Suicide first-aid – a useful life skill? HSE ASIST training …

Following my last post over on Facebook, I’ve just registered with the HSE to complete their ASIST (Applied Suicide Intervention Skills Training) course. Though not highly publicised, it’s a free, two-day interactive workshop in suicide first-aid which trains participants to reduce the immediate risk of suicide and increases the support for a person at risk.

ASIST

The issue of  our high suicide rates is always simmering away in the background, but it feels like recently, frustration with our mental health services, and increasingly, the difficulty in accessing treatment is starting to reach boiling point, as more and more people tell their story. There was the horrific death of Caoilte O’Broin, whose family had so desperately tried to get him the help he needed, only to meet frustration and closed doors at every turn, the tragic death of Stephen Byrne, and of course the dreadful loss a while back of Sharon Grace and her little girls, not to mention the loss of Una Butler‘s family. And of course Bressie’s impassioned appeal to the Oireachtas Joint Committee on Health and Children to address the “epidemic of our generation”. I could go on; these are just a handful of examples.

Dealing with service issues can be fraught, frustrating and there are many problems to be navigated, not least the question of the involvement of families in mental health treatment, and the terrifying barriers to treatment that exists when a person, such as Caoilte, has a dual diagnosis.

I therefore feel, that for as long as we live in a country where equity of access to well-resourced, timely, affordable, holistic, compassionate, recovery-led mental health treatments is at present, a distant aspiration, we need to start equipping ourselves to better deal with the reality around us. That reality is that approximately 500 people annually in this country lose their lives to suicide. While our government has an obligation to step up to the plate, I can’t – won’t – accept that there is nothing we ourselves can do as a society to try and change this.

Prevention strategies have their place when it comes to addressing suicide; however, we can all sit at any point on the mental health spectrum at any time, and sometimes, it’s emergency intervention that’s needed. While we have become very, very good at telling people in distress that they should “seek help” or “talk to someone”, if someone did exactly that and told you they were considering killing themselves, would you know what to do? Would you feel confident you could help?

I know I wouldn’t.

According to the HSE, the ASIST workshop encourages honest, open and direct talk about suicide as part of preparing people to provide suicide first aid, and helps participants understand what help and support people in crisis might need. But it aims to instil a confidence in dealing with crisis situations that may just save a life. ASIST workshop places are limited, they say, therefore preference must be given to participants who are likely to come into contact with someone who is at risk of suicide in their daily lives. Given our current suicide rates, that could be any of us.

See how I got on.

Further Information

  • Training dates: Regular trainings are scheduled around the country – you can find more information on these by contacting your Regional Resource Officer for Suicide Prevention at the following link. http://www.hse.ie/…/resour…/officers_suicide_prevention.html
  • Cost: ASIST training is free. You just need to register in advance.
  • Who can take part? Anyone can partake in ASIST training, but it is particularly suitable for all kinds of caregivers – health workers, teachers, community workers, Gardai, youth workers, volunteers, people responding to family, friends and co-workers. he course can be intense, and it’s not recommended for people who may have lost someone to suicide or have been recently bereaved.

Download the ASIST leaflet 

Other mental health training resourses from the HSE National Office for Suicide Prevention

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Our broken health system

This article was first published in The Mayo News on 19th January 2016.

Raising your voice to an overworked nurse in the middle of the A&E department, teeming with patients, crammed with beds and trolleys; that sounds like a pretty obnoxious thing to do. Yelling at her as she tries to do her job sounds like the height of ignorance. But when you’re sitting in the waiting room and a relative calls you from inside the emergency department to tell you they urgently need your help, it means something’s not quite right.

Everyone knows A&E is a busy spot. But in our visit over Christmas, a result of a respiratory illness, my relation was seen surprisingly quickly. In the midst of their assessment, they suffered a severe asthma attack. They were helped to a small room at the back of the department and sat in a chair, with the promise of relief to come via a nebuliser, a device that uses oxygen to break up a liquid medical solution to deliver relieving medicine directly to the lungs. They were left alone. As the minutes passed, they started to feel faint, as they struggled to get air into their lungs. And no-one returned.

So when my phone rang, I knew something was amiss. Confused, by the time I made my way into the department – where I wasn’t technically meant to be – and located them, their distress was evident. Although I tried to appear calm, it was obvious that help was urgently needed.

I ran to seek assistance from someone – anyone. I hijacked a nurse, already occupied, and begged her to help. And when she started asking perfectly reasonable questions like the patient’s name, the location of their file, the identity of the original nurse, panic got the better of me. And I raised my voice to that nurse. That tired, overworked nurse near the end of a long shift, trying to do her job in what can only be described as horrendous conditions – to yell at her to forget the files and to please, just help, right now.

And she did, without batting an eyelid. And within seconds the oxygen was flowing, and with it, a tiny bit of relief amidst the chaos. The blood returned to all our cheeks. We thanked her profusely.

As we waited in the room for a doctor to arrive, both trying to calm ourselves, I got my bearings. I went to find water, and the corridors strewn with people on trolleys. One man was starving, he said. No food for hours. In the waiting room, the coffee machine was broken, the snack machine was broken and the toilets were out of order. There was nowhere to get a bite to eat.

 Across the way lay an elderly gentleman in a gown. “When will the doctor see him, do you think?” asked his wife. “I’m afraid there are eight other people ahead of him,” said the nurse apologetically, “that need attention more urgently.”

patients on trolleys

When the doctor arrived, he was young and gentle and tired. Sensing our distress, he spoke in soft and reassuring tones, explaining what he was going to do and why. And we started to feel safe again.

And the mystery of why the original nurse didn’t return, or administer oxygen when all the equipment was right there in the room, was never solved, because it didn’t matter, and because I didn’t trust myself not to raise my voice again. Maybe someone else needed attention more urgently. Perhaps, with a hundred other things on her plate in the midst of that madness, she just forgot. Nurses are human too.

I chatted with the porter as he wheeled the trolley down to the deserted X-ray department. “I love coming down here for a bit of a peace and quiet,” he said. “That place”, he gestured, “is like a zoo.” A doctor had been assaulted in a row earlier in the day, he said.

We were lucky. After treatment, we escaped in a matter of hours. I drove back down the road feeling fortunate to have a passenger. I wondered what would have happened had I not been there. Perhaps it would have been fine. But perhaps not, and that’s the thing.

They say this is a country in recovery. But its health system is very ill.

Patients deserve – at the very least – to feel safe in A&E. To know they are getting the best possible care, not to feel at the mercy of an overcrowded system. Medical professionals – among them many unsung heroes – deserve to feel safe and have sufficient resources to work to the best of their ability.

And none of them deserve to be yelled at while doing their jobs.