PROTECT | Suicide Prevention Training Podcast: Recent Episodes
Manaan Kar Ray
DAWN HEALS THE DARKEST HOUR | The antithesis of suicide’s promise of pain relief, is the healing hope of human compassion and connection. Founded on this principle of Relational Safety, PROTECT is a new dawn in the practice of assets-based recovery oriented care for people in suicidal distress. When seeking out the source of pain, PROTECT transcends the deficits-focus of “what’s the matter with you” to “what matters to you”, a novel mindset that unlocks the true potential in both the professional and the person, to chip away at the pain and/or raise their tolerance to it… The author / podcaster, Dr Manaan Kar Ray, a leader, and innovator in Mental Health Crisis Care, trained as a Psychiatrist in Oxford and then served for a decade as a Director in Cambridge. Currently the Director of Mental Health Services at Princes Alexandra Hospital, Brisbane; he is passionate about transforming the clinical practice of suicide prevention. PROTECT combines the latest research with person-centred practice from the internationally acclaimed initiatives he has led. This training podcast is an essential listen read for all health care professionals and provides both the essential and advanced competencies in suicide prevention. Further information at www.PROGRESS.guide.
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In this episode we move from concept to practice, stepping into the four anchors at the centre of the STEPS model: State, Source, Span, and Scenario.
Through Ari’s story, we show how to:
- Locate where someone is right now (State).
- Trace what hurts most and what values are under threat (Source).
- Map how risk ebbs and flows, and how close someone has come to crossing the ideation–action divide (Span).
- Co-create what if / if…then… plans that make the future safer and more liveable (Scenario).
We also weave in the four types of risk—static, stable, dynamic, and fluid—and explain why warning signs trump risk factors, as well as the distinctions between acute, chronic, and acute-on-chronic presentations. Together, these elements shift our practice from prediction to prevention, from deficits to assets, and from TOP (The Only Professional) to TAP (Together As Partners).
You’ll learn:
• How to integrate State–Source–Span–Scenario into real conversations.
• Practical ways to keep the ideation–action divide open.
• How to embed risk awareness into collaborative, values-based safety planning.
Next time, we’ll step into the HOPE framework—grounded in Acceptance and Commitment Therapy—to explore how values can be woven into daily conversations as anchors of safety and recovery.
Content note: This episode discusses suicide. If you are struggling right now, please reach out to local crisis supports or someone you trust.
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Progress to Practice
This World Suicide Prevention Day 2025 Special episode explores the three critical mindset shifts that bring suicide prevention from concept to care.
First, the shift from prediction to prevention — moving beyond static categories of “low, medium, high” risk to dynamic, forward-focused conversations that anticipate what lies ahead.
Second, the shift from past to future — learning from history but ensuring time is spent preparing for the immediate days and weeks where safety can truly be shaped.
Third, the shift from deficits to assets — not only naming what is wrong, but reconnecting people to their strengths, values, and relationships that hold them in distress.
Together, these shifts are woven into a deeper transformation: from TOP (The Only Professional) to TAP (Together As Partners). Relational safety grows not through control, but through shared responsibility, dignity, and connection.
This special episode also reflects on Creating Hope Through Action — a new song released on 10 September 2025 to mark World Suicide Prevention Day. Inspired by the idea that hope lives in small, shared actions, the song invites us all to consider how we can nurture hope for ourselves and for others.
We close by setting the stage for the next episode, where we’ll explore the four guiding tasks of the STEPS model: Step, Source, Span, and Scenario — practical anchors for turning mindset into method, and hope into action.
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A Song for World Suicide Prevention Day
Released on 10 September 2025 for World Suicide Prevention Day, this original song captures the heart of this year’s theme: Creating Hope Through Action.
Hope has been described by poets as the thing with feathers, fragile yet enduring. But hope is more than a feeling — it is something we create together through the choices we make, the questions we ask, and the care we offer one another.
This song is our tribute to those we have lost, to those who are struggling, and to those who continue to work each day to build safer, kinder communities. It reminds us that prevention is not about prediction, but about presence. That dignity lies not only in survival, but in reclaiming connection, meaning, and agency.
