1 00:00:00,000 --> 00:00:02,125 AMBER BALDET: I'm Amber Baldet, 2 00:00:02,125 --> 00:00:05,709 and I'm going to be presenting 3 00:00:05,709 --> 00:00:06,999 tactics to you. 4 00:00:07,083 --> 00:00:10,375 I'm going to give a quick intro 5 00:00:10,375 --> 00:00:13,209 at DEF CON 6 00:00:13,209 --> 00:00:18,250 a PT or hacking cars and then we 7 00:00:18,999 --> 00:00:21,999 So first off, I would 8 00:00:21,999 --> 00:00:24,000 dissonance for you. 9 00:00:24,209 --> 00:00:26,999 My main goal here 10 00:00:27,125 --> 00:00:30,334 So trigger warning, this 11 00:00:30,334 --> 00:00:34,375 and mental health and that might be 12 00:00:34,999 --> 00:00:37,292 If you feel uncomfortable in any way, 13 00:00:37,292 --> 00:00:40,918 in the room that have been affected 14 00:00:40,918 --> 00:00:44,501 or have made attempts themselves 15 00:00:44,501 --> 00:00:48,250 If you feel uncomfortable, feel free 16 00:00:48,250 --> 00:00:49,876 We won't judge you at all. 17 00:00:49,999 --> 00:00:54,000 So I will be also be speaking a lot 18 00:00:54,000 --> 00:00:58,417 And that is no way meant to say this 19 00:00:58,417 --> 00:00:59,999 Your experience may vary. 20 00:00:59,999 --> 00:01:01,459 If you want to have 21 00:01:01,459 --> 00:01:04,083 we'll be able to do that after the fact. 22 00:01:04,292 --> 00:01:08,999 So today what we're going to go 23 00:01:08,999 --> 00:01:12,959 We have risk analysis framework which 24 00:01:12,959 --> 00:01:17,834 how to identify clues and warning signs 25 00:01:17,834 --> 00:01:21,209 indicate some brewing crisis, how 26 00:01:21,209 --> 00:01:23,375 threat assessment. 27 00:01:23,375 --> 00:01:26,083 So this is how 28 00:01:26,083 --> 00:01:29,999 determine how to make 29 00:01:30,083 --> 00:01:32,250 So, if something is low risk, 30 00:01:32,250 --> 00:01:36,083 to tackle it differently than someone 31 00:01:36,083 --> 00:01:39,751 to get immediately to some sort 32 00:01:39,751 --> 00:01:42,083 cover volunteer and first responder 33 00:01:42,083 --> 00:01:46,999 is really where my training comes from, 34 00:01:47,083 --> 00:01:49,999 But the main point there 35 00:01:49,999 --> 00:01:52,876 the type of people that 36 00:01:52,876 --> 00:01:55,459 to know how the real people do it. 37 00:01:55,584 --> 00:01:58,834 So I will show you lots and lots 38 00:01:58,834 --> 00:02:01,083 But none of that is required 39 00:02:01,083 --> 00:02:03,959 a successful intervention. 40 00:02:03,959 --> 00:02:08,918 There's very few things that are needed 41 00:02:08,959 --> 00:02:11,501 Also just listen 42 00:02:11,501 --> 00:02:13,876 out in the community. 43 00:02:14,209 --> 00:02:17,999 This isn't the type of talk you need 44 00:02:17,999 --> 00:02:21,876 or research so you can actually 45 00:02:21,999 --> 00:02:25,584 Although there is that much research 46 00:02:25,584 --> 00:02:26,542 The goal is to make it 47 00:02:26,542 --> 00:02:28,999 and usable immediately as possible. 48 00:02:29,292 --> 00:02:33,209 Also we'll cover how to talk 49 00:02:33,250 --> 00:02:36,375 This is an important topic 50 00:02:36,459 --> 00:02:42,209 So active listening, question phrasing, 51 00:02:42,209 --> 00:02:48,999 et cetera: So hopefully we'll pick 52 00:02:48,999 --> 00:02:51,709 Who am I and why am I standing there. 53 00:02:51,709 --> 00:02:53,918 I work 54 00:02:53,918 --> 00:02:55,918 Had is not what I do full time. 55 00:02:56,083 --> 00:02:58,999 Some of what I do involves info sec 56 00:02:58,999 --> 00:03:03,542 Nothing you want to hear me talk 57 00:03:03,542 --> 00:03:07,417 with girls who code must 58 00:03:07,417 --> 00:03:10,709 is QPR institute training. 59 00:03:10,999 --> 00:03:13,626 Question, persuade, refer, that's 60 00:03:13,626 --> 00:03:16,250 they teach autopsy responders. 61 00:03:16,250 --> 00:03:17,999 They have a bunch 62 00:03:17,999 --> 00:03:22,459 and I got involved with them 63 00:03:22,459 --> 00:03:24,792 Which is the same thing as you 64 00:03:24,792 --> 00:03:28,792 the numbers we see posted everywhere 65 00:03:30,459 --> 00:03:32,334 I group you on IRC. 66 00:03:32,334 --> 00:03:33,667 and I'm the kind 67 00:03:33,667 --> 00:03:36,083 up the phone and talk 68 00:03:36,999 --> 00:03:38,999 I have no problem throwing my heart 69 00:03:38,999 --> 00:03:40,542 on the Internet. 70 00:03:43,751 --> 00:03:47,709 So we have 71 00:03:47,709 --> 00:03:52,292 more used to reading the cadence 72 00:03:52,292 --> 00:03:56,292 down than maybe other people don't 73 00:03:56,292 --> 00:03:59,292 So we might be stronger responders 74 00:03:59,292 --> 00:04:00,918 So that's why I got involved. 75 00:04:00,918 --> 00:04:01,959 But I ended 76 00:04:01,959 --> 00:04:06,209 with it because it turned out I wanted 77 00:04:06,751 --> 00:04:08,667 Not exclusively but it 78 00:04:08,667 --> 00:04:11,751 in being able to understand and talk 79 00:04:11,751 --> 00:04:15,250 It turns out now that everyone has 80 00:04:15,834 --> 00:04:17,999 So they're all on IM. 81 00:04:17,999 --> 00:04:20,584 And the people that contact 82 00:04:20,584 --> 00:04:24,083 from the Internet or from Reddit 83 00:04:24,083 --> 00:04:28,626 They're just regular people so I decided 84 00:04:28,626 --> 00:04:33,125 the skill set and bring it directly 85 00:04:33,125 --> 00:04:36,999 So that we can you know, 86 00:04:36,999 --> 00:04:38,375 I'm going to touch everyone. 87 00:04:38,375 --> 00:04:39,375 No. 88 00:04:39,375 --> 00:04:40,375 In that sort of way. 89 00:04:40,375 --> 00:04:41,375 Whew! 90 00:04:41,375 --> 00:04:43,834 If we good get everybody here 91 00:04:43,834 --> 00:04:48,918 they can then tell somebody, 92 00:04:48,918 --> 00:04:50,999 And it's the kind of thing you can do 93 00:04:50,999 --> 00:04:52,999 And people find suicide fascinating. 94 00:04:52,999 --> 00:04:57,876 It's that morbid idea to learn 95 00:04:58,167 --> 00:05:01,083 So it's actually really easy knowledge 96 00:05:02,542 --> 00:05:08,459 I can't give you the official 97 00:05:08,459 --> 00:05:14,751 theory, the basic course 98 00:05:14,751 --> 00:05:17,292 So I had to make a title for DEF CON. 99 00:05:17,292 --> 00:05:19,876 So, if you want your certification. 100 00:05:28,167 --> 00:05:32,876 Every time I freaked 101 00:05:32,876 --> 00:05:37,083 to shut up and do it and thank you 102 00:05:37,083 --> 00:05:41,876 of them are here (Applause.) So how 103 00:05:42,083 --> 00:05:45,083 This is the most depressing slide 104 00:05:45,083 --> 00:05:46,334 I have a unicorn chaser. 105 00:05:46,999 --> 00:05:49,959 There were two suicides 106 00:05:49,959 --> 00:05:52,125 up that affected me. 107 00:05:52,626 --> 00:05:56,918 I come from a family of brilliant artists, 108 00:05:56,918 --> 00:06:01,999 out these people are prone 109 00:06:02,501 --> 00:06:06,999 So, when my mother was diagnosed 110 00:06:06,999 --> 00:06:10,751 she was going to follow the same path. 111 00:06:10,999 --> 00:06:12,876 So I kind of took the nerd 112 00:06:12,876 --> 00:06:16,167 to learn everything I possibly could 113 00:06:16,167 --> 00:06:18,125 And that's how I ended up volunteering. 114 00:06:18,125 --> 00:06:20,584 And why I'm here and she's fine now, 115 00:06:20,584 --> 00:06:21,667 Thanks, mom. 116 00:06:26,083 --> 00:06:29,751 Right around the time I was doing this 117 00:06:29,751 --> 00:06:33,542 the Aaron Swartz situation happened 118 00:06:33,792 --> 00:06:36,250 If you're from the previous track, 119 00:06:36,250 --> 00:06:39,584 of Aaron's suicide earlier this year. 120 00:06:39,876 --> 00:06:43,250 And what surprised me was that 121 00:06:43,250 --> 00:06:45,999 people in the community who reached 122 00:06:45,999 --> 00:06:48,999 they were worried about their friends. 