Content Warning: The following article contains discussions about suicide and mental health issues. If you’re not feeling great right now or if these topics may be triggering, it’s OK to proceed with caution, skip, or talk to someone you trust. You are not alone.
Utah has been one of the leading states for deaths by suicide for the past decade, especially within teen populations. The most recent health statistics indicate that in 2022, the Centers for Disease Control and Prevention reported 22.1 percent of all deaths in Utah were suicide-related. In 2024, The Trevor Project’s National Survey on Mental Health reported 42 percent of LGBTQ+ young people (ages 13-24) in Utah seriously considered suicide in the prior year, with 11 percent attempted.
These consistently high statistics have led to a push for sucicide prevention trainings like NAMI’s QPR Suicide Prevention Education and Live On Utah’s Suicide Prevention Playbook. QPR trainings have been re-occurring in many organizations, municipalities and communities this spring/summer 2025 season.
QPR stands for Question, Persuade and Refer — the three steps at the core of their suicide prevention training. QPR training asks participants to challenge the myths around deaths by suicide that they may have internalized.
The first myth participants must face is the “no one can stop a suicide” myth. Legally, good Samaritan and bystander laws protect against negative outcomes of intervening. Over 3 million people have gone through QPR training with no reports of lawsuits.
Another important myth that must be debunked pretty quickly during suicide prevention training is “once a person decides to commit suicide … there’s no stopping them.”
“Suicide is the most preventable kind of death. Almost any positive action may save a life,” said DaSheek Akwenye, senior director for Salt Lake Community College’s Center for Health & Counseling.
The first step outlined in QPR training is question. Suicide prevention research warns that people considering suicide will communicate intent within the week before an attempt. That intent is often subtle through verbal, situational and behavioral clues. Question those subtle clues.
Some examples of indirect verbal clues may be: “I’m tired of life,” “Pretty soon you won’t have to worry about me,” and “I just want out.”
QPR training recommends responding quickly to such verbal clues by asking what was meant by the statement and talking about the stigma and/or feeling around it. These conversations are more impactful in private settings with plenty of time.
“It takes some courage to be able to have this type of conversation,” said José Rodríguez Hernández, support case manager.
Some examples of behavioral clues include sleep deprivation or inability to stay asleep; unexplained anger, aggression and irritability; sudden interest or disinterest in religion; putting personal affairs in order; giving away prized possessions; acquiring a gun; and stockpiling pills.
Situational clues may include being fired or expelled, a recent unwanted move, loss of any major relations, sudden unexpected loss of freedom, fear of punishment, and fear of becoming a burden to others.
QPR training recommends asking thought-providing questions about these behaviors and situations to engage in conversations about them — which may challenge another myth around suicide-related death: “Asking about suicide will make the person angry and increase risk.”
Instead, QPR training has found that asking direct questions lowers anxiety and opens up an opportunity for communication — which can help lower the risk of suicide. That may look more direct, like “Are you feeling suicidal now or lately?” or less direct, like “Do you ever wish you could go to sleep and never wake up?”
After questioning warning sign clues, the next step is to persuade. QPR training seeks to answer the question “But how do I persuade someone to stay alive?”
Their answer? Utilizing active listening as a skill set.
Don’t worry, QPR training breaks down active listening skills for those who may not feel confident in their abilities quite yet. Mainly, listen to the problem with full attention, stop and ask clarifying questions, and do not rush to judgment.
“Giving advice is not listening,” Hernández said.
QPR training offers reassurance to ask the direct questions of “Will you go with me to get help?” and “What can we do to keep you safe for now?”
Now, it’s time to move to the third step of refer. QPR training recommends taking a moment to figure out where and how referral will make the most impact, even if that’s getting a commitment from the person to accept help and move toward making those arrangements.
This leads to the final myth participants must challenge when learning about suicide prevention: that “only experts can prevent suicide.” Instead, QPR training asks participants to think about offering support, hearing someone out, and steering them in the right direction to get professional help.
“In every culture, village and social system, there are people who are called upon for times of severe distress,” Hernández said.
QPR training offers reassurance to ask the direct questions of “Will you go with me to get help?” and “What can we do to keep you safe for now?”
Referral may look like setting up conversations with clergy, religious leaders, school nurses, therapists and/or counselors. Hernández encourages that there’s no shame in noticing your own limitations and finding someone who can have these conversations.
“Suicidal people often believe they can not be helped,” Akwenye said. “Any willingness to accept help at some time in the future is a good outcome.”
Some additional pro-tips include:
Think about the use of language. It’s important.
Offer encouragement, such as saying, “I want you to live,” “I’m on your side,” and “We will get through this.”
Come from a place of compassion.
Follow up with a visit, phone call or card.
Develop and foster a culture of care.
“It’s about the time and effort put into listening to someone,” Hernández said.
Additional resources for when you or someone you know needs support:
988 Suicide & Crisis Lifeline:Text or call 988, if you or someone you know is in crisis. The 988 helpline provides immediate emotional and mental health support from trained crisis workers 24/7. www.988lifeline.org
SafeUT Smart Phone App: Download at the Apple Store or download at Google. It offers real-time crisis intervention and a confidential tip line; responds to all chats, texts, and calls. www.healthcare.utah.edu/uni/programs/safe-ut-smartphone-app
Veterans Crisis Line: Call 1-800-273-8255 (Press 1) or text to 838255. It provides confidential help for veterans and their families. www.veteranscrisisline.net
Salt Lake County Crisis Line: Call 801-587-3000. It is operated by the University of Utah Neuropsychiatric Institute 24/7. www.healthcare.utah.edu/uni/programs/crisis-diversion
The Alex Project: Text LISTEN to 741741. It gives all youth in crisis the chance to reach life-saving help via texting regardless of where they live. www.alexproject.org
The Trevor Project: Call 1-866-488-7386. The free 24-hour services are geared toward LGBTQ+ teens in crisis. www.thetrevorproject.org
Utah Suicide Prevention Coalition: It offers crisis counseling, mental health information, and referrals in your county. www.utahsuicideprevention.org
Hope4Utah: It provides hope and promotes change through school programs, community connections and mental health partnerships. www.hope4utah.com
American Foundation for Suicide Prevention: It features training for survivors to facilitate survivor support groups or to get involved in education and advocacy. www.afsp.org.