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ANNOUNCEMENT

25*WHAT IS YOUR SUICIDE SAFETY PLAN?

MY SUICIDE SAFETY PLAN
 

I,  _________________________agree to  follow the safety plan of treating suicidal thoughts seriously.  I will talk openly about any suicidal thoughts with my counselor, therapist, psychiatrist, Primary Care Doctor, RN or any other member of my support systems. If needed, I will seek immediate help by calling 911 or going to the Nearest  Emergency Room

 

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I believe the Spiritual Journey is inwardly directed toward the God Spot... along the way but close to the God Spot is the area of spontaneous healing.
Posted by Doc Wilmot
 
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Ownership of one’s safety plan is an important key. I believe consumers should be encouraged to share their plan with whomever they trust: clinician, family member, friend or certified peer supporter, and surely,
the more the better. If a safety plan is developed within a trusted relationship and the consumer owns his/her plan, chances are they won’t feel quite as alone, even when in crisis.

Consumers do more readily trust peer supporters than clinicians who may never have “walked in their shoes”. Many health/mental health organizations in my community are implementing intentional peer support programs. My previous employer provided peer workers some education about suicide, but peer workers cannot intervene on their own and must report a serious risk to self [or others] to someone with professional qualifications.

Crisis/suicide “hotline” workers ask for a [verbal] safety contract before the caller hangs up the phone, especially in cases where the caller declines to meet with a mobile crisis team or refuses a call to 911. The verge of ending one’s life is a terrible and lonely place to be. If you can get a suicidal person to agree to some kind of safety plan or contract, and then follow up with the person an hour or two later, or even the next day, you just might have ‘bought’ them time to think about what they have to ‘live for’.

I specifically remember one slide from an educational presentation on suicide intervention; the rest of its content has blurred in my mind. The slide made reference to an investigation into one man’s death by jumping off a bridge. Police found a suicide note that said, in effect, ‘If even one person smiles at me today, I will not kill myself.’

In my opinion, clinicians DO care; it really hurts to lose a consumer/patient/client. If you can convince someone to call back, or call  911 before they take a lethal step, then what does it matter whether you use the word safety ‘contract’ or safety ‘plan’?
Posted by Annie Kent Jollymore
 
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I could see if you were terminally ill. After see what my father went through at hospice. If it was me I would want the option to die fast like when they put down a pet. On the other half, look at all the people who lived to share there story of living. was it through prayer, was it beleving.

This is a great discussion.
Posted by Kirk Axelson
 
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Group: Counseling/Guidance & Social Worker Coordinators

Discussion:MY SUICIDE SAFETY PLAN

That is what I said but a bit more practical, hehe always contract for treatment not no suicide....smile
Posted by Dr Gary Kitto
 
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The literature indicates that " suicide contracts" do not assure safety. I agree that contracts for treatment, the development of a thorough lethality assessment and safety plan that includes reliable collateral input represents best practices when addressing lethality concerns.
Posted by Lewis Perna
 
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I must speak to this. When I was working in the U.S. it was common for this type of a "contract" to be used with clients. They don't work. I think that the contract is more of an illusion for the benefit of the therapist. Suicide occurs when someones options run out. It takes just seconds to kill yourself.

The only solution I see is to build strong working relationships of trust and understanding that let the person feeling this level of depression express their thoughts.

I presently reside in Netherlands and have talked with Dutch professionals about this. When I asked about "contracts" there were rolled eyes. If a person wants help they will reach out and if they are wanting to end it THAT IS what they will do. WE can only provide a safe place to talk. we can provide resources. No contract that I've seen would come close to keeping someone alive. Just my 2 cents as someone who works with, and has known those who have been successful at suicide.
Posted by Gail Nicolaysen-Shurtleff
 
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OK. Just wanted to say what I believe and experience in my role has shown me, thats all. If it has been consumers that wrote the contract for your organisation, then I guess I will bow out of the conversation. I have only ever seen contracts like this written by clinicians who are concerned, but thats not nesessaily recovery focused. I like the idea of this is what I am like when I am well. When I experience these symptoms this is what I will do. Having ownership of ones own written plan, experience has shown me, it is more likely the person will reach out. Im for anything that saves lives, I have lost far too many family members and friends to suicide. Why would the person neccesarily talk about suicidal thoughts or feelings with only professional people? Would they do so with an intentional peer support person? Or perhaps you dont employ people in this organisation to provide intentional peer support?
Posted by Lynda Thoumine
 
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It is a really great discussion.
Posted by Carolyne Shapiro
 
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I think you should write a contract for treatment not a suidide plan, the treatment must include participating in treatment of the course of several sessions.
Posted by Dr Gary Kitto
 
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Hi Lynda – We operate using a client-centered recovery based approach that is entirely consumer driven, so when folks are doing well we would have the  conversation re: the safety planning. Clients would never be coerced to  sign this however. Sounds like you have some good stuff happening in NZ.

