The Way Forward: Pathways to hope, recovery, and wellness with insights from lived experience Prepared by the Suicide Attempt Survivors Task Force of the National Action Alliance for Suicide Prevention July 2014 Suggested Citation: National Action Alliance for Suicide Prevention: Suicide Attempt Survivors Task Force. (2014). The Way Forward: Pathways to hope, recovery, and wellness with insights from lived experience. Washington, DC: Author. 1 This report advances Objective 10.3 of the National Strategy for Suicide Prevention: Engage suicide attempt survivors in suicide prevention planning, including support services, treatment, community suicide prevention education, and the development of guidelines and protocols for suicide attempt survivor support groups. To download a copy of the NSSP, please visit www.actionallianceforsuicideprevention.org/NSSP. 2 Message from the Suicide Attempt Survivors Task Force Co-Leads The newly revised National Strategy for Suicide Prevention, advanced through the National Action Alliance for Suicide Prevention, calls for a new conversation to reduce suicidal actions and death. That conversation is being given a new voice and a new tone by inviting suicide attempt survivors to share their insights on both staying alive and finding hope. The mission of the Suicide Attempt Survivors Task Force of the Action Alliance is to create a resource that would convey the voice of suicide attempt survivors. The untold stories of hope and recovery that belong to attempt survivors are the stories of suicide prevention; what they learned is what we all must learn. With these new voices come new ideas, new questions, and new insights. The Way Forward emerges from those new voices. For far too many years suicide prevention has not engaged the perspectives of those who have lived through suicidal experiences. Because of social stigma and fear, as well as personal shame, a culture of silence prevailed. The Way Forward represents a seminal moment in this field's history; it is an opportunity to benefit from the lived experience of suicide attempt survivors. Many of its recommendations are derived from evidence-based practices, and several are aspirational. All are grounded in the evidence of recovery and resiliency that is clear in the lives of our Task Force members. Viewing suicide prevention through the lens of the eight core values presented in The Way Forward can help us enhance safety while also bringing hope and meaning to those in suicidal despair. It is our hope that The Way Forward will also help serve as a bridge to developing a conversation about suicide prevention between mental health policy makers and consumer advocates. Often, many mental health professionals have narrowly focused on ‘identifying persons at risk and getting them into treatment.’ Conversely, many mental health consumer advocates either avoid or react negatively to suicide prevention discussions, at times due to traumas associated with historically coercive practices and policies. This resource may enable these two powerful forces for change to come together and develop new, more effective approaches to reducing suicide attempts and deaths. Like the Task Force itself, we, its co-leads, bring a range of personal and professional perspectives to these efforts. Through our work together over years, one a survivor of suicide attempts and mental health advocate, the other a psychologist with years of experience working with people in suicidal crisis, we have come to believe that collaboration and understanding are critical. Like all of the partners, colleagues, and supporters that helped to develop this resource, we feel deeply that suicide is preventable. It will be the spirit of collaboration – from policy-makers and advocates to clinicians and clients – that will make suicide prevention possible. We greatly hope that The Way Forward will serve as a model for your new collaborations with others, aligned around a new vision for a world free of the tragedy of suicide. Eduardo Vega, M.A. John Draper, Ph.D. Executive Director Project Director Mental Health Association of San Francisco National Suicide Prevention Lifeline 3 Acknowledgements The Suicide Attempt Survivors Task Force of the National Action Alliance for Suicide Prevention (Action Alliance) would like to acknowledge the significant contributions of many individuals in the development of this unprecedented document, which recommends suicide prevention practices, programs, and policies for saving lives from the perspective of those who have lived through experiences of suicidal feeling, thinking, and acting. First, we would like to thank the primary writer for The Way Forward, Dr. DeQuincy Lezine of Prevention Communities, for his outstanding skills, energy, and thoughtfulness in consolidating vast research along with a wide array of inputs from many stakeholders into this cohesive, highly-readable work. Dr. Lezine has been a leader in advocating for the inclusion of suicide attempt survivors in our field since 1996, and his stewardship in developing this resource has emerged through a combination of his own experience as a suicide attempt survivor and his years of experience as a well-respected professional in suicide prevention. We would also like to acknowledge the important feedback we received from the many insightful experts who were interviewed to provide input about this resource and others who reviewed it (See Appendix E). They helped us prepare The Way Forward for a broad audience including researchers, clinicians, policy makers, advocates, and persons who have lived—or are living—with experiences of suicidal thoughts, feelings and behaviors. In addition, we would like to recognize the extraordinary efforts of the National Action Alliance of Suicide Prevention’s Secretariat, specifically, David Litts, former Executive Secretary, for his support and insightful feedback throughout the process, and Jason H. Padgett, Manager of Operations and Technical Assistance, for his dedicated support, patience and organizational skills in helping our Task Force accomplish responsibilities/activities in more efficient ways. Angela Mark, a Public Health Advisor in SAMHSA’s Suicide Prevention Branch, also lent her valuable time and expertise to this effort in organizing, documenting, and resourcing Task Force meetings. We are also extremely grateful to staff from the Mental Health Association of San Francisco, Center for Dignity, Recovery, and Empowerment, particularly Melodee Jarvis, Suicide Prevention Specialist, and Anita Hegedus, (former) Executive Associate, for support with coordination and communication that aided Task Force efforts in many ways. Finally, we would like to thank our Task Force members (See Appendix B for more detail), whose collective intelligence and passion made this possible. Their individual discoveries of hope and meaning following their suicidal experiences provided the heart and soul of this effort, and now provide a pathway for disseminating hope and meaning for all who read The Way Forward. 4 Suicide Attempt Survivors Task Force John Draper, PhD – Co-Lead, Project Director, National Suicide Prevention Lifeline Eduardo Vega, MA – Co-Lead, Executive Director, Mental Health Association of San Francisco Lilly Glass Akoto, LCSW, Looking In ~ Looking Out, LLC Cara Anna, Editor, Talking about Suicide blog and What Happens Now blog Heidi Bryan, Senior Director of Product Development, Empathos Resources Julie Cerel, PhD, Associate Professor, College of Social Work, University of Kentucky Mark Davis, MA, Consumer Advocate Linda Eakes, CMPS, New Frontiers, Truman Behavioral Health Barb Gay, MA, Executive Director, Foundation 2, Inc. Leah Harris, MA, Communications and Development Coordinator, National Empowerment Center Tom Kelly, CRSS, CPS, Manager, Recovery and Resiliency, Magellan Health Services of Arizona Carmen Lee, Program Director, Stamp Out Stigma Stanley Lewy, MBA, MPH, President, Suicide Prevention Association DeQuincy Lezine, PhD, President & CEO, Prevention Communities Jennifer Randal-Thorpe, CEO, MR Behavior Intervention Center Shari Sinwelski, MS, EdS, Director of Network Development, National Suicide Prevention Lifeline Sabrina Strong, MPH, Executive Director, Waking Up Alive, Inc. CW Tillman, Consumer Advocate Stephanie Weber, MS, LCPC, Executive Director, Suicide Prevention Services of America Staff Support Anita Hegedus, (former) Executive Associate, Mental Health Association of San Francisco Melodee Jarvis, Suicide Prevention Specialist, Mental Health Association of San Francisco Angela Mark, Public Health Advisor, Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services 5 Table of Contents Executive Summary ....................................................................................................................................................8 Introduction ............................................................................................................................................................. 14 Section I: Core Values for Supporting Attempt Survivors ....................................................................................... 16 Part 1: The Core Values ....................................................................................................................................... 16 Foster hope and help people find meaning and purpose in life ..................................................................... 16 Preserve dignity and counter negative