which includes World Suicide Prevention Day on September 10.  A multitude of events and observances during this time demonstrates that there are so many movements throughout the world continuously addressing and trying to combat the public health crisis of suicide.

Dealing with suicide requires listening to stories. So often those stories are riddled with self-doubt, shame, unmet expectations, bitter loneliness and the overwhelming sense that things will never be ok. Sometimes we silently agree that the story is too painful to hear, and too burdensome to tell, so we just keep walking past each other. But that’s the challenge – stopping, listening with such empathy and understanding that a person literally standing at the edge of their own existence pauses long enough to look back – to take a chance – and trust that you want to hear about their darkness. 

QPR (Question, Persuade, Refer) is one of a number of suicide prevention curriculum offerings available in the U.S., and it’s the one used at KidsPeace.   QPR was created by Paul Quinnett in 1995 as an emergency mental health intervention. It was first offered in Spokane, Washington; after a three-year partnership with Spokane Mental Health, the QPR Institute was formed in 1999. Anyone – and not just a mental health professional – can be trained as a QPR gatekeeper (a person with the knowledge and training to utilize the Question, Persuade, Refer intervention) in as little as one hour. 

QPR starts with knowledge – learning the seriousness of suicide as both a personal and public health crisis. The statistics are sobering, and certainly remind us about the importance of paying attention to warning signs. (For example – in 2019, there were nearly 2 ½ times the number of suicides than there were homicides). When we consider these statistics, we may be more likely to wonder why someone jokes about killing themselves each time a friend doesn’t answer a text, or how come someone keeps to themselves so much more these days, even after some of the pandemic restrictions have lifted and being with other people is OK again.  

Armed with these insights, we ask the Question – “Are you OK?” “You haven’t seemed yourself lately,” “I’m worried about you,” “Do you ever think about suicide?” “I’m worried that you’re thinking about killing yourself.”  Here is where the story begins. We listen, without interrupting or debating whether what the person believes or feels is “right” or not. We keep listening, without offering an easy solution to their most complex problem. We hear the story that is their hardest to tell, because they’re not the hero in their story. They’re not saving the day and they believe they’re out of options. 

Persuading someone (the second step of QPR) is not about convincing someone not to think about suicide. It’s about persuading that person to consider staying alive until they can get help, consider that their lives changed from just a few minutes ago. This is where the hope begins: one person listening to the story another person tells. We can change their lives in that moment from “no one cares” to “this person is listening to me,” “this person is trying to understand what is happening to me,” and “this person is not blaming me for what has happened or judging me for what I’ve done.” Maybe…

Then the last piece – Refer. We join their story. We talk with them on an inpatient unit. We go with them to their parents’ house, and sit with them while they tell their mom how awful things have been. We wait with them at the Emergency Room for an evaluation, and possible hospitalization. We help them find the number to that therapist they were always going to call and encourage them to take that first available appointment. 

Their story doesn’t automatically have a happy ending. Hear enough people’s stories and you know the hero doesn’t always win – and the ending isn’t always happy. But, armed with the tools to see where a story needs to be told, to listen to that story and join the next chapter as the person finds their way back from that edge, we can all find the next important chapter of our own story. 

For more information about the QPR Institute, visit For more information about becoming a QPR Gatekeeper, email, with the subject line: QPR Gatekeeper training. 

IMPORTANT: if you or someone you care about are thinking of suicide or self-harm, please call 911 or the National Suicide Hotline at 1-800-273-8255.

Jessica Racine

Jessica Racine

Jessica Racine, MS, LPC, NCC, is Clinical Training Manager at KidsPeace.