Cheers, Ivan
Posted by Ivan Evers
 
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"How many people at Jone's Town felt this way and how were those emotions orchestrated?"

Orchestrated emotion, I believe, is something very different. From my understanding of what happened at Jonestown, it was very similar to mindset of Taliban suicide bombers - they honestly and truly believe that they are dying with a purpose and that they will be eternally rewarded in the afterlife. There was also an obvious element of groupthink and programming going on at Jonestown.

What I am talking about is what I saw with both my mom and my friend that I lost about 10 years ago. The happiest I ever saw my mom was 2 months before she died when she entered hospice care for terminal cancer. It was utter joy for her to be referred to hospice. The happiness was due solely to the fact that she knew she was going to die soon. All of her suffering became bearable because she knew there was an end in sight. If physician assisted suicide were legal in PA, she would have done it. She wanted to die to end her physical and emotional suffering - there was no other means to an end for her. She was never going to recover. It's the same level of happiness that the man had in "The Sea Inside" when his death wish was finally granted. Complete peace and acceptance of death with open arms. While it's not true of everyone who plans their death, I don't think it's all that uncommon.
Posted by Ashley Potter
 
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Ivan, really good that the staff love it! But do the consumers love it? That is really the question. We are here to serve and offer theraputic relationship upon which trust is built that automatically allows open sharing to happen. BTW I am a consumer advisor to a forensic mental health service so my views are gathered from personal experience of living daily with a mental illness. I thought I should be clear about that because of what I am saying. I would find being asked to sign something like this manipulation. I accept that not every consumer operates at the same level, as most clinicians dont either. I have no probelm with the WRAP that gives clear self learned instruction to the self in the case of beginning to experience early warning signs. Mary Ellen knows what shes talking about from her own lived experience. If you research suicide contracts or should I say non suicide contracts the evidence base is that they dont work to keep people alive. I have no idea what country this is taking place in but here in New Zealand they wouldnt be used.
Posted by Lynda Thoumine
 
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Yayha ...BTW they are not the psychotics they are people with psychosis!!!
Posted by Lynda Thoumine
 
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Ashley great input and love your honesty!
Posted by Kirk Axelson
 
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"orchestrated emotion" is the faith part of faith healing... watch a faith healer work... he or she is an excellent bio-chemist keeping the person on a natural high so that they appear to thrive-- at least while they are on stage. Below stage or in "green rooms" the audition and rehearse for the faith healing stage appeanace. Bet you didn't know there were auditions for being faith healed but my XXX friend Benny Hinn, faith healer extraordinaire justifies an American Idle approach as he says God is doing the healing under the stage and we are celebrating that healing on stage.

When follow-ups have been done of those healed on stage there has been no greater rate of healing than spontaneous remissions.
Posted by Doc Wilmot
 
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Ashley, I totally agree with you .
Great posts !!

Jones Town ?: interesting one to explore Doc !
Let me drink some Kool-Aid and ponder it..Would orchestrated emotions be separated from group/societal pressure to do something they may not have done otherwise? Still orchestrated emotions ?

Cornell University is dealing with their image in the last 10 years. The suicide rate is high. They are a town full of bridges. They have hired groups of folks to intervene. The fences are not very appealing either. How effective is this route ?..There is no more stress at this U than others at this academic level .
http://www.huffingtonpost.com/2010/03/24/cornell-suicide-barrier_n_511991.html
http://www.huffingtonpost.com/2011/11/28/bradley-ginsburg-suicide-_n_1116348.html
Posted by Kathleen Norman
 
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"... it's almost as if the clouds have parted and the sun in shining on them for the first time in a long time. There is a peace, a readiness, a tranquility that comes to them by knowing that it's all going to be over soon and they won't have to suffer any longer..."

That's beautiful. It's like entering an altered state of consciousness... like having a moment of clarity! You bring up something which is-- too me-- brand new and perhaps is a perspective that needs further exploration on a serious level. How many people at Jone's Town felt this way and how were those emotions orchestrated?
Posted by Doc Wilmot
 
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I see an image of Justin Townes Earle singing my favorite song about suicide to date, Harlem River Blues. I have not heard a more perfect song about ending one's own life.

http://www.youtube.com/watch?v=5LLqFF89UtU

"Lord, I'm goin' uptown to the Harlem River to drown Dirty water gonna cover me over and I'm not gonna make a sound

I'm on a roll, mama, I gotta go, gotta get there while I still can  Troubled days are behind me now and I know they're gonna let me in
When you see me walkin' up the empty yard, just a-singin' and a-clappin' my hands  Tell my mama I love her, tell my father I tried, give my money to my baby to spend."

