Wednesday 12 June 2013

An experience of ASIST 

A guest blog from a mental health team leader

As a Mental Health Liaison worker in a busy A & E department, it is the role
of our team to assess and support people who are in crisis, often with
suicidal thoughts. Many people we see have already attempted suicide and
many others are contemplating it.  I have done this work for twelve years, so
I was really interested to go on the two day ASIST (Applied Suicide
Intervention Skills Training), which is an interactive and practical course-
it explores our attitudes to suicide and helps to identify risk and
interventions for people who are experiencing suicidal thoughts.

I didn't have any preconceptions about the course, I was just pleased to
find some training which was so relevant to the area that I work in.  I was
really impressed.  Right from the start I found the approach interesting and
thought provoking; challenging too, but in a very positive way.  The training
content was relevant and practical, really well delivered and sensitively
thought offers some excellent approaches and skills for those
with no experience at all, to the very experienced in this field.

A common theme that I hear from most people considering suicide is: "not
being able to see a way out" of their difficulties.  Although everybody's
individual story differs, a common pattern that I see is people experiencing
a build up of stresses and not feeling able to confide in others, causing an
increase in feelings of isolation and desperation.  A big challenge that
people in distress, or people with mental health problems face is the stigma
attached and the fear of how people might react to them if they disclose
what they are experiencing.  It's a big step to admitting to someone that
they are thinking about suicide and it can also feel like a big
responsibility to know how best to respond sometimes.

This course equips us all to acknowledge those difficult feelings, to
gradually explore alternatives to suicide at a helpful pace, moving forward
to looking at safety planning and support options.  If more people in our
community are equipped to respond, then the aim is to intervene and help at
an earlier stage, before people act on those suicidal thoughts - and this is
where the ASIST skills are so valuable in overall suicide prevention.  I was
reassured to see that the approaches that ASIST use are very similar to what
we have learned to do in our team naturally through years of experience and
through observing what seems to be effective.  For me the ASIST trainers put
into words what works  in practice, in a very clear and digestible format,
which was very reassuring.  What I hadn't previously considered was that
anyone can work towards this and be skilled- not just professionals.
Naturally the  more people equipped with consistent skills and the more
overall healthy attitudes are developed, the better for all us. Attitudes
towards suicide are slowly shifting, but it remains a taboo subject for

I think that the training encourages a more open dialogue about suicide and
encourages much healthier attitudes and approaches.  It is well thought out
and really practical. I have recommended it to colleagues and would
encourage anyone to attend.

Fiona Ellis
Team Leader
Mental Health Liaison Team
A & E


  1. I think it is great that Fiona has written about her experiences of ASIST and hopefully all A and E staff will attend.

    As an ASIST trainer with many years under my belt I know how effective this training is at saving lives. I have also been a service user in the last few years attending A and E in Brighton and inpatient and community psychiatric services. Sadly my experience in A and E was not a good one, both times I felt judged and dismissed at my most vulnerable. (I literally was dismissed the first time with advice to see my Doctor and some valium)

    I understand the pressures that staff are under, the reporting, the lack of resources and the conditions that can be at the least challenging. To my mind compassion is one of the most important attitudes that most be communicated to people in A and E and in my experience was ignored by reception, nurses and the mental health team. To reach out to the person at their time of crisis helps more than the valium, to connect with and communicate that there is understanding of the depths of their pain is vital as aloneness and pain is at the core of the person with suicidal feelings.

    I have no doubt that there are many, many people with positive experiences of A and E when they were suicidal but unfortunately I know there are many experiences similar to mine. To be treated badly when speaking, thinking and living seem impossible, is to my mind appalling.

    For me the model at Maytree (where I also stayed) saved my life, they work with people in the most compassionate, considerate and human way. A lot can be learnt from their work.

    I hope that Fiona communicates to her team the importance of inhabiting the values that ASIST teaches. I hope that attending the training and this blog will enable Fiona and her staff to continue the essential work at A and E and together we will save more loves.

    1. Hello Jim, thank you very much for your comment. We will pass it on to Fiona and let her know your thoughts. Grassroots is also very interested in the Maytree model - we have made a connection with Maytree and often tell people about the amazing service they offer.

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