123 00:06:48,999 --> 00:06:51,375 They don't know what to do, 124 00:06:51,375 --> 00:06:53,999 and wanted resources 125 00:06:53,999 --> 00:06:56,083 of red flags for me. 126 00:06:58,292 --> 00:07:02,959 Contagion is a very well known effect 127 00:07:02,959 --> 00:07:04,459 When someone high profile dies. 128 00:07:04,459 --> 00:07:08,999 So it's actually based it's called 129 00:07:08,999 --> 00:07:13,584 on a book 130 00:07:13,999 --> 00:07:18,292 It detailed a suicide at a writing desk 131 00:07:18,292 --> 00:07:20,999 it that they banned the book. 132 00:07:21,417 --> 00:07:23,959 You see this in clusters 133 00:07:25,292 --> 00:07:30,125 The Godzilla is Mount Mihara which 134 00:07:30,125 --> 00:07:34,999 in to trap him is based 135 00:07:34,999 --> 00:07:40,250 has been presence of hundreds 136 00:07:40,250 --> 00:07:42,918 So San Francisco 137 00:07:42,918 --> 00:07:46,375 familiar with our cultural attachment 138 00:07:46,375 --> 00:07:52,626 So we're doing it wrong when it comes 139 00:07:52,876 --> 00:07:56,542 There are standards which I've taken 140 00:07:56,542 --> 00:07:59,999 to social media published 141 00:07:59,999 --> 00:08:03,542 of encourage you 142 00:08:03,542 --> 00:08:07,626 whether it's in our community or not, 143 00:08:07,626 --> 00:08:10,459 they don't quite get right. 144 00:08:10,999 --> 00:08:13,375 We want 145 00:08:13,375 --> 00:08:17,459 suicide is never the result 146 00:08:17,918 --> 00:08:21,584 There might have been a trigger, 147 00:08:21,584 --> 00:08:26,959 into a crisis situation, but don't wake 148 00:08:26,959 --> 00:08:28,083 That's not what happens. 149 00:08:28,083 --> 00:08:32,417 If you look at the first bullet point there, 150 00:08:32,417 --> 00:08:34,584 and slashed out. 151 00:08:34,626 --> 00:08:36,626 That's because it would be great 152 00:08:36,626 --> 00:08:40,083 if all of us could stop saying committed 153 00:08:40,209 --> 00:08:43,250 That is not clinically accurate. 154 00:08:43,250 --> 00:08:45,250 It's a throwback 155 00:08:45,250 --> 00:08:48,375 which does not exist in a majority 156 00:08:49,834 --> 00:08:55,083 And people say clinically died 157 00:08:55,083 --> 00:08:57,834 Killed themselves, a whole variety 158 00:08:57,834 --> 00:09:01,542 other words you can use that don't 159 00:09:01,542 --> 00:09:04,542 and don't refer 160 00:09:04,542 --> 00:09:06,125 don't need. 161 00:09:06,125 --> 00:09:09,999 We also want to point out that suicide 162 00:09:09,999 --> 00:09:12,250 long history of problems. 163 00:09:12,999 --> 00:09:18,334 Generally not making it seem 164 00:09:18,334 --> 00:09:24,292 I guess Maybe we could do that 165 00:09:24,292 --> 00:09:26,417 So it's not just Aaron. 166 00:09:27,334 --> 00:09:30,501 These are computer science suicides 167 00:09:30,501 --> 00:09:34,626 of course would be when we would see 168 00:09:34,626 --> 00:09:37,751 And before that, 169 00:09:37,751 --> 00:09:39,751 We're probably a lot more familiar 170 00:09:39,751 --> 00:09:43,959 because they tends 171 00:09:44,999 --> 00:09:49,584 It's prevalent in the highly gifted 172 00:09:49,999 --> 00:09:51,751 That said, the vast majority 173 00:09:51,751 --> 00:09:54,542 by suicide don't have Wikipedia pages. 174 00:09:54,584 --> 00:09:56,959 So while it's nice 175 00:09:56,959 --> 00:10:00,626 in our research, really this 176 00:10:00,626 --> 00:10:03,042 across every demographic. 177 00:10:03,751 --> 00:10:05,667 I will say though that you probably 178 00:10:05,667 --> 00:10:07,667 a Nobel prize for chemistry. 179 00:10:09,542 --> 00:10:12,999 (Laughter) So I'm just going 180 00:10:12,999 --> 00:10:14,042 And then we're going to leave 181 00:10:14,042 --> 00:10:15,959 of the presentation. 182 00:10:15,959 --> 00:10:19,959 So in America someone dies 183 00:10:19,999 --> 00:10:22,501 In China it's every two minutes. 184 00:10:23,999 --> 00:10:26,459 Overall we're talking 185 00:10:26,459 --> 00:10:28,709 death in the United States. 186 00:10:29,000 --> 00:10:35,501 That's way ahead of homicide, cancers, 187 00:10:35,918 --> 00:10:38,792 And most critically for us and not 188 00:10:38,792 --> 00:10:43,375 but just briefly you're demographically 189 00:10:43,667 --> 00:10:44,999 We can do this by a show of. 190 00:10:44,999 --> 00:10:45,999 Hands. 191 00:10:45,999 --> 00:10:49,542 How many men fall between 15 and 24? 192 00:10:51,751 --> 00:10:57,999 For you guys, this 193 00:10:58,334 --> 00:11:00,918 Behind accidents and homicide. 194 00:11:01,209 --> 00:11:03,542 How about 25 and 34. 195 00:11:04,083 --> 00:11:06,292 Hey, that's almost all of you. 196 00:11:07,834 --> 00:11:09,709 It's second for you. 197 00:11:10,999 --> 00:11:15,334 Second only to accidental death 198 00:11:16,083 --> 00:11:19,167 If you look at 45 54 bracket, 199 00:11:19,167 --> 00:11:22,083 but we start to lose people 200 00:11:22,083 --> 00:11:24,083 the data that way. 201 00:11:24,083 --> 00:11:25,501 Skews the data that way. 202 00:11:27,375 --> 00:11:29,959 Twice the number of homicides 203 00:11:29,959 --> 00:11:33,083 More than half 204 00:11:34,125 --> 00:11:36,626 Women are three times as likely 205 00:11:36,626 --> 00:11:39,792 by men are four times as likely to die 206 00:11:39,876 --> 00:11:47,417 That largely has to do not 207 00:11:47,584 --> 00:11:52,999 That's you choose pills which you think 208 00:11:52,999 --> 00:11:56,250 men tend 209 00:11:56,250 --> 00:11:58,999 have high lethality. 210 00:11:59,959 --> 00:12:01,083 So goodness. 211 00:12:01,083 --> 00:12:03,209 You're going to make me drink, 212 00:12:03,209 --> 00:12:04,375 (Applause) All right. 213 00:12:04,375 --> 00:12:15,083 Can I borrow the microphone 214 00:12:15,999 --> 00:12:17,834 You know the drill. 215 00:12:17,834 --> 00:12:20,250 We have a tradition we decided 216 00:12:20,250 --> 00:12:23,125 up somebody from the audience. 217 00:12:23,125 --> 00:12:26,083 But we need somebody who 218 00:12:29,334 --> 00:12:31,542 I like you. 219 00:12:32,250 --> 00:12:34,999 You have to answer trivia question. 220 00:12:35,209 --> 00:12:37,792 Do you know 221 00:12:39,083 --> 00:12:40,834 Excellent, 222 00:12:40,834 --> 00:12:42,125 at DEF CON. 223 00:12:42,125 --> 00:12:43,125 Come on up. 224 00:12:50,250 --> 00:12:53,959 AMBER BALDET: I'm taking this 225 00:13:00,834 --> 00:13:02,292 Your time is up now. 226 00:13:02,417 --> 00:13:07,834 How is it going so far? 227 00:13:07,834 --> 00:13:08,834 She doing okay? 228 00:13:08,834 --> 00:13:09,834 (Applause). 229 00:13:09,834 --> 00:13:10,834 All right. 230 00:13:28,792 --> 00:13:31,167 Now let's talk about clinical things. 231 00:13:33,834 --> 00:13:36,334 I'm segue independent. 232 00:13:36,999 --> 00:13:38,250 So all right. 233 00:13:38,250 --> 00:13:40,999 We're going to skip over most 234 00:13:40,999 --> 00:13:44,751 I want to make you aware that this talk 235 00:13:44,751 --> 00:13:49,626 of diagnosis that I would be remiss not 236 00:13:49,626 --> 00:13:55,083 of diagnosis here I'm sure we're aware 237 00:13:55,083 --> 00:13:57,167 at the bottom. 