May this song be a reminder that hope is not abstract. It is actionable. And each of us, in our own ways, can take part in creating it.
Lyrics:
Creating Hope Through Action
Verse 1
We remember the names, the lives, the years,
Stories carried through silence and tears.
No label, no number can capture their song,
Their voices remind us we all belong.
Verse 2
Hope, Emily said, is a bird in the soul,
A feathered companion that sings and consoles.
But hope is not only a whisper or rhyme,
It lives in our actions, it grows over time.
Chorus
Hope is not waiting, it’s what we create,
In each small action, in love we demonstrate.
Together we carry the flame through the night,
Creating hope through action, in each other’s light.
Verse 3
The past is a teacher, but the future’s our thread,
Woven in moments, in words we have said.
Not just what is broken, but what still survives,
The ember of meaning that keeps us alive.
Bridge
From silence to speaking, from shadows to sight,
We find in each other the courage to fight.
Not one hand alone, but all hands combined,
A circle of safety, a thread redefined.
Chorus
Hope is not waiting, it’s what we create,
In each small action, in love we demonstrate.
Together we carry the flame through the night,
Creating hope through action, in each other’s light.
Outro
For the lives we’ve lost, for the lives we save,
Hope is the thread we choose to brave.
Final Chorus
Hope is not waiting, it’s what we create,
In each small action, in love we demonstrate.
Together we carry the flame through the night,
Creating hope through action, in each other’s light.
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This episode is a deliberate pause: a chance to gather the threads of Ari’s journey and see the STEPS model as a whole. We begin with the heart of any assessment—the room between two people. We explore relational safety as a felt sense created by presence, tone, pacing, and transparency, and we name the real tension clinicians hold: the story that needs to unfold and the structure we need to make good decisions.
From there, we model a balanced stance—curious, compassionate, and clear—drawing on the posture of motivational interviewing. We show how narrative first honours meaning, and how validity techniques (used gently and transparently) help complete the jigsaw: normalisation, shame attenuation, behavioural incident, gentle assumption, denial of the specific, and symptom amplification.
We introduce B4Now, a simple time-window scaffold (Day 1, Two Weeks, Three Months, Before, Now) that weaves story into structure—especially when time is short or memory is scattered. We name common pitfalls (all heart/no map; all map/no heart; cannon questions; hidden agendas; premature reassurance) and how to repair them.
Then we revisit each phase—FABRIC, THREAD, NEEDLE, TIP, MEND, FLOW—before hearing Ari’s reflection in her own words: continuation is not neat, but it is possible.
We close by previewing what comes next: three practice shifts that deepen STEPS in real-world care—from prediction to prevention, from past to future, and from deficits to assets—alongside four guiding tasks that help us see not just the tear, but the tapestry in motion.
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In this episode, we return to Ari a month after her attempt — not at an ending, but at a continuation. This is FLOW, the phase of living in motion.
FLOW does not promise smoothness. It promises awareness. It helps us notice how life breathes after survival — imperfect, uneven, yet alive.
We explore the four strands of FLOW:
- F – Fluctuations in mood and risk: recognising that ups and downs are not failures, but early signals to listen to.
- L – Learning from setbacks and successes: turning survival into lived wisdom, and spotting the small strategies that already help.
- O – Openness to support and change: recognising when to reach out, and building a circle of safety that feels possible.
- W – What If / If Then planning: rehearsing safety through concrete steps, so the next wave does not overwhelm.
Through Ari’s story, we see how these strands begin to take shape: some days heavy, some lighter, but now with more awareness and preparation. FLOW reminds us that life after survival is not a return to “before,” but a rehearsal of life as it is — tender, resilient, and ongoing.
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MEND – After the Rupture, the Reweaving Begins
After a suicide attempt, survival is not the end of the story — it’s the fragile beginning of another chapter. In this episode, we explore the MEND phase of the STEPS framework:
- Meaning-Making: searching for fragments of understanding in the aftermath.
