What Is QPR Training for Suicide Prevention?

Think of it as CPR for a mental health emergency.

female friends hugging mental health crisis QPR training
Photo: Katja Kircher/Getty Images

The majority of people know what CPR training is and how it saves lives. Each year, the American Heart Association trains more than 16 million people around the world on how to act during a cardiac emergency. But have you ever heard of QPR training? (

While the acronym isn't as commonly known as CPR, QPR saves lives, too. Led by QPR Institute, it's a training program designed to help you know how to react and what steps to take when you learn someone is suicidal. Currently, more than 3 million people are trained in QPR.

It all began more than two decades ago, when clinical psychologist Paul Quinnett, Ph.D., founder and CEO of the QPR Institute, hit the road with a group of doctors and nurses talking about suicide. He'd written a book about suicide for some of the patients he'd been seeing who had attempted, but not succeeded—and it led to people asking questions about how to deal with suicide within the practice of medicine.

"What people couldn't do was ask about suicide—they might suspect it, but were afraid to ask," says Quinnett. "They thought asking the question might put the idea in someone's mind, and therefore cause it to happen. But that's just the general fear around this very taboo subject."

He had a brainstorm around how CPR works and considered how he could apply that same procedure for a mental health emergency. In CPR, you're trained to recognize symptoms and apply a technique to get them breathing again. "I thought, maybe you could do that with [suicidal individuals] by leaning into their pain and questioning them directly on whether they were having thoughts of suicide," Quinnett explains. "If they said yes, you could persuade them or take them to get help." (BTW, here's more on how simply asking can make a difference.)

Working with the public health department in Spokane, Washington, Quinnett published a training manual for a three-step intervention that could help save someone in a mental health emergency (that might even mean a stranger). Since 1999, the QPR Institute has grown from having a few hundred trainers, known as "gatekeepers," to nearly 12,000.

The acronym QPR stands for Question, Persuade, Refer. Before you can save someone from potential suicide, you must know if they are thinking about it—and the only way to know is to ask, says Quinnett.

QPR training can be completed through a 60-minute online course or through a 90-minute classroom seminar (find one near you). While both provide the same education, the latter can end up being a little more impactful. During in-person classroom training, the last 30 minutes are spent practicing an intervention with a partner. It's basically roleplay, or scenario-based learning, Quinnett explains. One person plays the role of a person in crisis, and another plays the "gatekeeper" role. "It's good practice to get the words out of your mouth, which is hard to do," he adds.

While suicide prevention training may sound dark, organizations around the country are hosting seminars meant to dissolve the taboo around the topic (and here's why it's time to speak up about suicide). In Fort Worth, Texas, the Jordan Elizabeth Harris Foundation holds events called "Let's Taco about QPR" that include free training and free tacos. The Atlanta-based nonprofit Giving Kitchen, which advocates for food service workers, offers free QPR training to restaurant workers through its website (and won Humanitarian of the Year from the James Beard Foundation this year for doing so).

Other companies are partnering with the QPR Institute to offer incentives to take the online training, which normally costs $30. For example, beauty brand Save Me From is offering savings on the course, as well as a discount on products for those who get certified, through October. It's a move that's personal for Save Me From Founder April Peck, who lost her sister to suicide and is now QPR certified.

QPR Institute has already been around 20 years, but Quinnett says they're just getting started. Sadly, the suicide rate is rising dramatically in the U.S.; it's now the 10th leading cause of death in the country. From 1999 through 2017, suicide rates increased 33 percent, according to the CDC, making it the highest rate seen since World War II. QPR Institute is collaborating with the federal government on grants to evaluate the QPR training effect and whether it's impacting suicide rates. "The suicide rate is rising in almost every county and state you look at, but [data is showing] the rate has slowed in places where training has taken place," reports Quinnett. "It hasn't lowered the suicide rate, but it has slowed the growth." The data will be officially published next year.

In the future, QPR Institute is looking to run microlessons via email so those who have taken the training can practice their skills, and therefore be better prepared to use them in event of an emergency. "It's sort of like having a plane on deck with the engine warm," says Quinnett. "You need to be ready to go when a crisis occurs."

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