238 00:13:58,584 --> 00:14:02,959 Harm reduction is great 239 00:14:02,959 --> 00:14:04,999 Sobriety is very heavily indicated 240 00:14:04,999 --> 00:14:07,876 of mental health management program. 241 00:14:07,999 --> 00:14:10,918 That's because harm reduction works 242 00:14:10,918 --> 00:14:12,999 but you accidentally die. 243 00:14:13,209 --> 00:14:16,209 So, if death is your end game, 244 00:14:16,250 --> 00:14:17,999 We won't go 245 00:14:17,999 --> 00:14:22,375 but most importantly pay attention 246 00:14:22,375 --> 00:14:23,626 They're most common. 247 00:14:23,626 --> 00:14:25,834 If you look 248 00:14:25,834 --> 00:14:29,999 this kind of outlines the number 249 00:14:29,999 --> 00:14:34,125 if you're classified within one 250 00:14:34,125 --> 00:14:39,250 that your chance or your likelihood 251 00:14:39,250 --> 00:14:40,918 So obviously, 252 00:14:40,918 --> 00:14:42,626 of off the charts. 253 00:14:42,918 --> 00:14:43,918 But also, depression, 254 00:14:43,918 --> 00:14:46,125 all of these are heavily indicated. 255 00:14:46,125 --> 00:14:47,626 Of what you might not see on there 256 00:14:47,626 --> 00:14:49,751 at the bottom that I added 257 00:14:49,751 --> 00:14:52,626 is all these other medical illnesses. 258 00:14:52,626 --> 00:14:54,999 People think there's 259 00:14:54,999 --> 00:14:59,167 who are medically ill are more likely 260 00:14:59,167 --> 00:15:00,918 It's very small. 261 00:15:00,918 --> 00:15:04,083 Not statistically relevant and autism 262 00:15:04,334 --> 00:15:05,584 Okay. 263 00:15:05,876 --> 00:15:08,417 So within our community, 264 00:15:08,417 --> 00:15:13,959 in our community but everywhere 265 00:15:13,959 --> 00:15:15,999 So within our community, I kind 266 00:15:15,999 --> 00:15:19,083 of a few archetypes 267 00:15:19,083 --> 00:15:21,876 about it that might happen. 268 00:15:21,876 --> 00:15:23,083 So I'll sleep when I'm dead. 269 00:15:23,083 --> 00:15:24,417 I'm too busy crushing it. 270 00:15:24,459 --> 00:15:26,999 This to me typifies 271 00:15:26,999 --> 00:15:30,250 They have something called "the 272 00:15:30,250 --> 00:15:33,792 And that's that basically mania 273 00:15:33,792 --> 00:15:35,083 Depression is stigmatized. 274 00:15:35,083 --> 00:15:37,334 There's youth and burnout. 275 00:15:37,667 --> 00:15:39,334 Chronically underinsured. 276 00:15:39,417 --> 00:15:41,375 Drug use is trivialized. 277 00:15:41,918 --> 00:15:46,501 There's overlap 278 00:15:46,999 --> 00:15:49,999 That might match what, you know. 279 00:15:49,999 --> 00:15:53,292 that's a witch's brew 280 00:15:54,667 --> 00:15:57,834 Just because I'm paranoid doesn't 281 00:15:58,918 --> 00:16:01,999 Sounds like underdiagnosis 282 00:16:02,167 --> 00:16:06,792 If you look at this in regular population, 283 00:16:06,792 --> 00:16:09,584 to find 284 00:16:09,584 --> 00:16:13,959 if you work in some 285 00:16:13,959 --> 00:16:15,626 They don't really understand you. 286 00:16:15,626 --> 00:16:18,417 They don't understand 287 00:16:18,417 --> 00:16:20,918 And they might not be able 288 00:16:20,918 --> 00:16:23,501 what is actually an acceptable level 289 00:16:23,501 --> 00:16:26,709 for the things that you're involved in. 290 00:16:28,125 --> 00:16:31,709 You might also be more likely open 291 00:16:31,709 --> 00:16:33,999 which can be a problem. 292 00:16:33,999 --> 00:16:37,542 So, if you want to learn more 293 00:16:37,542 --> 00:16:41,709 these are some 294 00:16:41,709 --> 00:16:46,417 if you are a heavily creative type, 295 00:16:46,417 --> 00:16:51,542 about manic depression in artists 296 00:16:51,542 --> 00:16:55,999 a good thing, touched by fire 297 00:16:56,375 --> 00:16:58,999 All of this stuff is on the CDs 298 00:16:58,999 --> 00:17:04,083 So for us, if we self diagnose, 299 00:17:04,083 --> 00:17:07,918 Ph.D.s in psychology 300 00:17:07,918 --> 00:17:11,999 and we go online, we tend 301 00:17:11,999 --> 00:17:15,999 of like we'll post a forum post 302 00:17:15,999 --> 00:17:19,999 but not we don't have one 303 00:17:19,999 --> 00:17:22,667 to get away from that. 304 00:17:22,709 --> 00:17:26,626 So this is the online intervention that 305 00:17:27,125 --> 00:17:30,459 30% of college 306 00:17:30,459 --> 00:17:33,501 We get a lot higher retention rate 307 00:17:33,501 --> 00:17:37,959 It's more anonymous 308 00:17:38,083 --> 00:17:40,542 Mostly they don't track you just 309 00:17:40,542 --> 00:17:43,999 because they really don't know how 310 00:17:44,999 --> 00:17:48,626 Kind of hinders their ability 311 00:17:49,083 --> 00:17:53,083 Efficacy is equivalent with hotline. 312 00:17:53,584 --> 00:17:54,834 Training is great. 313 00:17:55,083 --> 00:17:56,083 Good resource. 314 00:17:56,083 --> 00:17:59,250 But like I mentioned earlier your pairing 315 00:17:59,250 --> 00:18:00,709 So we're bringing it to you. 316 00:18:00,709 --> 00:18:04,167 Now what's the difference 317 00:18:04,167 --> 00:18:10,167 like to fall a friendtervention, 318 00:18:12,125 --> 00:18:14,999 The person comes to you, 319 00:18:14,999 --> 00:18:17,999 they want to tell you their problems. 320 00:18:18,209 --> 00:18:22,334 They assume that you know what 321 00:18:22,834 --> 00:18:24,792 There's enforced anonymity, 322 00:18:24,792 --> 00:18:28,083 to give them your name or have 323 00:18:30,999 --> 00:18:33,584 In a friendtervention you may need 324 00:18:33,584 --> 00:18:35,959 and that can harm your friendship. 325 00:18:38,083 --> 00:18:40,959 Maybe you start to lose credibility. 326 00:18:42,250 --> 00:18:44,999 The ultimate end game is not 327 00:18:44,999 --> 00:18:47,918 unless you want 328 00:18:48,083 --> 00:18:51,375 No, you want to get them 329 00:18:51,375 --> 00:18:52,999 So we need to get people 330 00:18:52,999 --> 00:18:56,751 through really accepting professional 331 00:18:56,751 --> 00:18:57,999 It's very hard 332 00:18:57,999 --> 00:19:00,459 because a lot 333 00:19:00,459 --> 00:19:03,751 in the past with people that didn't 334 00:19:03,751 --> 00:19:05,250 didn't work. 335 00:19:05,250 --> 00:19:08,292 The medication 336 00:19:08,292 --> 00:19:11,999 a lot better, 60 80% 337 00:19:11,999 --> 00:19:15,999 you find the right therapy it 338 00:19:15,999 --> 00:19:19,626 down and you have to trust 339 00:19:19,626 --> 00:19:21,792 of work yourself. 340 00:19:21,999 --> 00:19:23,209 So we need 341 00:19:23,209 --> 00:19:25,709 to seek help 342 00:19:25,709 --> 00:19:28,751 and responding 343 00:19:28,751 --> 00:19:31,918 How are we going to identify risks? 344 00:19:31,918 --> 00:19:34,292 There's a few clues you want 345 00:19:34,459 --> 00:19:39,334 Direct verbal cues, this 346 00:19:39,417 --> 00:19:43,083 If I don't get a boyfriend soon, 347 00:19:43,709 --> 00:19:47,125 Obvious, often encoded as jokes. 348 00:19:47,417 --> 00:19:49,250 Keep your eyes out for that. 349 00:19:49,459 --> 00:19:51,834 Indirect, I'm tired of life, 350 00:19:51,834 --> 00:19:53,999 off without me, 351 00:19:53,999 --> 00:19:55,918 to worry about me. 352 00:19:55,918 --> 00:19:58,501 These are big red flags 353 00:19:58,501 --> 00:20:01,584 throw out there to see 354 00:20:01,584 --> 00:20:02,999 to them. 355 00:20:03,209 --> 00:20:04,459 Behavioral. 356 00:20:04,459 --> 00:20:06,000 Maybe they just seem depressed. 357 00:20:06,000 --> 00:20:07,375 That's kind of important. 