- Emotions in Motion: navigating the waves of guilt, relief, anger, or quiet.
- New Stressors & Support: facing stigma, disclosure, and the shifting responses of others.
- Direction Forward: beginning to reweave identity, purpose, and values into daily life.
Through Ari’s story, we witness how survival carries both weight and possibility. Healing doesn’t arrive all at once — it is stitched together thread by thread: a sketchbook rediscovered, a message sent, a small gesture of presence.
This is the phase of re-entry into life, where compassion and values-based conversations can guide recovery. MEND is not the conclusion of crisis, but the weaving of a future that holds both scars and strength.
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Action - We enter the fourth phase of the STEPS model — TIP — the moment when suicidal thought becomes action.
TIP is an acronym for:
T – Tension Builds – the lead-up to the act: the events, emotions, and pressures that coiled the thread so tight it broke.
I – Impact Unfolds – the act itself: whether impulsive or rehearsed, interrupted or completed, and the mindset that accompanied it.
P – Postscript Remains – the immediate aftermath: what followed physically, emotionally, and relationally when survival was still possible.
We explore how the crossing into action can happen in two ways:
- Gradually, through the NEEDLE phase, as intention sharpens into planning.
- Or suddenly — as it does for one in four people — bypassing planning entirely and leaping straight from ideation into action.
Drawing on trauma-informed care, motivational interviewing, and solution-focused strategies, we discuss how to have these critical conversations — most often in the hours or first day after an attempt — to validate the pain, uncover the story of the rupture, and begin to stitch safety back into the weave of a life that has been torn.
Ari’s story returns, showing how the second time was different — fast, impulsive, fuelled by alcohol — and how a knock at the door became the thread that held.
Because the story does not end at the point of rupture.
Not if the person is still breathing.
Not if we are still listening.
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Intention and the Quiet Planning of Death
When risk tightens, our questions must soften. This is where the thread turns sharp.
Sometimes the thread of suicidal thought sharpens—quietly, steadily—until it points toward a plan.
This is the NEEDLE phase of the STEPS framework, where risk is no longer just emotional or ideational, but begins to take form.
In this episode, we explore the six stages of NEEDLE:
- Navigating Ambivalence – feeling torn between holding on and letting go
- Excluding Options – when nothing else feels possible
- Examining Means – researching, imagining, preparing
- Drafting an Exit – forming a plan, even silently
- Leaving Subtle Signs – the quiet goodbyes, often missed
- Exploring the Exit – rehearsing, visiting, coming close… and sometimes turning back
Through Ari’s story and clinical reflections, we learn how to sit beside the weight of intention—not to rush, not to retreat, but to trace the thread with care before it slips through the needle’s eye.
Because even here, motion can still shift.
Presence matters. And every thread held is a life with more to live.
🎧 Listen now and stay connected as we walk the STEPS together.
#STEPS4HOPE #SuicidePrevention #MentalHealth #TraumaInformedCare #NEEDLE #Intention #ClinicalEducation #RelationalSafety
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Ideation. It doesn’t always arrive loudly.
Sometimes it starts with a whisper—“I’m just tired.”
Other times, it circles silently, gaining strength beneath the surface.
In this episode, we explore THREAD, the second phase of the STEPS model. Here, suicidal ideation begins to take shape—not yet a plan, but not just passing pain. This is the moment to notice the pull, to trace the thread before it tightens.
We walk through six elements of THREAD:
🧠 Thoughts of Suicide
🌫 Headspace of Suicidality
🔁 Recurrence & Distractibility
🔍 Escalation in Specificity
⚖️ Ability & Desire to Resist
➡️ Direction Toward Planning
With motivational interviewing and trauma-informed questions, we learn how to sit beside the person—not to interrogate, but to understand.
Because when we notice early, we can stay close.
And when we stay close, we create safety—one thread at a time.
