The Many Paths to Suicide Risk Factors Triggers Means Demographic Poison Expelled Arrested Age Sex Gun Race Geog-raphy Fired Sexual Orientation Hanging Personal History Increasing Hopelessness Contemplation of Suicide as Solution Culture Shock/ Shift Model for Suicide Com-mitted WALL OF RESISTANCE Values Beliefs Religion Child Abuse ? Autocide Jumping Psychological Status Major Loss ? Substance Use ? Personality Traits ? Divorced Diagnosis

WALL OF RESISTANCE TO SUICIDE PROTECTIVE FACTORS RELIGION/SPIRITUAL (PROHIBITION) SOBRIETY BEST FRIENDS MEDICATION COMPLIANCE COUNSELOR/ THERAPIST DUTIES TO OTHERS PETS FEAR (PAIN, DISGRACE,ETC.) RESPONSIBILITY FOR CHILDREN JOB SECURITY JOB SKILLS GOOD HEALTH SAFETY AGREEMENT TREATMENT AVAILABILITY (HOPE) POSITIVE SELF-ESTEEM These are some key protective factors. The more “bricks in the wall’ the better. One risk assessment approach, developed by David Jobes at the Catholic University of America, is to ask the client how many reasons for living and reasons for dying he/she has. If the individual can’t list a few reasons for living, you’re in trouble. This wall includes many reasons for living. Consistent with the Philosophy of Care, one of our strategies is to identify, reinforce or develop as many protective factors as we can. Religion and religiosity are considered protective factors Organized religion provides a support system and social network Spirituality can be a coping resource Religious people are much less likely than non-religious people to abuse drugs and alcohol Many religious persons morally object to suicide Responsibility for one or more children is a powerful protective factor against suicide in women CALM AFFECTIVE ENVIRONMENT SUPPORTIVE SIGNIFICANT OTHERS DIFFICULT ACCESS TO MEANS ? ? ? ?