358 00:20:07,375 --> 00:20:11,667 If they get their affairs in order, 359 00:20:11,667 --> 00:20:16,999 if they were into drugs or alcohol 360 00:20:16,999 --> 00:20:18,959 huge red flag. 361 00:20:22,999 --> 00:20:24,999 Situationally trigger events. 362 00:20:25,167 --> 00:20:28,375 Lose a job or relationship you're 363 00:20:28,375 --> 00:20:32,000 you're suddenly being prosecuted 364 00:20:32,000 --> 00:20:35,999 these things are huge, 365 00:20:36,584 --> 00:20:40,334 So you want to watch for red flags 366 00:20:40,876 --> 00:20:44,250 So take them all seriously 367 00:20:44,250 --> 00:20:47,000 If somebody is talking about suicide, 368 00:20:47,000 --> 00:20:48,000 Not true. 369 00:20:48,834 --> 00:20:50,999 If you're talking to someone 370 00:20:50,999 --> 00:20:53,083 to put the idea in their head, 371 00:20:53,083 --> 00:20:55,876 if you're that worried about your friend, 372 00:20:55,876 --> 00:20:57,542 about it themselves. 373 00:20:58,626 --> 00:21:00,167 Seize the day. 374 00:21:01,250 --> 00:21:04,167 This is a big wall of text, 375 00:21:04,999 --> 00:21:07,542 But it's to take away 376 00:21:07,542 --> 00:21:11,083 is how you form 377 00:21:11,083 --> 00:21:13,876 This is something you carry 378 00:21:13,959 --> 00:21:15,959 So it doesn't really change day to day. 379 00:21:15,959 --> 00:21:17,083 It's about who you are and 380 00:21:17,083 --> 00:21:19,250 of bag you've picked up. 381 00:21:19,542 --> 00:21:21,751 Some of it might be changeable 382 00:21:21,751 --> 00:21:23,125 at the bottom. 383 00:21:23,459 --> 00:21:24,999 So maybe you moved 384 00:21:24,999 --> 00:21:29,167 the sociopolitical climate 385 00:21:29,459 --> 00:21:31,250 That might lower your risk. 386 00:21:35,167 --> 00:21:37,250 One time I called this the lint 387 00:21:37,250 --> 00:21:40,959 of life and people enjoyed that so I go 388 00:21:40,959 --> 00:21:44,584 These are things you cannot get 389 00:21:44,584 --> 00:21:46,834 to cope with them. 390 00:21:46,999 --> 00:21:49,999 And then biologically, this 391 00:21:49,999 --> 00:21:51,334 you are. 392 00:21:51,834 --> 00:21:55,459 So this would be your mental illnesses, 393 00:21:55,459 --> 00:21:57,999 That's the foundation 394 00:21:57,999 --> 00:21:59,834 proximal risks. 395 00:21:59,834 --> 00:22:00,709 So these are 396 00:22:00,709 --> 00:22:02,209 about before. 397 00:22:02,209 --> 00:22:04,083 This is the stuff that 398 00:22:04,083 --> 00:22:07,292 they will say is why you killed yourself. 399 00:22:07,292 --> 00:22:10,501 So it's a relationship crisis, 400 00:22:10,501 --> 00:22:11,999 It's losing money. 401 00:22:11,999 --> 00:22:14,999 It's whatever the event 402 00:22:14,999 --> 00:22:19,626 But what's most important 403 00:22:19,709 --> 00:22:24,999 It's your perceived level of loss, 404 00:22:24,999 --> 00:22:27,999 And one interesting note 405 00:22:27,999 --> 00:22:32,876 is any sort of risk or protective factor 406 00:22:33,083 --> 00:22:34,999 Absolutely irrelevant. 407 00:22:35,375 --> 00:22:40,999 A relative loss of financial stability 408 00:22:40,999 --> 00:22:42,918 But having a lot of money does not 409 00:22:42,918 --> 00:22:44,876 against suicide risk. 410 00:22:45,083 --> 00:22:47,999 So as we move across the way, 411 00:22:47,999 --> 00:22:49,834 of hopelessness which 412 00:22:49,834 --> 00:22:52,999 the one thing we really want to try 413 00:22:53,250 --> 00:22:56,751 We're trying to provide hope 414 00:22:56,751 --> 00:22:58,334 That's the most important thing. 415 00:22:58,334 --> 00:23:01,542 And then you have a wall of resistance, 416 00:23:01,542 --> 00:23:04,083 pushing back, keeping you safe. 417 00:23:04,083 --> 00:23:08,751 Once that's broken through, 418 00:23:09,083 --> 00:23:12,125 So the resistance, 419 00:23:12,125 --> 00:23:16,083 are pretty obvious, these are 420 00:23:16,083 --> 00:23:20,999 we want to have all these things, again, 421 00:23:20,999 --> 00:23:24,918 there's a few like the AA sponsor 422 00:23:24,918 --> 00:23:28,083 of a meal mental health plan that 423 00:23:28,083 --> 00:23:32,459 but positive therapeutic relationship 424 00:23:32,459 --> 00:23:35,167 but you do want to check them 425 00:23:35,167 --> 00:23:39,125 to people mentally and know 426 00:23:39,125 --> 00:23:42,667 or whether they have somebody 427 00:23:43,292 --> 00:23:45,751 Oh, my God, 428 00:23:45,751 --> 00:23:47,334 be suicidal. 429 00:23:47,417 --> 00:23:49,083 Here's the process. 430 00:23:49,083 --> 00:23:50,709 You find a safe place to talk. 431 00:23:51,417 --> 00:23:52,999 Set aside time. 432 00:23:52,999 --> 00:23:55,292 Best face to face but it doesn't have 433 00:23:55,542 --> 00:23:56,999 You build rapport and trust. 434 00:23:56,999 --> 00:23:58,959 That's the talking to a human thing. 435 00:23:59,083 --> 00:24:00,626 We'll cover that in a second. 436 00:24:00,709 --> 00:24:02,999 You're going to ask 437 00:24:02,999 --> 00:24:07,751 This is the most critical step 438 00:24:07,751 --> 00:24:11,999 someone if they are thinking about, 439 00:24:11,999 --> 00:24:14,918 are you feeling suicidal? 440 00:24:15,501 --> 00:24:20,626 It's very important to ask this 441 00:24:20,876 --> 00:24:22,999 You can kind of roundabout it 442 00:24:22,999 --> 00:24:27,501 about not waking up" you don't want 443 00:24:27,501 --> 00:24:30,792 We'll talk about different ways 444 00:24:30,959 --> 00:24:33,999 This is the hardest step and 445 00:24:33,999 --> 00:24:35,999 the most lives. 446 00:24:35,999 --> 00:24:38,584 People are just waiting for someone 447 00:24:38,918 --> 00:24:40,999 So once you ask the question 448 00:24:40,999 --> 00:24:44,250 you just shut up and listen 449 00:24:44,709 --> 00:24:47,542 While you're listening, 450 00:24:47,542 --> 00:24:51,375 of their current situation based 451 00:24:51,375 --> 00:24:53,375 in a second here. 452 00:24:53,876 --> 00:24:56,751 And you're doing active listening. 453 00:24:56,751 --> 00:24:57,999 So you're responding 454 00:24:57,999 --> 00:25:00,999 you're asking relevant questions, 455 00:25:00,999 --> 00:25:03,834 around things that you want to know. 456 00:25:03,834 --> 00:25:06,999 But mostly just giving them space 457 00:25:06,999 --> 00:25:08,999 And throughout that kind 458 00:25:08,999 --> 00:25:11,334 you are determining 459 00:25:11,334 --> 00:25:15,334 moderate risk, super high risk, 460 00:25:15,375 --> 00:25:18,626 And then once you've determined 461 00:25:18,626 --> 00:25:21,999 to implement 462 00:25:23,083 --> 00:25:25,834 Most importantly or usually we want 463 00:25:25,834 --> 00:25:27,709 like I mentioned before. 464 00:25:27,709 --> 00:25:30,918 You don't want to stop 465 00:25:30,918 --> 00:25:32,959 You want 466 00:25:32,959 --> 00:25:37,083 on treatment and that 467 00:25:37,083 --> 00:25:38,709 And then you want to follow up. 468 00:25:38,709 --> 00:25:40,626 You don't want them to feel abandoned. 469 00:25:40,626 --> 00:25:41,459 You want to check 470 00:25:41,459 --> 00:25:43,876 is there and somebody cares. 