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Predisposition and the Invisible Unravelling
Where suicide risk begins — quietly, invisibly. This episode explores the earliest, often overlooked signs of emotional unraveling through the metaphor of FABRIC: Fragile sense of self, Alienation, Burdensomeness, Repetitive rumination, Inescapable circumstances, and Curtain of despair.
Before there are plans, before there are words, there are feelings — of being hollow, disconnected, stuck, or unseen. These are not yet cries for death, but whispers of disconnection from life.
Through Ari’s story and clinical reflection, we learn how to recognise these early warning threads and respond with presence, not panic. We explore how careful, curious questions can help surface what hurts — and what still matters.
This is where prevention begins: not in fixing, but in noticing.
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STEPS 4 HOPE: Suicide Prevention Through Story, Song & Meaning
Welcome to PROTECT (Season 4), a podcast where suicide prevention meets story, values, and the quiet power of music. Hosted by Dr. Manaan Kar Ray, psychiatrist, educator, and creator of the STEPS and HOPE frameworks, this series blends narrative, metaphor, and original music to explore how we can respond with presence and purpose to life’s most fragile moments.
Each episode follows Ari’s story—a tapestry of struggle, meaning, and recovery—and invites listeners into the emotional and clinical landscapes of suicide prevention. Grounded in values-based therapy and ACT principles, STEPS for HOPE is both poetic and practical, designed for health professionals, lived experience advocates, and anyone walking alongside someone in pain.
You’ll hear:
- Story passages from the STEPS for HOPE books
- Original songs created to capture the soul of the story
- Reflections on how to notice, respond, and reweave meaning after distress
This is not a podcast of quick fixes. It’s a space for reflection, compassion, and learning to hold hope—even in the fray.
Visit ATLAS.
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Wrapping Up The Courage to Explore
In this heartfelt final episode of 2024, the PROTECT Podcast explores the profound value of inner strength as Sunny meets his new guide, Goro the Gorilla. Through a challenging climb up a rocky hillside, Goro teaches Sunny that true strength isn’t about physical power—it’s about resilience, patience, and the determination to keep going, one step at a time.
Dr. Manaan Kar Ray and Mahi reflect on the interconnected values from The Courage to Explore: courage with Leo, adventure with Max, curiosity with Milo, wonder with Hazel, and now inner strength with Goro. Each value builds on the others, forming a foundation for resilience and growth.
The episode also delves into the role of inner strength in mental health, highlighting its importance for navigating stress, building emotional resilience, and supporting others with kindness and compassion. Dr. Kar Ray discusses the vital role inner strength plays for mental health practitioners and the importance of self-care in sustaining their work.
As this special episode marks the end of the year, Mahi bids farewell (for now) as she prepares for her next adventure studying medicine in the UK. Dr. Kar Ray takes a moment to celebrate her growth as a host, storyteller, and voice artist, sharing heartfelt wishes for her journey ahead.
Filled with warmth and wisdom, the episode closes with festive Christmas wishes and a reflection on how the values of The Courage to Explore can guide your New Year’s resolutions. Join us again in January 2025 for The Art of Wisdom, starting with the value of wisdom itself.
May your holidays be filled with courage, adventure, curiosity, wonder, and strength. Merry Christmas and Happy New Year!
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Explore Sunny's Values Scouts
In Episode 64 of the PROTECT Podcast, Dr. Manaan Kar Ray and Mahi explore the transformative value of Wonder. Building on last week’s theme of curiosity, this episode dives deeper into the magic of noticing and appreciating the beauty around us. Wonder isn’t just about grand, life-changing moments—it’s about finding awe in the ordinary, from a shimmering flower to a breathtaking sunset.
Through the enchanting story of Sunny’s journey with Hazel the Hummingbird, we learn how wonder helps us pause, notice, and marvel at life’s everyday miracles. Hazel’s vibrant perspective reminds us that even the smallest things can fill us with joy if we take the time to truly see them.
Dr. Kar Ray shares fascinating research on the mental and physical benefits of wonder, revealing how awe reduces stress, boosts mood, and fosters a profound sense of connection. Wonder shifts our perspective, helping us feel part of something greater and instilling hope, even in challenging times.
