Suicide & Self-Harm

What is a major risk factor for suicide?

• ABeing employed
• BMaintaining relationships
• CHistory of mental health conditions, especially depression✓
• DHaving hobbies

Answer: Major risk factors for suicide include mental health conditions (particularly depression), history of self-harm, previous suicide attempts, and significant life stressors.

True or False: Talking about suicide with someone will make them more likely to attempt it.

• AFalse, asking directly about suicide can help identify risk and enable support✓
• BTrue; only trained professionals should ever raise the subject of suicide with someone
• CTrue, you should never mention it
• DFalse, but only with people you already know well enough to judge how they will react

Answer: Research shows that asking about suicide does not increase risk. In fact, being able to openly discuss suicidal thoughts can reduce isolation and enable help-seeking.

What are warning signs that someone may be at risk of suicide?

• AThese are just normal behaviours that everyone shows from time to time and can be ignored
• BOnly changes that have happened in the past week matter; anything older can be discounted
• CTalking about being a burden, saying goodbye, giving away possessions✓
• DChanges in mood are irrelevant, because risk depends only on a person's diagnosis

Answer: Warning signs include expressions of hopelessness, talking about being a burden, making final arrangements, giving away possessions, saying goodbye, and withdrawn behaviour.

What should you do if someone tells you they are having suicidal thoughts?

• ATake them seriously, listen without judgment, avoid leaving them alone, and help them access crisis support✓
• BTell them not to be silly, change the subject, and talk about something more cheerful until they seem to feel better again
• CLecture them about why they shouldn't
• DOnly tell a professional after they leave

Answer: If someone expresses suicidal thoughts, take them seriously, listen empathically, keep them safe, and help them access immediate professional support.

What is the ALGEE Action Plan step 'Listen'?

• AListen only to positive things they say
• BListen but plan what you'll say in response
• CListen without judgment, showing empathy and validating their feelings✓
• DListen and immediately offer advice

Answer: The Listen step involves active, empathic listening without judgment, validating the person's feelings, and resisting the urge to immediately problem-solve.

What is safety planning in suicide prevention?

• AA plan developed with the person including warning signs, coping strategies, social supports, and crisis contacts✓
• BRemoving all stressful situations
• CKeeping the person under constant surveillance, so that they are never left on their own at any point in the day or night
• DTelling them not to think about it

Answer: Safety planning is a collaborative process where the person and supporter identify triggers, internal coping strategies, supportive people, and professional resources to access in crisis.

What is self-harm?

• AAlways a suicidal gesture, whatever the person says about their own reasons
• BIntentional injury to oneself, often to cope with emotional distress✓
• CA sign that someone does not care about themselves or about the people around them
• DA behaviour that only occurs in teenagers and always stops on its own by early adulthood

Answer: Self-harm (or self-injury) is intentional injury to oneself, typically to manage overwhelming emotions. While serious, it is different from suicidal behaviour.

What is the primary function of self-harm for many people?

• AAttention-seeking only, and best ignored so that the behaviour is not reinforced
• BTo cope with emotional pain or numbness✓
• CAn attempt at suicide in every case, whatever the person says about it
• DA sign they are 'bad' people

Answer: Self-harm often serves as a coping mechanism to manage intense emotions, release tension, or shift from emotional to physical pain.

How should you respond to someone who self-harms?

• ABy dismissing it as attention-seeking
• BBy punishing them
• CWith compassion, avoiding judgment, and helping them access support✓
• DWith disgust or judgment

Answer: Respond with empathy and without judgment. Help the person understand their triggers and develop alternative coping strategies, and encourage professional support.

What should you NOT do when someone expresses suicidal thoughts?

• ALecture them or minimise their feelings
• BBlame them or express judgment
• CLeave them alone for long periods
• DAll of the above✓

Answer: Never leave someone expressing suicidal ideation alone, minimise their feelings, lecture them, or express judgment - these responses can worsen their distress.

Which demographic group has the highest suicide rate in the UK?