The reason why I love this song and believe in the honesty of it is because the lyrics are completely dark and celebratory at the the same time. Not only that, but the music is very upbeat. It's the most upbeat song on the record.

For many people who have made the decision to end their lives, who have thought it through, planned it, and who are ready, it's almost as if the clouds have parted and the sun in shining on them for the first time in a long time. There is a peace, a readiness, a tranquility that comes to them by knowing that it's all going to be over soon and they won't have to suffer any longer. This song, more than any other song I have heard, reflects the true reality of suicide for many people - including a dear friend of mine who took his own life almost 10 years ago.
Posted by Ashley Potter
 
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If you cross your eyes and look at your posts, images begin to emerge... what do they mean?
Posted by Doc Wilmot
 
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“Adversity causes some men to break; others to break records." - William Arthur Ward

"Character cannot be developed in ease and quiet. Only through experience of trial and suffering can the soul be strengthened, ambition inspired, and success achieved." - Helen Keller.
Posted by Nick C. Cicchino, MABC
 
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i like and respect ellen copeland and often refer to her work on WRAP. Her work is grounded in evidence and i hope to use this piece in the future. I like that it says "suicide plan and not contract". most evidence now shows that "contracts" as in inpatients settngs do not work. thanks
Posted by Sandra Debiparshad
 
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I agree with each of you. While a signed contract won't take the place of a good therapeutic relationship, it can be part of the foundation of trust, and while it may not be relevent to someone in their "11th hour", it may be. Resolving suicidal ideation is often about creating hope and knowing that supports are available when all seems futile. Ideally discussed and cemented when one is well, these contracts are meant to strengthen the commitment of an individual to stay well, and are not entered into lightly, or forced upon an individual. They often initiate further discussion with clients who are ambivalent about signing, and move the conversation forward. They do not assign blame or offer relief to any party in the event that someone takes their life. I have tweaked this a bit to reflect the type of staffing we have in my agency, and my staff have indicated that they love it!
Posted by Ivan Evers
 
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I'm not sure if anyone on here has had any experience with people who threaten suicide in order to seek attention but I have. I'm not trying to say it in a mean way or an insensitive way - although I can understand how it may be perceived that way - but it is an accurate statement.

Someone who threatens suicide repeatedly so they can watch friends and family get flustered and flock to their rescue is something that I've experienced with two family members of mine some years ago and a few girls in my middle school I was friends with at the time. Their self image, esteem, personal value, meaning of life, and coping mechanisms are intensely lacking and they are in need of intensive therapy to help them build a sense of self worth and meaning to their life.

The issue is that there is never any amount of love, caring, affection, or attention that they can receive from their loved ones that will change their own self image. It ends up becoming exhausting for their friends and family which will only end up making matters worse for them once the stream of love and pity runs dry and compassion fatigue sets in. But then there are those "girl who cried wolf" stories too about someone who has talked about suicide so much to the point that no one believed them any longer and they went out and did it. So it's a tough call.

This is why it's important to understand - as best we can - what the intentions are of someone who is speaking openly about suicide or who begins speaking with phrases like "well, I'll have have to worry about that" or "don't worry, I won't be bothering you any longer", or "you won't have to put up with this anymore, trust me". Are they seriously considering suicide or is it something else? It is obvious that they need help but it's the "type" of appropriateness of intervention that must be determined.
Posted by Ashley Potter

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i like and respect ellen copeland and often refer to her work on WRAP. Her work is grounded in evidence and i hope to use this piece in the future. I like that it says "suicide plan and not contract". most evidence now shows that "contracts" as in inpatients settngs do not work. thanks
Posted by Sandra Debiparshad
 
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I agree with each of you. While a signed contract won't take the place of a good therapeutic relationship, it can be part of the foundation of trust, and while it may not be relevent to someone in their "11th hour", it may be. Resolving suicidal ideation is often about creating hope and knowing that supports are available when all seems futile. Ideally discussed and cemented when one is well, these contracts are meant to strengthen the commitment of an individual to stay well, and are not entered into lightly, or forced upon an individual. They often initiate further discussion with clients who are ambivalent about signing, and move the conversation forward. They do not assign blame or offer relief to any party in the event that someone takes their life. I have tweaked this a bit to reflect the type of staffing we have in my agency, and my staff have indicated that they love it!
Posted by Ivan Evers
 
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I'd be interested to know as well. I learned in my training that I should ask every client to write and sign a similar statement, committing to not taking any action. If the client is unwilling to do that, then I should ask him or her to write or sign a statement saying they will not do anything along those lines until our next appointment at a set time and date. If they still won't commit to that, then I am to phone the authorities in order to protect both my client and myself.
Posted by Gretchen Jakub Fabre
 
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I would want to at least try to help someone if they were at the point of suicide. It hurts my heart too much to see someone at that level, or to attend a funeral of someone who took their life. Maybe it's cause I've been there.