The episode also highlights the importance of wonder in mental health practice, showing how it fosters deeper connections, enhances creativity, and nurtures both clients and practitioners. Through thoughtful prompts and a spotlight on Norway’s awe-inspiring landscapes, this episode invites you to rediscover the magic all around you.
Join us as we celebrate wonder—the value that transforms the ordinary into the extraordinary. Prepare to pause, marvel, and let the beauty of life fill your heart.
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Explore Sunny's Values Scouts
In this heartwarming episode of the PROTECT Podcast, we explore the transformative power of curiosity. Join Dr. Manaan Kar Ray and his daughter, Mahi, as they dive into Sunny’s latest adventure in Sunny’s Values Scouts. Guided by Milo the Meerkat, Sunny discovers how curiosity can unlock creativity, build resilience, and solve even the trickiest puzzles.
Curiosity isn’t just for kids—it’s a powerful tool for navigating life’s challenges and finding joy in the everyday. This episode features:
- Thoughtful insights on the value of curiosity in building emotional resilience.
- Real-world research showing how curiosity reduces anxiety, boosts relationships, and fosters problem-solving.
- Practical discussion prompts to help parents, teachers, and mental health professionals spark curiosity in their kids, clients, and themselves.
Packed with storytelling, humor, and heartfelt reflections, this episode also spotlights Japan’s philosophy of shoshin (beginner’s mind) and its lifelong lessons on living curiously. Stay tuned for a sneak peek of next week’s value: Wonder!
Discover how asking “What if?” can lead to deeper connections, greater empathy, and a more resilient life. Tune in now and let curiosity light your way!
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In Episode 62 of the PROTECT Podcast, Mahi and Dr. Manaan Kar Ray explore the thrilling value of adventure. From small steps like taking a new route on a morning walk to daring feats in the unknown, adventure is about embracing life’s possibilities with courage and curiosity. Sunny, guided by Max the playful monkey, journeys through the Everwild Jungle, crossing rope bridges and uncovering hidden waterfalls. Along the way, he learns that adventure isn’t just about the thrill—it’s about discovering the beauty in stepping outside your comfort zone.
Mahi and Manaan discuss how adventure fuels curiosity, builds resilience, and promotes mental well-being, offering insights for families to nurture this value in everyday life. Featuring stories, humor, and engaging prompts, this episode inspires listeners to embrace their own adventures, big or small, and explore life with an open heart.
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In Episode 61, Courage in the Savanah, Mahi and Dr. Manaan Kar Ray dive into courage—the strength to move forward, even in the face of fear. With Sunny’s new guide, Leo the Lion, the duo explores how courage is a value that empowers both children and adults to face life’s uncertainties with resilience and calmness. In a delightful mix of research and storytelling, Mahi and Manaan share how small acts of courage can build emotional resilience, bolster mental health, and nurture empathy.
Through prompts for parents and teachers, the episode offers practical ways to encourage courage in children’s daily lives, helping them see bravery in their actions. Mahi and Manaan also explore iconic characters like Frodo, Neville Longbottom, and Atticus Finch, showing how stories can teach us about courage. Whether you’re facing a personal challenge or just taking the first step toward a new goal, Episode 61 reminds us that courage takes many forms—and sometimes, it’s simply about not giving up.
Tune in to learn how courage can help you embrace life’s journey, one brave step at a time!
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Join hosts Mahi and Dr. Manaan Kar Ray for a heartfelt exploration of loyalty in Episode 60 of the PROTECT Podcast. As they celebrate reaching listeners in 98 countries, Mahi and Manaan share their excitement and gratitude for their global community, with hopes of soon completing their worldwide puzzle by reaching 100 countries.
In this episode, they wrap up “The Path to Belonging” with a beautiful story about loyalty, told through Sunny's adventures in Terra Vale. Seraphina the Swan steps into the spotlight, embodying loyalty with grace and resilience. Through an enchanting tale set in the icy flats, Sunny learns that loyalty shines brightest when times are hardest.