471 00:25:43,999 --> 00:25:48,584 Often people feel so crushingly alone 472 00:25:48,584 --> 00:25:51,999 brighten their day and change their 473 00:25:52,501 --> 00:25:55,501 I usually asked this question so I throw 474 00:25:56,459 --> 00:26:00,792 What are my reporting obligations 475 00:26:00,999 --> 00:26:02,083 Basically none. 476 00:26:04,125 --> 00:26:07,999 Unless you're getting paid 477 00:26:08,167 --> 00:26:10,083 If you're a teacher, social worker, 478 00:26:10,083 --> 00:26:14,542 there are other obligations you'd know 479 00:26:14,667 --> 00:26:18,250 But as a Good Samaritan, 480 00:26:18,250 --> 00:26:20,209 you'll be fine. 481 00:26:23,999 --> 00:26:26,334 Reverse 482 00:26:26,334 --> 00:26:30,626 and somebody storms out and says 483 00:26:30,626 --> 00:26:34,083 Z or whatever I'll kill myself, 484 00:26:34,083 --> 00:26:37,709 to see them and and they go 485 00:26:37,709 --> 00:26:40,167 or responsible in some way? 486 00:26:40,167 --> 00:26:41,999 The answer is no, absolutely not. 487 00:26:41,999 --> 00:26:43,667 You had nothing to do with it. 488 00:26:43,667 --> 00:26:44,918 You can't control them. 489 00:26:44,999 --> 00:26:49,626 There's usually lots of survivor guilt 490 00:26:49,999 --> 00:26:52,999 But you don't have an obligation 491 00:26:52,999 --> 00:26:56,083 If you know what to do, it's great 492 00:26:56,083 --> 00:26:57,999 to talk about. 493 00:26:57,999 --> 00:27:03,792 But it's most important that you get 494 00:27:03,792 --> 00:27:08,250 and do it and activate 495 00:27:08,250 --> 00:27:13,250 is Uma Thurman's do you listen 496 00:27:13,501 --> 00:27:15,083 Or Vincent Vega's response. 497 00:27:18,125 --> 00:27:20,834 That's how I explain active listening. 498 00:27:21,083 --> 00:27:23,292 It's not from the still. 499 00:27:23,292 --> 00:27:26,667 It's from the director's cut, 500 00:27:27,417 --> 00:27:29,083 It's the important things. 501 00:27:29,501 --> 00:27:32,667 So building rapport, 502 00:27:32,999 --> 00:27:35,334 Ask one question at a time. 503 00:27:35,334 --> 00:27:37,125 Give the person time to respond. 504 00:27:37,334 --> 00:27:39,876 This is a little counterintuitive. 505 00:27:39,876 --> 00:27:41,667 But, if you repeat back 506 00:27:41,667 --> 00:27:44,626 it makes them feel understood 507 00:27:44,626 --> 00:27:49,459 People in an acute suicidal state 508 00:27:49,459 --> 00:27:52,542 they have blinders on. 509 00:27:53,959 --> 00:27:56,834 Research has been done 510 00:27:56,834 --> 00:28:01,501 or various cognitive skill tests that you 511 00:28:01,501 --> 00:28:05,292 You can't see a variety of options 512 00:28:05,292 --> 00:28:08,292 So your thinking is impaired 513 00:28:08,292 --> 00:28:11,792 there's one way 514 00:28:11,792 --> 00:28:16,792 So it's important to get people 515 00:28:16,792 --> 00:28:22,542 it's like this now 516 00:28:22,542 --> 00:28:23,999 Tell me how you feel. 517 00:28:24,792 --> 00:28:28,709 Let me show you that I understand what 518 00:28:28,709 --> 00:28:31,667 So say when you don't understand, 519 00:28:31,667 --> 00:28:33,083 you don't. 520 00:28:33,083 --> 00:28:34,959 They catch on to that very quickly. 521 00:28:35,125 --> 00:28:37,792 And ask open ended questions, 522 00:28:37,876 --> 00:28:40,999 So obviously the opposite 523 00:28:40,999 --> 00:28:43,501 Active listening 524 00:28:43,501 --> 00:28:45,459 That's the takeaway from this. 525 00:28:45,459 --> 00:28:47,584 Yes, you may be filling 526 00:28:47,584 --> 00:28:50,501 or thinking about what they say. 527 00:28:50,999 --> 00:28:53,334 That's what people do all the time. 528 00:28:53,876 --> 00:28:56,792 You're not manipulating an outcome. 529 00:28:57,709 --> 00:29:01,999 And most importantly 530 00:29:01,999 --> 00:29:06,999 to form cognitive functions, 531 00:29:06,999 --> 00:29:12,792 arguments that you can step them 532 00:29:12,999 --> 00:29:15,083 People do not respond 533 00:29:15,083 --> 00:29:17,125 in that sort of state. 534 00:29:17,125 --> 00:29:19,751 What you want to do is create 535 00:29:19,751 --> 00:29:21,876 they can get through a crisis 536 00:29:21,876 --> 00:29:25,167 will eventually end where 537 00:29:25,167 --> 00:29:28,209 and they kind of get back 538 00:29:28,209 --> 00:29:31,292 almost like if you're 539 00:29:31,292 --> 00:29:34,709 drinking and you can't talk 540 00:29:34,709 --> 00:29:36,584 You have to get them 541 00:29:36,584 --> 00:29:38,709 confront their problem. 542 00:29:38,709 --> 00:29:42,292 You can use cognitive behavioral 543 00:29:42,292 --> 00:29:45,834 of the industry 544 00:29:45,834 --> 00:29:48,709 and change their world view. 545 00:29:48,709 --> 00:29:49,999 But you're not going to be able 546 00:29:49,999 --> 00:29:52,083 is in the middle of a crisis. 547 00:29:52,375 --> 00:29:53,667 Okay. 548 00:29:53,918 --> 00:29:56,876 So separating feelings from states 549 00:29:56,876 --> 00:29:57,876 This is actually a great slide 550 00:29:57,876 --> 00:30:00,751 is something you can do on yourself 551 00:30:00,999 --> 00:30:03,959 That you might not it's one 552 00:30:03,959 --> 00:30:06,959 about you hear yourself say but, 553 00:30:06,959 --> 00:30:09,999 it can actually start to change 554 00:30:09,999 --> 00:30:11,501 the world. 555 00:30:11,501 --> 00:30:14,000 So stop saying you are so many things. 556 00:30:14,000 --> 00:30:15,375 I am lonely. 557 00:30:15,626 --> 00:30:17,542 I am a mess. 558 00:30:17,542 --> 00:30:19,292 I am angry. 559 00:30:19,584 --> 00:30:22,542 Like it's a sense 560 00:30:22,542 --> 00:30:24,584 and who you are. 561 00:30:24,709 --> 00:30:26,999 When you introduce someone, 562 00:30:26,999 --> 00:30:31,125 is the worst possible word 563 00:30:31,292 --> 00:30:32,584 They are smart. 564 00:30:32,584 --> 00:30:35,250 It means you accept this person 565 00:30:35,250 --> 00:30:36,918 to change. 566 00:30:36,918 --> 00:30:38,626 So, if you change that 567 00:30:38,626 --> 00:30:42,125 but I could change that it might change 568 00:30:42,209 --> 00:30:43,667 This gives you wiggle room 569 00:30:43,667 --> 00:30:46,167 the way you think about things. 570 00:30:46,167 --> 00:30:47,292 So it's a good tactic. 571 00:30:47,292 --> 00:30:52,999 This slide is a slight deviation 572 00:30:52,999 --> 00:30:56,876 But I just wanted to point out this 573 00:30:56,876 --> 00:30:59,999 I'm so burned out. 574 00:30:59,999 --> 00:31:02,999 And it's another thing that really means 575 00:31:03,417 --> 00:31:06,999 It's euphemistic and we all use it 576 00:31:06,999 --> 00:31:09,959 I don't want to deal with it. 577 00:31:09,959 --> 00:31:10,959 But you don't know. 578 00:31:10,959 --> 00:31:11,999 It could mean anything. 579 00:31:11,999 --> 00:31:14,125 So I called the beer therapy 580 00:31:14,125 --> 00:31:17,751 a couple beers with people 581 00:31:17,751 --> 00:31:20,292 out the "I'm so burned out." 582 00:31:20,292 --> 00:31:20,999 And you talk 583 00:31:20,999 --> 00:31:23,584 important than employer and everybody 584 00:31:25,918 --> 00:31:30,417 If you dig down into that a little bit, 585 00:31:30,417 --> 00:31:32,250 all the time. 586 00:31:32,999 --> 00:31:36,626 Get somebody to express anger 587 00:31:36,626 --> 00:31:37,999 Now that's more relevant. 588 00:31:37,999 --> 00:31:40,584 If you can get under that and find 589 00:31:40,584 --> 00:31:44,375 of that's making them feel that way, 590 00:31:44,375 --> 00:31:46,417 and get them 591 00:31:46,417 --> 00:31:49,375 will make them feel less burned out. 592 00:31:49,375 --> 00:31:51,834 So you can probably read this one later 593 00:31:51,834 --> 00:31:54,125 of extracting that information. 594 00:31:54,292 --> 00:31:57,083 So bringing it 595 00:31:57,083 --> 00:32:02,250 S question that I mentioned earlier why, 596 00:32:02,250 --> 00:32:06,501 you're talking to your friend 597 00:32:06,959 --> 00:32:11,209 You've assessed that they are at risk, 598 00:32:11,209 --> 00:32:12,626 You think they trust you. 599 00:32:12,626 --> 00:32:14,125 And now you're ready to ask. 600 00:32:14,125 --> 00:32:15,999 So you can ask directly. 