• AChildren under the age of ten, especially boys living in large cities
• BAdult men, particularly in middle age✓
• CElderly women who are living alone in residential care homes
• DAdult women, particularly those in their early twenties

Answer: Suicide is the leading cause of death in men aged 15-49 in the UK. Understanding gender-specific risk factors is important for prevention.

What does 'ask, care, act' mean in suicide prevention?

• AAsk why they feel that way, care about the answer, and then act unconcerned so they relax
• BAsk about suicidal thoughts, show genuine care, and take action to get help✓
• CCare about how they feel but take no further action, so that they keep their independence
• DAsk others instead of the person

Answer: Ask about suicide directly, show genuine care and empathy, and take action by helping the person access professional support.

What is the difference between suicidal ideation and suicidal intent?

• AIntent is less serious than ideation
• BOnly intent matters
• CThey are the same thing
• DIdeation is thinking about suicide; intent is a decision and plan to attempt✓

Answer: Suicidal ideation refers to thoughts about suicide, while intent indicates the person has made a decision and may have a plan to attempt.

Which crisis organisation in the UK provides 24/7 support for people in suicidal crisis?

• ARethink Crisis Teams (via NHS)
• BSamaritans (available to anyone)
• CShout Crisis Text Line (text SHOUT to 85258)
• DAll of the above✓

Answer: Multiple UK resources are available: Samaritans (116 123), Crisis Text Line, Crisis Teams via NHS, and Emergency Services (999).

True or False: You should promise to keep suicidal thoughts a secret if someone tells you.

• AFalse; you should tell everybody in the workplace straight away so that they can all keep watch on the person
• BTrue, although you may tell a professional about it later without saying anything to the person first
• CFalse, while respecting privacy, serious risk requires breaking confidentiality to access help✓
• DTrue; confidentiality matters more than anything else, so you should keep the promise whatever the risk

Answer: While confidentiality is important, if someone is at serious risk of harm, you have a responsibility to ensure they access professional help, which may mean breaking confidentiality.

What protective factors can reduce suicide risk?

• ASocial isolation and long stretches of time spent away from other people and from work
• BStrong relationships, sense of purpose, and access to mental health support✓
• CProtective factors do not exist; suicide risk depends entirely on the diagnosis a person has been given
• DKeeping emotions bottled up, so that other people are never burdened with them

Answer: Protective factors include strong social connections, sense of purpose and meaning, access to mental health care, problem-solving skills, and reasons for living.

What is 'postvention'?

• ASupport provided after a suicide death to prevent further deaths✓
• BTreatment of mental illness
• CPrevention of suicide attempts
• DIntervention during an attempt

Answer: Postvention is the support, care, and intervention provided after a suicide death to help survivors cope with grief and reduce their own suicide risk.

How does substance use relate to suicide risk?

• AOnly alcohol affects risk, and then only when someone drinks daily
• BOnly illegal drugs affect risk; alcohol and prescribed medicines do not
• CSubstance use and suicide risk are unrelated
• DSubstance misuse increases impulsivity and risk✓

Answer: Substance misuse significantly increases suicide risk by increasing impulsivity, depressing mood, and reducing inhibitions.

What role can physical activity play in suicide prevention?

• AIt cures suicidal thoughts completely, so no other support or treatment is needed
• BIt can improve mood, reduce hopelessness, and support overall mental health✓
• COnly certain types of exercise help, and only when they are done at a gym with others
• DIt has no impact on mood or hopelessness, and is only of benefit to physical health

Answer: Physical activity can improve mood through endorphin release, reduce anxiety, improve sleep, and support overall mental wellbeing as part of comprehensive care.

What is a safety contract or no-suicide contract?

• AA way of guaranteeing that someone will not harm themselves once they have signed it
• BA legal document which, once signed, prevents the person from taking their own life
• CA collaborative safety plan (now preferred) rather than a one-way promise✓
• DAn agreement where someone promises not to harm themselves

Answer: Traditional no-suicide contracts have limited effectiveness. Modern practice emphasises collaborative safety planning with the person, identifying support and coping strategies.