Like I said before: "It's those who you leave behind that suffer thru the emotional pain" That's why we are each different and spiritual beings.

As for someone looking for attention, let him/her. Show the compassion and love them to the best that you know how. We are here to help and love each other the best we can.

Capt. Kirk
FANTASTIC!
Posted by Kirk Axelson
 
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I don't think I would assist in someones suicide until they had a psychedelic experience.That way I could say something I've always wanted to say: if you don't have any absolutely fantastic experience, I'm killing you... with laughter!
Posted by Doc Wilmot
 
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I do support the use of psychedelics for those who are suicidal. Why not, right? I do believe there's therapeutic potential with them. HOWEVER, they need to used under the tightest of controls to ensure (to the best of our abilities) the patient has a positive experience because most people who are not in the right mindset will just have a bad trip which will ultimately make things worse for them - increased anxiety, depression, paranoia, etc. I don't believe any science has been done in the area of the use of psychedelics as a suicide prevention intervention but I do believe there's unlocked potential that should be explored.
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What about a little psychedelic experience before they kick the bucket with their own foot.

I don't know if you saw the Clint Eatwood Film Million Dollar Baby with Hilary Swank playing a female prize fighter who becomes a quadriplegic at the end of the film. She also wanted to die and wanted Eastwood's character to assist her suicide even though he was a devout Catholic. She said at the end she'd given up because she'd never be able to go anywhere again... she'd never be able to take a trip... I thought to myself,,, but she could take a trip on acid!
Posted by Doc Wilmot

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As someone who has experienced suicides of people close to me (3 actually and 1 friend in a very very gruesome way), I am pretty confident in saying that people who are serious about committing suicide are going to do it regardless of any type of intervention they receive. Most often, a suicide is a "surprise" to their loved ones as there was no obvious talk of ending one's life prior to the event. There is little - if anything - anyone could say to prevent a serious suicide attempt. And people who are serious about ending their own life do not "attempt" suicide. They carefully plan it to ensure it's success.

A majority of the time, people who openly talk about suicidal thoughts are not serious about ending their lives. For many, it's indicative of attention seeking behavior and perhaps a plan like this may feed into their need for love and concern. I'm not putting this pact down in any way, but given my personal experience with it and speaking with friends of mine who either work in crisis counseling or have shared similar experiences, I doubt this will be an effective intervention for anyone who is serious about ending their own life.

Speaking for myself as someone who has been suicidal at one point, I am 100% confident that if I were ever to commit suicide I would not tell anyone about it. I would not want to risk having someone talk me out of it or hospitalize me. I would want to be left alone to do my business.

I may catch flack for what I'm about to say but I'll say it anyway. I also do not view suicide as a selfish act. I believe that friends and family members trying to talk someone out of suicide is more selfish. They want them around and they'd be very sad and upset if they were to talk their own life. That's their true motivation and it's coming from a selfish place. If someone has done a thorough cost / benefit analysis, spent a significant amount of time thinking and planning their own death, is ready to die, and especially if they have a history of mental illness or chronic health issues or terminal illness, then I support their decision to end their life. Who am I to tell them otherwise?
Posted by Ashley Potter
 
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Hi- this appears to be a safety "pact" or agreement to follow a safety plan and talk about suicidal thoughts with providers. I am assuming then you work with people to develop their safety (i.e. wellness) plan that includes their wellness vision (how it looks, feels), recognition of the types of things that interefere with the wellness vision (i.e. triggering situations, thoughts, etc), and ways to respond to those situations so that self harm or suicide isn't the most ideal tool to deal with life's struggles that re impeding your wellness. I'd be very interested in seeing what a safety plan looks like at sacpros and am more than happy to share examples myself.
Posted by Cherene Allen-Caraco
 
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"Positive talk is a MUST and how you talk to yourself is huge. And most of all loving yourself and being yourself."I think it might have to do with that "God Spot" in your brain... and that's OK... mine has a name, Zenobia, and she's my guardian angel.
http://www.foxnews.com/story/0,2933,507605,00.html
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I'm sure this was written with very good intentions but maybe the person who is potentially suicidal needs to have their own very specific plan. This seems to imply that something will happen to the person if they do not sign. How about the "Suicide Safety Plan" being WRAP plan. If a person has these supports, they have the intelligence to use them without signing a form. If a person is truly suicidal, agreements mean nothing. If a person is in such despair that they no longer feel they make a difference to people in their lives and those lives won't be changed by their death, why would signing this little piece of paper change their mind?