601 00:32:16,584 --> 00:32:19,999 Some of the things that you said made 602 00:32:19,999 --> 00:32:21,626 about suicide. 603 00:32:21,626 --> 00:32:22,626 Am I right? 604 00:32:22,876 --> 00:32:25,209 This is probably one 605 00:32:25,209 --> 00:32:28,083 but you can figure it out for yourself. 606 00:32:29,125 --> 00:32:31,834 Indirectly, have you ever wished that 607 00:32:31,834 --> 00:32:33,709 with all this any more? 608 00:32:33,999 --> 00:32:36,459 The point is you can actually practice 609 00:32:36,459 --> 00:32:39,292 a statement that feels good for you. 610 00:32:39,501 --> 00:32:42,751 It's really weird how difficult it 611 00:32:42,751 --> 00:32:45,459 without it catching in your throat. 612 00:32:45,459 --> 00:32:47,999 It's like when you first start talking 613 00:32:47,999 --> 00:32:52,083 to ask someone about contraception 614 00:32:52,083 --> 00:32:55,626 Like you might be able to just talk 615 00:32:55,626 --> 00:32:58,459 or other settings, 616 00:32:58,459 --> 00:33:03,083 and ask them a vulnerable question 617 00:33:03,584 --> 00:33:06,209 You have to suck it up and do it and 618 00:33:06,209 --> 00:33:09,292 about somebody, you need 619 00:33:11,667 --> 00:33:15,083 Don't say this 620 00:33:15,083 --> 00:33:16,918 Everything else there's not 621 00:33:16,918 --> 00:33:18,751 people are concerned 622 00:33:18,751 --> 00:33:21,083 like you're going to say 623 00:33:21,083 --> 00:33:22,834 over the edge. 624 00:33:22,834 --> 00:33:23,999 Don't worry about that. 625 00:33:23,999 --> 00:33:28,459 But don't say you're not thinking 626 00:33:28,834 --> 00:33:30,792 This is the worst. 627 00:33:31,083 --> 00:33:33,459 First of all, you've delegitimized 628 00:33:33,459 --> 00:33:37,083 if they actually are suicidality, 629 00:33:37,083 --> 00:33:39,999 and you're asking 630 00:33:39,999 --> 00:33:44,292 like you're basically saying don't bother 631 00:33:44,292 --> 00:33:48,584 You're not going to get a yes 632 00:33:48,584 --> 00:33:52,542 depending on their response, 633 00:33:52,542 --> 00:33:56,834 is a screen shot of what's actually 634 00:33:56,834 --> 00:33:58,417 This 635 00:33:58,417 --> 00:34:01,459 that volunteers actually use 636 00:34:01,459 --> 00:34:03,626 off all these boxes. 637 00:34:03,626 --> 00:34:07,375 I know it's really little we're going 638 00:34:07,375 --> 00:34:08,542 You don't have to check 639 00:34:08,542 --> 00:34:10,918 to do a successful intervention. 640 00:34:10,918 --> 00:34:12,334 This is just 641 00:34:12,334 --> 00:34:14,626 everybody everyone loves. 642 00:34:14,626 --> 00:34:18,999 So once you get a yes to this sort 643 00:34:18,999 --> 00:34:21,584 a threat assessment. 644 00:34:21,626 --> 00:34:25,167 So first, immediate state. 645 00:34:25,501 --> 00:34:27,083 This is probably more relevant 646 00:34:27,083 --> 00:34:28,584 up the phone. 647 00:34:28,584 --> 00:34:31,334 If a suicide is already in progress, 648 00:34:31,876 --> 00:34:33,751 You can't handle that yourself. 649 00:34:34,083 --> 00:34:36,999 Are they currently under influence 650 00:34:37,083 --> 00:34:39,292 Are methods nearby. 651 00:34:39,292 --> 00:34:41,459 You usually can't convince somebody 652 00:34:41,459 --> 00:34:44,501 there's a long trust building process 653 00:34:44,918 --> 00:34:47,167 But eventually they will. 654 00:34:47,751 --> 00:34:51,667 And also self harm is there self harm 655 00:34:51,667 --> 00:34:53,083 Is it part of their world view? 656 00:34:53,083 --> 00:34:54,083 Whatever. 657 00:34:54,083 --> 00:34:56,918 That's the first triage that you do. 658 00:34:56,918 --> 00:34:58,999 But we're going to assume 659 00:34:58,999 --> 00:35:00,459 this critical. 660 00:35:00,459 --> 00:35:02,876 Are you currently suicidal? 661 00:35:02,999 --> 00:35:05,584 This is the meat we're looking for. 662 00:35:07,334 --> 00:35:11,250 Are you having suicidal recently 663 00:35:11,250 --> 00:35:13,626 is the buffer zone. 664 00:35:14,876 --> 00:35:18,209 Was the person asked directly 665 00:35:18,209 --> 00:35:19,209 We asked that. 666 00:35:19,209 --> 00:35:24,584 If this current intent exists, 667 00:35:24,584 --> 00:35:25,626 Do you have a method? 668 00:35:25,999 --> 00:35:27,918 Do you have easy access to that? 669 00:35:27,918 --> 00:35:32,918 So the more concrete someone's idea 670 00:35:32,999 --> 00:35:36,167 Obviously if you say yeah, I'm going 671 00:35:36,167 --> 00:35:38,999 and you have that gun 672 00:35:38,999 --> 00:35:42,375 is and you have things in order, 673 00:35:42,375 --> 00:35:45,751 if somebody says I have pills 674 00:35:45,751 --> 00:35:48,501 but I just don't want to be here. 675 00:35:48,501 --> 00:35:50,292 That risk is lowered. 676 00:35:50,417 --> 00:35:54,667 Doesn't mean you walk away 677 00:35:54,999 --> 00:35:58,626 Capability and desire is how strongly 678 00:35:58,626 --> 00:36:02,709 to actually execute 679 00:36:02,709 --> 00:36:04,542 So have you made prior attempts? 680 00:36:04,542 --> 00:36:06,876 Remember the early graph 681 00:36:06,876 --> 00:36:08,959 of future attempts. 682 00:36:08,999 --> 00:36:13,209 Have you made rehearsals not quite 683 00:36:13,999 --> 00:36:19,250 There's entire addiction underlying 684 00:36:19,250 --> 00:36:21,209 to talk about. 685 00:36:21,709 --> 00:36:26,334 It's like a safety blanket where people 686 00:36:26,334 --> 00:36:29,209 problems don't exist any more. 687 00:36:29,751 --> 00:36:31,626 Digging down to where 688 00:36:31,626 --> 00:36:34,876 out of the fantasy world 689 00:36:35,709 --> 00:36:38,584 You document what's wrong, why not? 690 00:36:38,584 --> 00:36:39,876 Why not tomorrow? 691 00:36:40,083 --> 00:36:41,125 Why not now? 692 00:36:41,334 --> 00:36:43,083 What are the buffers? 693 00:36:43,083 --> 00:36:45,375 You want to start eliciting 694 00:36:46,667 --> 00:36:48,834 And who else is involved? 695 00:36:48,834 --> 00:36:51,999 You don't want to try 696 00:36:51,999 --> 00:36:55,999 So risk indicators, this is your desire, 697 00:36:56,209 --> 00:36:57,999 This builds the profile. 698 00:36:57,999 --> 00:37:00,375 This is where you find 699 00:37:00,375 --> 00:37:02,999 or are they feeling lonely? 700 00:37:02,999 --> 00:37:05,167 Do they feel like a burden 701 00:37:05,250 --> 00:37:08,083 This is the core 702 00:37:08,083 --> 00:37:09,834 you'll see. 703 00:37:09,918 --> 00:37:12,918 Their intent would be again 704 00:37:12,918 --> 00:37:16,959 you already called 911 705 00:37:16,959 --> 00:37:18,959 This is a check box to some 706 00:37:18,959 --> 00:37:20,918 describing before. 707 00:37:20,918 --> 00:37:23,501 But just you kind of learn to kind 708 00:37:23,501 --> 00:37:27,083 the various check boxes 709 00:37:27,083 --> 00:37:29,999 of the various types of people. 710 00:37:31,626 --> 00:37:35,959 Obviously all of our lives are individual 711 00:37:35,959 --> 00:37:38,083 of categories, I guess. 712 00:37:38,083 --> 00:37:39,999 And then your buffers. 713 00:37:39,999 --> 00:37:42,999 Internal buffers always better than 714 00:37:42,999 --> 00:37:44,459 If you can cope with stress. 