Connection You may have picked up Healing for Healers because you are supporting a colleague who has lost a patient to suicide. Do not forget to offer your unconditional support. I am here for you, you can call me any day anytime if  you want to talk things through or just a shoulder to lean on. Saying something doesn’t make it better, what makes it better is connection. If you have your own story to share, do so without making it about yourself. To be truly empathic one has to reach within...

In the third recap episode for ESF, we cover the STEPS model, the Validity techniques of Shawn Shea, the Narrative method and the B4Now approach from PROTECT.

In conversation with Tracey Chitty, the AWARE framework has been contextualised into the educational setting in this podcast episode. The recap begins with a discussion on rational vs rationalising and then goes into each of the factors: AnxietyWeightingAgendaResourcesExperienceIn particular the agendas of parents and principals are discussed in details. Clearly all parties want the same in terms of a flourishing young person, but their approach might be different and there are different...

A special episode to mark the 10th of September - World Suicide Prevention Day. Humor Heals #LOL @the Sound of Hope provides 3 exercises of therapeutic humour.   Pile ‘o PunchlinesThe Comedy of ComplaintsThe Comedy of ContradictionsIts a collaboration with Mallori DeSalle and Lodge McCammon. By brining humour to one of the most serious of topics, "suicide", they are providing an avenue for people who work in mental health care to fill their cups. Supporting people in suicidal distress over a...

In the second of the Recaps we go through the four chapters in the CORE module and pin down the key messages: Care Compass - Risk vs Recovery - without risk there is no recovery, with the right care the person has more controlOptimise Pain Relief - Dig deep to establish the need and interests that lie beneath the position of dying, help them see that they want to be pain free and our role is to help them be pain free.Risk Rethink - High - Medium - Low are static categories to characterise...

In the first of this sequence of guest episodes with Tracey Chitty, we share ESF's (Hong Kong) whole of school approach to suicide prevention after an intensive four days of training for school counsellors and teachers. In the upcoming episode, we will be summarising the key messages from the training for the attendees to recap what was taught and how they could incorporate into their practice the theoretical constructs they have gained.

A unique perspective to establish common ground between the Health Regulators and the practitioner under investigation is the basis for this episode. It builds on the previous episode of why Health Regulators need to be trained in Suicide Prevention and how Doctors and Nurses and Allied Health are an ultra high risk group when a notification happens. In this episode, Manaan shares how the practitioner considers the Health Regulator to be the problem where as the Health Regulators consider...

Joiner's model of desire and capability is used to explain the high risk period that health practitioners face when they have had a notification to AHPRA (any health regulator for that matter). Manaan explains the training that is on offer for health regulators in this episode. We also take the opportunity to welcome listeners from the English Schools Foundation in Hong Kong as we start a 12 month journey to support 22 schools embellish their suicide prevention pathway through skills...

In the third of the 5 Critical Crisis Conversations, Manaan explores how the person's agenda of ensuring short term safety through admission may be quite different to the long term focus of resilience for the professional. Both want safety but the route to it is different. Being able to show the similarity of the overarching goal amidst the dissimilarity of the immediate outcome is a critical conversation to have with the person in distress. If they are able to understand that the...

The second of the Borderline AWARE conversations relates to Weighting (Diagnosis, Course, Social Causation - how these factors may influence the weighting that we put on a person's suicidality). The conversation is named Empowerment vs Containment. The episode builds on the Advice vs Action conversation and goes a step further providing the listener a thorough understanding of the different approaches to take and when to take those approaches. Based on whether the presentation is acute,...

In this sequence of nuanced conversations, listeners will be guided through some of the most sensitive issues that they will have to navigate while supporting a person in suicidal distress. This episode captures the essence of Advice vs Action. The advice we give - face your fears, applies to us as well when we make decisions regarding whether we admit or not. We must role model the advice we provide to have credibility.  Listeners will learn the in-parts conversation to put on the table the...

Jill presents to the Emergency Department in a suicidal crisis, she has Borderline Personality Disorder and believes that the only way her safety can be maintained is through an inpatient admission. This is not an infrequent occurrence for those working in an ED setting. Dr Kar Ray talks you through the different AWARE factors that can influence the decision you make. Also learn about the criterion for Borderline Personality Disorder in this episode. 

Understanding splitting is essential to supporting people in Borderline Personality Disorder (BPD), particularly when they are in suicidal crisis. In this episode Dr Kar Ray shares some foundational constructs as well as some practical tips that can help a health care professional or even family members provide the most appropriate support. 