If they are open to help at this moment, and have all these supports, they will seek them out without having to be treated like a child. You also left out supports such as hot lines and Peer Warm Lines. I'm sorry to be so critical, but I think you are asking for comments.
Posted by Susan Corey, MA
 
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Yes, there are so many unanswered questions that stay with you for a long time. Even today I ask myself questions as to why Brad killed himself. To me I thought he had everything in the world, he saved my life many times.

I agree with you on it's NOT A Selfish act. When you are in that state of mind the emotions are so horrendous that you feel there is no way out, even reaching out to someone is out of reach. That's where the real courage comes to reach out to someone who can talk some simple positives in your mind, so that you can rebuild that you do make a difference. That you are loved and you have touched many people.

Meditation was a huge break-through for me the last 3 years, and continue to practices it everyday, right along with positive affirmations, and prayer. It MUST be done everyday, if not I do find it slips away.

A few years back I had filed bankruptcies and was struggling to make ends meat. I was living paycheck to paycheck, when my car engine blowup. I had no credit, no cash, no family to borrow from. I ended up selling my wife’s jewelry that I had plans to give to Nicole when she was older to have something of her mothers. This of course through me to such pain all my thoughts we on dying. I was so emotional drained that it was hard to pull energy from FANTASTIC. Turning it around to positive affirmations was huge, but well worth it. I thought my wife dying was bad; WOW the loss of security was another experience.

Positive talk is a MUST and how you talk to yourself is huge. And most of all loving yourself and being yourself.

Love and Blessing
Capt Kirk
FANTASTIC!
Posted by Kirk Axelson

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Having a friend or family member kill themselves must be an extreme pain to deal with.So many questions are left unanswered . I have not experienced this pain,thank goodness.

I am shocked at the views by society when someone does kill themselves. Some are so critical and disgusted. They view it as a selfish act. I DO NOT. I think when someone takes this measure they had to have been going through extreme pain. (emotionally or physical) I don't judge this as a selfish act.

Kirk,you have mentioned thoughts of this. I think this thought has passed in ones mind briefly or otherwise at some difficult point or another. If this thought are ruminating, repetitious thoughts, for whatever your reasons (grief,depression,etc) One technique is practicing mindfulness ,meditation and metallization based techniques. Skills to switch the negative neuropathways in your head to new ones when this happens. Its a conditioning exercise of the mind. Like building a muscle,learning a new sport.

These are just a few ways you can access,exercise your thoughts instantly after you have conditioned yourself. However,just like any muscle or skill one has to keep doing it to become proficient . Its a ongoing journey not a destination.
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This subject is serous. Having been there many times in my life I would have to really trust my counselor, therapist, psychiatrist, Primary Care Doctor, RN. Half the time they are just thought from being attached to the point you feel it's the only way out. You could land yourself in 72 hour lock up and later stuck with $$$$$$ of bills, loss of job etc.

With this said I lost my best friend to suicide and my mother tried it twice when I was young. I have since lost a few others to suicide.

With grief and addiction I have had thoughts of suicide, sometimes I would cry so much hoping the thoughts would go way. Were these thoughts produced because of mother, best friend, or that fact I'm having a real hard time with life, and I'm feed up.

Most of the time I'm the cause of these thoughts as I'm filling my head of negative thoughts versus looking at the gratitude in my life.

It's an ugly place to be in. I have signed up for a workshop called Safe Talk in which you learn skills to see when you need to take action.

When my best friend died I say him the night before, and we talked about going into business together. Not one time did he mention he was going to take his life, Of course I took the pain internally for years as to why I didn't see the signs, back then they buried grief.

What I have learned is that it's who you leave behind that hurts the most for years.

Capt. Kirk
FANTASTIC!
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I do like the layout of the statement that you've shown. I hope everyone who reads it understands that the contract for safety is more about covering us than it is preventing suicide. Those who have the conviction to take themselves out of this life will say, sign, or do anything you ask, just so they can get on with their own plan. Unfortunate, yes. True, yes. Anytime the pain of living outweighs the pain of dying, the person will take their own life.
Posted by Dr. Jack Booth
 
 
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