715 00:37:46,375 --> 00:37:49,375 Spiritual believes tend 716 00:37:49,709 --> 00:37:53,083 If you have a purpose in life or 717 00:37:53,083 --> 00:37:54,999 is a big one. 718 00:37:56,083 --> 00:37:59,250 I remember talking to someone 719 00:37:59,250 --> 00:38:02,626 and then they said well, God, 720 00:38:02,626 --> 00:38:06,209 to have to do it differently 721 00:38:06,209 --> 00:38:09,083 I was just like oh, okay, 722 00:38:09,083 --> 00:38:12,125 so I guess risk lowered, good. 723 00:38:13,083 --> 00:38:15,250 And then external 724 00:38:15,250 --> 00:38:18,209 your community bonds, 725 00:38:18,542 --> 00:38:21,334 We may feel isolated just 726 00:38:21,334 --> 00:38:24,167 behind our computer every day. 727 00:38:24,167 --> 00:38:27,459 But that doesn't mean that we're not 728 00:38:27,459 --> 00:38:29,250 Doesn't mean we don't have people 729 00:38:29,250 --> 00:38:31,709 have strong relationships, 730 00:38:31,709 --> 00:38:34,083 and people that are there for us. 731 00:38:34,125 --> 00:38:39,250 And then out comes and next actions. 732 00:38:39,250 --> 00:38:42,542 This is the GTD portion 733 00:38:42,542 --> 00:38:43,542 So you never walk away 734 00:38:43,542 --> 00:38:46,083 without having your next actions 735 00:38:46,083 --> 00:38:47,834 is responsible. 736 00:38:47,876 --> 00:38:51,918 So you want 737 00:38:51,918 --> 00:38:56,999 persuaded to accept assistance 738 00:38:56,999 --> 00:39:00,083 a commitment to safety. 739 00:39:00,459 --> 00:39:04,834 A commitment to safety 740 00:39:04,834 --> 00:39:07,167 If you're going to let someone 741 00:39:07,209 --> 00:39:11,083 This is where the person agrees 742 00:39:11,083 --> 00:39:14,709 to not use drugs and alcohol. 743 00:39:14,709 --> 00:39:17,834 And to not kill themselves 744 00:39:17,834 --> 00:39:23,709 until you've had you know, more time 745 00:39:23,709 --> 00:39:26,999 It's basically a safety bubble that they're 746 00:39:27,167 --> 00:39:29,999 And it's critical 747 00:39:30,792 --> 00:39:33,792 People are incredibly determined. 748 00:39:34,459 --> 00:39:39,083 We cannot change their minds 749 00:39:39,083 --> 00:39:42,167 There are people 750 00:39:42,167 --> 00:39:47,167 ways to kill themselves when they're 751 00:39:47,709 --> 00:39:52,167 It's best not to lock them 752 00:39:52,167 --> 00:39:53,999 Sometimes it takes a while. 753 00:39:55,334 --> 00:39:57,083 Here's a threat assessment. 754 00:40:00,250 --> 00:40:04,999 At this point we've walked 755 00:40:04,999 --> 00:40:06,334 You've got a good idea 756 00:40:06,334 --> 00:40:10,501 on with the current situation, 757 00:40:10,501 --> 00:40:12,083 And you're willing to make a call. 758 00:40:12,083 --> 00:40:14,125 Is it high risk, moderate risk, low risk. 759 00:40:14,709 --> 00:40:18,709 What's most important 760 00:40:18,709 --> 00:40:23,751 on this one this is also 761 00:40:23,751 --> 00:40:25,918 So you can kind of use it. 762 00:40:26,417 --> 00:40:29,792 But generally, the people that you 763 00:40:29,792 --> 00:40:31,584 to be high risk. 764 00:40:31,584 --> 00:40:33,834 They probably won't even be moderate 765 00:40:37,626 --> 00:40:44,626 When you do a friendtervention 766 00:40:44,626 --> 00:40:48,584 or form, 767 00:40:48,584 --> 00:40:56,167 like an ungodly life and death isn't 768 00:40:58,209 --> 00:41:01,083 It's a nebulous idea they're having. 769 00:41:01,417 --> 00:41:05,999 So you're most likely statistically 770 00:41:05,999 --> 00:41:08,501 So in that case, you want 771 00:41:08,501 --> 00:41:12,667 to get them referral and then you can 772 00:41:14,959 --> 00:41:18,542 If you do have 773 00:41:18,542 --> 00:41:20,918 is a progression 774 00:41:20,918 --> 00:41:24,167 through an ER system 775 00:41:24,167 --> 00:41:28,667 involuntary commitment, it 776 00:41:28,751 --> 00:41:32,876 We don't have enough time to deal 777 00:41:32,876 --> 00:41:35,999 on that, I'm happy to talk about you. 778 00:41:35,999 --> 00:41:38,751 But it varies incredibly based 779 00:41:40,584 --> 00:41:42,999 It could be anything, honestly. 780 00:41:43,167 --> 00:41:47,667 Some states have great systems, 781 00:41:47,667 --> 00:41:50,626 the person in crisis 782 00:41:50,626 --> 00:41:53,250 in getting better help. 783 00:41:53,250 --> 00:41:55,584 You've established a commitment 784 00:41:55,584 --> 00:41:56,999 You have a safe space 785 00:41:56,999 --> 00:42:00,999 out for the next few hours 786 00:42:01,375 --> 00:42:03,209 Enlist other people. 787 00:42:03,209 --> 00:42:06,501 You want to keep them around, 788 00:42:06,501 --> 00:42:08,834 from being alone. 789 00:42:08,999 --> 00:42:12,083 You want to get them online resources 790 00:42:12,083 --> 00:42:14,375 for the future, maybe. 791 00:42:14,667 --> 00:42:17,999 But most importantly, you want 792 00:42:17,999 --> 00:42:22,209 and also you can move towards 793 00:42:23,125 --> 00:42:26,334 So this is kind of towards the end here, 794 00:42:26,334 --> 00:42:28,999 of people haven't seen before, 795 00:42:28,999 --> 00:42:31,542 of disappointing 796 00:42:31,542 --> 00:42:34,334 of any mental health strategy 797 00:42:34,334 --> 00:42:35,999 for yourself. 798 00:42:36,459 --> 00:42:40,999 So a crisis plan 799 00:42:40,999 --> 00:42:43,459 When you're not in a crisis. 800 00:42:43,918 --> 00:42:47,083 You identify your personal triggers, 801 00:42:47,083 --> 00:42:51,999 stuff that tells you personally that 802 00:42:51,999 --> 00:42:55,751 Your goal is to start outsmarting your 803 00:42:55,751 --> 00:43:00,209 brain is telling you that it needs 804 00:43:00,209 --> 00:43:01,792 to stop. 805 00:43:02,584 --> 00:43:05,999 It's actually very effective and one 806 00:43:05,999 --> 00:43:08,459 out earlier on the slide 807 00:43:08,459 --> 00:43:11,999 is called "how I stayed alive when my 808 00:43:11,999 --> 00:43:15,083 and it's a story of a woman 809 00:43:15,083 --> 00:43:18,417 she finally implemented this crisis plan. 810 00:43:18,667 --> 00:43:22,209 She said she had printed out copies 811 00:43:22,209 --> 00:43:27,083 and wall and given them to friends 812 00:43:27,083 --> 00:43:30,709 and refused to do anything 813 00:43:30,709 --> 00:43:35,083 and that's what finally got her 814 00:43:35,083 --> 00:43:39,375 than constantly trying to refer 815 00:43:39,959 --> 00:43:42,709 There's an example that's filled out. 816 00:43:44,292 --> 00:43:48,584 And there's a blank template you can fill 817 00:43:49,209 --> 00:43:57,626 So the crisis plan is really critical 818 00:43:57,667 --> 00:44:03,792 And I don't know how to describe that. 819 00:44:03,792 --> 00:44:04,792 I guess. 820 00:44:04,792 --> 00:44:08,375 It really helps you have an range 821 00:44:08,459 --> 00:44:10,584 I know we're rolling towards the end. 822 00:44:10,834 --> 00:44:13,999 Tactical crisis, 823 00:44:13,999 --> 00:44:18,375 to include toward the end 824 00:44:20,459 --> 00:44:24,375 So you, 911, therapist, hotlines this 825 00:44:24,375 --> 00:44:27,959 at if you want to get involved 826 00:44:27,999 --> 00:44:30,375 There's channels on IRC. 827 00:44:30,375 --> 00:44:31,999 There's subReddits. 828 00:44:31,999 --> 00:44:34,834 Our suicide watch is a good one. 829 00:44:35,250 --> 00:44:38,626 Our suicidology has 830 00:44:38,626 --> 00:44:40,375 a few sites. 831 00:44:40,459 --> 00:44:43,667 I tried to find some technically oriented. 832 00:44:43,667 --> 00:44:46,125 I talked 833 00:44:46,125 --> 00:44:48,626 and rose and died. 834 00:44:49,375 --> 00:44:53,999 If anybody would like to talk about this, 835 00:44:53,999 --> 00:44:56,626 the length 836 00:44:56,626 --> 00:44:58,125 at source. 