Mahi and Manaan dive into reflections on how loyalty binds us together, making us stronger and more resilient. They share how parents and educators can use this story to start meaningful conversations about loyalty, resilience, and connection with children. The hosts also discuss the vital role loyalty plays in fostering trust and supporting mental well-being, emphasizing its protective value against feelings of isolation and despair.
Listeners are encouraged to reflect on their own experiences with loyalty and to consider the invisible threads that connect us to loved ones, even across great distances. As Mahi and Manaan bid farewell to “The Path to Belonging,” they give a hint about their next adventure, “The Courage to Explore,” and invite listeners to guess the next companion in Sunny’s journey.
Tune in for laughter, heartfelt stories, and thought-provoking insights that underline how loyalty and other core values can transform our lives and relationships.
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The Value of Family: Roots, Resilience, and Dolphin Dreams
Welcome to Episode 59 of the PROTECT Podcast! Today, hosts Mahi and Dr. Manaan Kar Ray dive into a topic that resonates with every listener—family. Families shape our well-being, build our resilience, and are a pivotal element in suicide prevention.
We start with some listener engagement—Mahi and Manaan share the top animal picks that represent the value of family, with dolphins, elephants, and wolves taking the lead. There's even a delightful reference to ISMO Leikola’s dolphin joke, about why dolphins haven’t started their own civilization (hint: it has to do with their flippers!). It’s humor with a splash of wisdom, giving credit to ISMO and his brilliant Finnish humor.
In this episode’s Storytime, we listen to Elio the Elk, from Sunny’s Value Scouts, as he teaches Sunny and Penny about how family is like the roots of a tree—always intertwined, supporting each other through every storm. Through this metaphor, Manaan and Mahi explore how family bonds provide stability, offering insightful reflections on why these roots are critical for mental health, especially during tough times.
We also highlight the LOVE exercise and CARERS framework, practical tools for families supporting loved ones in crisis. Together, they showcase how understanding family roles—from emergency support to stepping back to allow growth—can help individuals regain strength and resilience.
Ending on a lighter note, Mahi and Manaan share some classic fictional families, from The Weasleys to The Parrs, with jokes about Sunny’s potential Pixar deal (we’re still waiting for that call, Disney!). It’s a humorous take on why these families, like our own, are so deeply special.
Join us for this heartfelt exploration of what it means to be a family, filled with laughter, real-world insights, and a call for community action. Help us grow by sharing this podcast—because together, we can make a difference in building resilience and changing lives. Don’t miss the sneak peek into our next episode featuring Loyalty in the Ice. Any guesses who the character might be? Write to us!
Listen now on Buzzsprout, Spotify, Apple podcasts or wherever you get your podcasts.
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Exploring the Value of Connection
The Essence of Inter-being: A Lesson from Oliver the Octopus
In this episode, Mahi and Manaan dive deep into the concept of Inter-being, a powerful idea introduced by mindfulness master Thich Nhat Hanh. Inter-being teaches us that everything in life is interconnected—nothing exists in isolation. Manaan shares Thich Nhat Hanh’s vivid metaphor: how clouds, rain, trees, and paper are all connected in a beautiful cycle. Just like Oliver the Octopus in Sunny’s story, the lesson is that even the smallest things can have a profound impact on the world around them.
Oliver’s Wisdom: The Web of Life
Mahi draws a connection to Oliver’s teachings in the story “Connecting the Dots,” where Oliver the Octopus shows Sunny and Penny the interconnected world beneath the river’s surface. Each creature in the lagoon, from the smallest fish to the tallest reeds, plays a role in maintaining balance. Their conversation explores how, just like in Terra Vale, each of our actions ripples through the lives of those around us, creating an invisible web of connection.
Connection and Suicide Prevention: Every Act Matters
Manaan and Mahi discuss how these lessons of connection are especially meaningful when it comes to suicide prevention. A simple gesture—a phone call, a smile, or an offer to listen—can be the lifeline someone needs. They emphasize how each small act of kindness can make a difference, sometimes even saving a life. In a world where many feel isolated, connection is a powerful remedy, reminding us that we are never truly alone.
