The Alternatives to Suicide approach formed as one of the first and only peer-to-peer supports in the country that has a particular focus on suicide. It is founded upon the belief that a non-judgmental space in which to talk about thoughts of suicide and other often taboo topics are an essential part of supporting people to move through those dark places. Groups are led by trained facilitators who themselves are suicide attempt survivors and/or have had significant struggles with thoughts of killing themselves. The primary focus is on creating a forum for voicing, sitting with, understanding and moving through suicidal thoughts as supported by mutual connection and relationship. Individuals are given freedom to talk openly, and facilitators are also trained to ask questions that help people build greater understanding about their experience. For example, one of the group’s beliefs is that being ‘suicidal’ is less a feeling than a consideration of an action and/or a word that people have been trained to use to evoke a particular response from a system. So, when someone says they “feel suicidal,” a facilitator might ask questions to elicit information about the feelings that are actually underlying the thoughts of killing one’s self.
The Alternatives to Suicide approach offers a head-on challenge to the long-held belief that people who are or have been suicidal can't support or are somehow a danger to one another. In fact, it has demonstrated that people who have such personal experience are sometimes the very best supports possible. The group also lives in the seeming contradiction that suggests that letting go of control and assessment and the very idea of being responsible for ‘suicide prevention’ is the very best route to actually making a difference in the life of someone who is contemplating killing themselves. Most of all, this approach is innovative for putting the voice of individuals who have ‘been there’ at the very forefront of this work when just about every other group, conference and training would have them take a back seat to clinicians and more conventional efforts.
When research is telling us that risk of actual suicide attempts are highest directly after someone has just been released from a hospital for being suicidal, it’s strong evidence that the mark is being missed. When we look at the National Institute on Mental Health’s 2014 report indicating that death from Leukemia, AIDS, stroke and heart disease have all shown dramatic reductions, but the rate of death by suicide has stayed steady, we know that something has to change right away. Alternatives to Suicide approach is offering just the sort of leadership necessary to make that change by taking fear and reactionary responses out of the picture as much as possible and supporting people to learn to sit with one another in discomfort and talk things through without attempting to take control. This is an approach that saves lives and is widely applicable within and beyond the mental health system.
Alternatives to Suicide groups are run by two trained facilitators and can take place in a variety of spaces. Although facilitators are generally paid a stipend, some have chosen to do the groups on a volunteer basis. As such, the cost to sustain groups is very low.
At present, the Western Mass Recovery Learning Community (RLC) has partnered with an organization beyond the normal boundaries of ‘mental health’ and holds a sub-contract with Tapestry Health to fund these groups. Indeed, part of what makes this work so sustainable and readily expandable is that suicide is an issue that touches so many people in this world, and thus generates interest and support well beyond the normal constraints of the mental health system.
Groups have already spread to neighboring states, and the RLC has developed a three-day training that they have offered in varied settings to both peer and mixed groups. (Similar to the Hearing Voices Network, Alternatives has made room for allies who are wholly committed to the values and approach.) Additionally, a two-day training has been developed for others who simply want to learn more about how to sit with conversations on suicide and other seemingly taboo topics. Feedback has included:
- “I want to thank [the trainers] for opening my Soul. I have done many different trainings. The completion of the Alt2Su Training is the one I am the most proud of, and the most inspired by.”
- “This is one of the best trainings I attended in a while because it challenged me to really look at my fear and how I connect with myself and others.”
There are currently around 10 Alternatives to Suicide groups in and around Western Massachusetts. More than 75 new facilitators have been trained in the last year, and additional new groups are in the works. The RLC was also given the 2014 Leadership in Suicide Prevention Award for their work with this approach. Most important, group attendees have reported powerful impact including:
- "Alternatives to Suicide is, at the end of the day, about relationship-building. It makes me feel connected, that I am finally not alone. Relationships that grow out of sadness can become incredibly rich and filled with laughter."
- "As a mother, there was shame around these thoughts. I thought I must be the most selfish person in the world. In the group, I discovered there were other mothers out there who have these thoughts. In this group, I found liberation."