Following two days of 7 SAFE Steps training, we caught up with our four professional actors who brought to life Sandeep in the simulations. They are the fabulous 4: Tegan Braithwaite, Charlie Baz, Sami Afuni and Kyra Thompson. This is an opportunistic recording of the debrief and the feedback they provided. 7 SAFE STEPS is a 7 session safety protocol for mental health inpatient wards and community settings. The theoretical underpinning and practical skills are from the PROTECT suicide...

In the lead up to a case study, Manaan delves deep into Personality Disorders and talks about all 10 conditions covering clusters A, B and C in this episode. Cluster A These personality disorders are characterized by odd or eccentric behaviour. People with cluster A personality disorders tend to experience major disruptions in relationships because their behaviour may be perceived as peculiar, suspicious, or detached. Cluster B The cluster B personality disorders are characterized by...

Yvette Bonilla, LMSW, is the Owner and CEO of Suicide Care Consulting Services. She has seen firsthand the fateful effects of the revolving door effect and how it can rattle the lives of clients, the work and motivation of providers, the cost labor for leaders, and the reputation of the hospital system.  Mrs. Bonilla is a thought leader in the suicide care space, a keynote speaker at mental health summits about post-crisis responses, an active contributor to the state of Connecticut Zero...

Building on the qualitative theme of Experience in the AWARE framework is the phenomenon of Creep Crash Crawl. The episode describes how risk taking gradually creeps up due to suicide being a rare event, rare events cause confirmation bias, what I decided clinically was the right decision... This results in a Creep up of risk taking which is inevitably followed by a Crash down of risk taking when an untoward incident happens, after that risk taking Crawls along for a while. Reflective...

Experience is the final AWARE factor. In this episode Manaan explores in detail the different ways in which experience generalises: Experience of the same patient over timeExperience of a diagnostic groupExperience of a demographic groupExperience of supporting people in suicidal distressIn the final half Manaan shares how the professional or personal experience of losing a patient to suicide impacts counsellors, psychologists, psychiatrists etc.

Dr Miguel de Seixas, Head of Psychiatry at Family Medical Practice in Vietnam shares valuable insights from his journey (Cambridge to Saigon). Miguel talks about how Psychiatric practice in Cambridge and Saigon are similar but also different. The foundation of our practice i.e. connecting with kindness and compassion with the pain that the person is suffering with does not change wherever in the world a mental health professional may be. He talks about the impact of COVID and some of the...

Are you eliciting an agenda in the referrer, patient or carer? And whatever you elicit is that impacting the way in which you listen to the person's story i.e. does it affect your clinical decision. Agenda is the third of the five AWARE factors and it was quite obvious that assessors were responding to agendas they perceived, sometimes positively but often negatively as well. Resources is the fourth AWARE factor and rationalizing resource led decisions was a key theme that came out in the...

Episode 16 explores how assessors rate suicidality in different kinds of presentation i.e. weighting. The AWARE study established that the weighting of suicidality could be impacted by: Diagnosis (Personality Disorder and Substance misuse counted for less)Course (Acute trumped acute on chronic, which trumped chronic) Social Causation (Carried less weight than biological presentations)These factors influenced the way in which the professionals would view the person's suicidality and ultimately...

Neurodivergent people in a neurotypical world face unique challenges when navigating a suicidal crisis. The busy, bright, noisy Emergency Department does not serve as a safety scaffolding, if anything could perpetuate the crisis or actually cause a melt down while waiting. Shazzy shares many such insights both from her lived and carer experience as well her quarter century of professional expertise. Shazzy Tharby is a UK trained and credentialed Counselling Psychotherapist and Mental Health...

This episode introduces the listeners to a key concept, the 2 mental spaces in which an assessor operates in an assessment. Rational - facts followed by decision Rationalizing -  decision followed by fact selection Manaan uses a range of practical examples to elaborate decision making processes including Festinger's original research from 1954 and the fascinating story of scientology believers. Listen in :)

Professionals need a good understanding of self before they can understand others. AWARE protects against undue influences in the act of clinical decision making. Intended to make practice safer, its use in clinical supervision or multidisciplinary case reviews should bolster practice by making individuals and/or teams who assess people in suicidal crisis, mindful of the implicit effect of the AWARE factors. The five factors are: Anxiety (generated/diffused in):...