Guess the Next Character: Join the Fun!
Before wrapping up, Mahi and Manaan invite listeners to play a guessing game for the next episode in Sunny’s Value Scouts series. The next story, “Family Ties,” explores the value of family. Who do you think will join Sunny on his next adventure? A caring elephant? A loyal wolf? Or perhaps a protective mother bear? Share your guesses in the comments on Spotify, Apple Podcasts, or Buzzsprout—or send your thoughts through the fan mail link or email us at admin@progress.guide.
Stay Connected for a Brighter Future
As always, Mahi and Manaan encourage listeners to stay hopeful and keep those connections alive. Mahi jokes that maybe someone will suggest a family of meerkats with impeccable dinner manners, or a kangaroo who’s all about keeping the family pouch organized! The episode ends with a heartfelt reminder that even when times are tough, it’s those small, everyday connections that keep us grounded. Tune in for this inspiring discussion, and let’s keep building a world where every connection counts.
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Exploring Acceptance: Lessons from Sunny’s Value Scouts
In this episode of the PROTECT Podcast, we continue our journey through the world of Sunny’s Value Scouts with an exploration of the value of Acceptance. Dr. Manaan Kar Ray, our content expert, and host Mahi Kar Ray take us through the enchanting story of Sunny’s latest adventure in Terra Vale, where he learns about acceptance from Kody the Koala. Beyond the story, the episode dives deep into why acceptance is a crucial value for mental health and resilience, and how it can help children and adults alike navigate adversity.
But before we dive into the value of acceptance, the episode begins with a timely reflection on World Mental Health Week.
Introducing the Value of Acceptance
In today’s episode, Sunny learns about Acceptance in the serene setting of the Crystal Lagoon, where he meets Kody the Koala. Acceptance, as discussed in the podcast, is about embracing reality as it is, without wishing things were different or resisting what we can’t control.
Acceptance at the Lagoon: Sunny’s Story
The heart of this podcast episode centers around Sunny’s adventure at the Crystal Lagoon. In the story, Sunny is hesitant to cross a log that stretches across the peaceful lagoon, afraid that he might fall. With the guidance of Kody the Koala and Penny the Penguin, Sunny learns that it’s okay to have fears and that he doesn’t have to push himself to do something he’s not ready for. Instead, he can accept his fear, choose a different path, and still enjoy the journey.
Kody the Koala also shares his own story of acceptance. He tells Sunny and Penny how his home was destroyed by a bushfire, and how he had to accept the loss and rebuild his life in a new way. Through this experience, Kody teaches Sunny that acceptance is about letting go of the need for things to be perfect and embracing life as it is, even when it doesn’t go as planned.
This story beautifully illustrates how acceptance can bring peace, even in difficult times. Sunny learns that by accepting his fear and choosing a different path, he can still have a fulfilling adventure without forcing himself to face something he isn’t ready for.
Why Acceptance is Crucial for Mental Health and Resilience
In the discussion following the story, Dr. Manaan Kar Ray explains why acceptance is such a powerful tool for mental health and resilience. When people face adversity—whether it’s a significant life event like the loss of a job or a daily frustration like a project that didn’t go as planned—acceptance helps them move forward.
Manaan highlighted global mental health statistics, noting that over 280 million people worldwide suffer from depression, and another 260 million experience anxiety disorders. In the face of such widespread adversity, acceptance becomes crucial. Studies show that people who practice acceptance in their daily lives experience less anxiety and depression because they are not constantly trying to control what is beyond their reach. Instead, they focus on how they respond to their circumstances.
For children, learning acceptance early on helps build emotional resilience. It teaches them that it’s okay to make mistakes, to feel scared, or to face challenges—because these experiences don’t define them. By practicing acceptance, childr
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Sunny's Values Scouts on Amazon
In this second episode of Sunny’s Value Scouts on the PROTECT Podcast, Dr. Manaan Kar Ray and Mahi Kar Ray introduce listeners to the heartwarming world of Sunny, the golden retriever, as he embarks on magical adventures in Terra Vale. The goal of this series is to explore essential human values that shape our lives and help build resilience, with each episode focused on one value. This episode centers around the theme of belonging.