837 00:44:58,125 --> 00:45:01,209 So there's just tons and tons 838 00:45:01,709 --> 00:45:04,584 So it's it might be useful 839 00:45:04,584 --> 00:45:08,792 down deeper and education 840 00:45:08,792 --> 00:45:13,125 be your first line of defense to hand 841 00:45:13,667 --> 00:45:16,083 Most of these organizations started 842 00:45:16,167 --> 00:45:20,125 It's a nascent area of study surprisingly, 843 00:45:20,125 --> 00:45:23,667 to our cultural things and these are 844 00:45:23,667 --> 00:45:27,417 about all the other stuff that's here. 845 00:45:27,876 --> 00:45:29,792 And I have questions. 846 00:45:29,999 --> 00:45:31,667 So thank you. 847 00:45:31,999 --> 00:45:34,999 I want to thank everybody 848 00:45:34,999 --> 00:45:36,334 AMBER BALDET: Okay, clap. 849 00:45:45,999 --> 00:45:47,083 Fine. 850 00:45:47,083 --> 00:45:49,292 I want to thank everybody 851 00:45:49,292 --> 00:45:52,834 about this and I want to feel 852 00:45:52,834 --> 00:45:55,751 knowledge and outline these steps 853 00:45:55,751 --> 00:45:57,876 out of here not depressed 854 00:45:57,876 --> 00:46:01,667 about the change that we can make 855 00:46:01,667 --> 00:46:04,709 So I'll do I mean, 856 00:46:04,709 --> 00:46:09,417 up but I can do Q&A in here 857 00:46:09,667 --> 00:46:11,250 Does anybody have like a counter. 858 00:46:11,250 --> 00:46:12,834 Do they give me extra time 859 00:46:12,834 --> 00:46:15,501 a counter up here, 860 00:46:15,918 --> 00:46:17,083 Okay. 861 00:46:17,417 --> 00:46:21,083 So does anybody have any questions 862 00:46:21,209 --> 00:46:23,626 Yeah, go ahead. 863 00:46:23,792 --> 00:46:27,459 AUDIENCE: Odd ethical sort 864 00:46:28,876 --> 00:46:30,999 I'll skip over the details. 865 00:46:30,999 --> 00:46:37,876 But a friend of mine she her life 866 00:46:38,834 --> 00:46:42,334 She has got chronic mental illness 867 00:46:42,334 --> 00:46:44,999 at the edge of homelessness. 868 00:46:44,999 --> 00:46:45,999 This sort of thing. 869 00:46:45,999 --> 00:46:51,999 AMBER BALDET: Your question 870 00:46:51,999 --> 00:46:52,999 That's your question. 871 00:46:58,417 --> 00:47:01,751 Right to die stuff, rational suicide. 872 00:47:01,751 --> 00:47:03,501 There is absolutely a case for that. 873 00:47:03,501 --> 00:47:07,876 It falls into a very different category 874 00:47:07,876 --> 00:47:11,083 Generally, the tenets 875 00:47:11,083 --> 00:47:16,083 terminal illness, support from friends 876 00:47:16,083 --> 00:47:21,501 a general comfort that everybody feels 877 00:47:21,709 --> 00:47:25,334 And in that case, I mean, personally, 878 00:47:25,751 --> 00:47:26,751 At all. 879 00:47:26,751 --> 00:47:28,834 But it's very different than people who 880 00:47:28,834 --> 00:47:32,751 will and I should have the right 881 00:47:34,125 --> 00:47:36,250 That may be the case. 882 00:47:36,250 --> 00:47:38,167 But as we talked about before, 883 00:47:38,167 --> 00:47:40,999 in the same way that it would normally. 884 00:47:41,751 --> 00:47:44,999 Like I mentioned at the beginning 885 00:47:44,999 --> 00:47:48,999 to completions, there's 15 attempts 886 00:47:48,999 --> 00:47:53,209 That didn't mean that every person 887 00:47:53,209 --> 00:47:55,876 No, it's a the vast majority 888 00:47:55,876 --> 00:47:59,999 do not complete suicide and never try 889 00:47:59,999 --> 00:48:01,667 about that. 890 00:48:02,459 --> 00:48:05,876 If those people were to have 891 00:48:05,876 --> 00:48:07,999 a different outcome, 892 00:48:07,999 --> 00:48:12,584 whether or not people actually are 893 00:48:12,584 --> 00:48:14,125 And that's the problem 894 00:48:14,125 --> 00:48:15,751 and failed. 895 00:48:15,999 --> 00:48:18,918 And also you're never going 896 00:48:18,918 --> 00:48:20,375 You only have failed attempts. 897 00:48:20,375 --> 00:48:22,083 So it doesn't really work. 898 00:48:22,083 --> 00:48:24,083 So that tends 899 00:48:24,083 --> 00:48:28,999 so we should also try to get rid 900 00:48:31,083 --> 00:48:33,167 There's a mic there. 901 00:48:34,999 --> 00:48:36,834 It's a meritocracy. 902 00:48:37,334 --> 00:48:43,167 I have a couple family members that 903 00:48:43,167 --> 00:48:47,999 about feeling suicidal and 904 00:48:47,999 --> 00:48:51,959 but I feel kind of helpless 905 00:48:51,959 --> 00:48:56,292 as a family member 906 00:48:56,292 --> 00:49:02,667 Also what to do when they both 907 00:49:02,667 --> 00:49:05,501 It's hard for me to know when 908 00:49:05,501 --> 00:49:09,167 of the time regardless 909 00:49:09,167 --> 00:49:11,999 to talk and talk and talk. 910 00:49:11,999 --> 00:49:13,459 That's the emotional exhaustion 911 00:49:13,459 --> 00:49:14,999 talking about. 912 00:49:15,375 --> 00:49:17,542 The difference with being 913 00:49:17,542 --> 00:49:19,999 is you have office hours 914 00:49:19,999 --> 00:49:22,417 and cannot speak with people, 915 00:49:22,417 --> 00:49:25,959 with your family even when they're not 916 00:49:25,999 --> 00:49:33,292 I would say that the crisis plan 917 00:49:33,501 --> 00:49:35,918 If you're a step 918 00:49:35,918 --> 00:49:39,999 all the other steps have been completed 919 00:49:39,999 --> 00:49:42,083 Did you already go walk your dog? 920 00:49:42,292 --> 00:49:45,083 Did you already journal today? 921 00:49:50,999 --> 00:49:54,999 Starting to take back your time you're 922 00:49:54,999 --> 00:49:58,999 you're supposed to be level or two 923 00:50:02,375 --> 00:50:05,501 It isn't always easy to enforce but, 924 00:50:05,501 --> 00:50:08,584 like you're working with them 925 00:50:08,584 --> 00:50:13,209 they call that it's valuable, 926 00:50:13,209 --> 00:50:14,459 AUDIENCE: Thank you. 927 00:50:18,999 --> 00:50:20,918 AMBER BALDET: Yeah. 928 00:50:20,918 --> 00:50:22,834 AUDIENCE: I'm render man. 929 00:50:25,876 --> 00:50:29,999 In February I went 930 00:50:29,999 --> 00:50:33,834 with depression which many of us do. 931 00:50:37,250 --> 00:50:41,209 We have a community we need 932 00:50:41,209 --> 00:50:45,876 out and we've lost a lot 933 00:50:45,876 --> 00:50:49,250 of people we haven't heard about. 934 00:50:51,918 --> 00:50:53,999 And we need to have 935 00:50:53,999 --> 00:50:55,999 within this community. 936 00:50:56,834 --> 00:50:59,876 To destigmatize depression 937 00:50:59,876 --> 00:51:05,999 out and you know taking that handed 938 00:51:05,999 --> 00:51:08,999 AMBER BALDET: I completely agree 939 00:51:08,999 --> 00:51:12,250 In a way we're progressively ahead 940 00:51:12,250 --> 00:51:14,959 a little counterintuitive. 941 00:51:15,167 --> 00:51:21,584 But because we're here, 942 00:51:21,584 --> 00:51:27,959 the stigma perpetuates all of society. 943 00:51:29,459 --> 00:51:34,918 Especially the mental health industrial 944 00:51:34,918 --> 00:51:39,292 we have done some really terrible 945 00:51:40,083 --> 00:51:43,334 We've we stigmatized it intentionally. 946 00:51:43,334 --> 00:51:46,083 In the 1800s, 947 00:51:46,083 --> 00:51:49,083 on religious grounds. 948 00:51:49,626 --> 00:51:51,834 In England 949 00:51:51,834 --> 00:51:54,999 from the person whose job it was 950 00:51:54,999 --> 00:51:59,584 a death was a suicide because if it was, 951 00:51:59,584 --> 00:52:03,209 and property to the crown 952 00:52:03,209 --> 00:52:05,999 of the crown and the coroner. 953 00:52:06,626 --> 00:52:20,542 And we're done.