The podcast begins with an introduction to the format, explaining how each episode will feature a story from Sunny’s Value Scouts, followed by a conversation on how the value of the day relates to children’s emotional development and suicide prevention strategies. The hosts highlight the importance of these values within the HOPE framework, which is central to the SAFE Life Guide—a guide designed to promote emotional security and well-being.
Mahi then reads the first story from The Path to Belonging titled Finding Belonging. In the story, Sunny finds himself in Terra Vale, a magical land where creatures from different environments come together to learn and teach important life values. Guided by Penny the Penguin, Sunny learns about the deep significance of belonging, both to a family and a community. The story conveys how belonging is not just about having a place, but about finding connection and security with the people or creatures who care for you.
After the story, Dr. Manaan and Mahi delve into the discussion of how the value of belonging can impact mental health, particularly among children. They explore the devastating effects of loneliness across various age groups, including children and adults, citing statistics about the rise in loneliness, especially during the COVID-19 pandemic. Research shows that loneliness is as harmful to health as smoking 15 cigarettes a day, and the episode sheds light on the dangers of prolonged isolation, which can lead to anxiety, depression, and suicidal ideation.
The hosts emphasize the importance of fostering belonging in children as a way to prevent these negative outcomes. Children who feel a strong sense of belonging are more likely to develop resilience, cope with challenges, and maintain a positive self-image. By feeling connected to family, friends, and their community, they gain emotional security that can protect them from feelings of hopelessness and despair.
The episode also provides practical prompts for parents, caregivers, and teachers to spark conversations with children about the value of belonging. These prompts encourage children to reflect on who makes them feel like they belong, what it feels like to be part of a group, and how they can help others feel included. Through these discussions, children can better understand their role in creating a caring and supportive environment for themselves and others.
By the end of the podcast, Dr. Manaan ties the concept of belonging to suicide prevention strategies, explaining how a sense of connection and community can serve as a protective factor against isolation and mental health struggles.
Tune in next week as Sunny’s adventures continue, and we explore the next core value—Acceptance.
Subscribe to Sunny’s Value Scouts for more heartwarming stories and deep conversations about the values that matter most.
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In this insightful podcast episode, Mahi sits down with Dr. Manaan Kar Ray to explore the essence of the Sunny’s Values Scouts series, a collection of children's stories designed to teach foundational values to children aged 5-8. With youth mental health issues on the rise globally, Dr. Kar Ray dives deep into the critical role values play in building resilience from an early age.
Tackling Rising Youth Mental Health Challenges
The conversation opens with startling statistics on youth mental health, including the rising rates of anxiety, depression, and suicidality among teens across various countries. Dr. Kar Ray explains that the early years of life are foundational in shaping a child’s worldview, emotional health, and coping mechanisms. Sunny’s Values Scouts offers an early intervention approach by targeting 5-8 year olds, equipping them with a lexicon of values to create a more resilient generation.
Meet Sunny and the Creatures of Terra Vale
The episode introduces listeners to the magical world of Terra Vale, where Sunny, the Golden Retriever, embarks on adventures that introduce children to important life values. Dr. Kar Ray explains how each animal character in the series—be it Freddy the Frog, Priyan the Peacock, or Chetan the Crane—was thoughtfully chosen to represent specific values like responsibility, accountability, professionalism, and more. The discussion highlights the importance of aligning each animal's traits to the values they embody, making it relatable and meaningful for young readers.
How Parents and Teachers Can Use the Series
Dr. Kar Ray shares practical insights on how parents, caregivers, and educators can use the books to support values-based conversations. Each story is paired with thought-provoking prompts, allowing children to reflect on the lessons and connect them to their own lives. These prompts serve as conversation starters that help children think deeply about their actions, emotions, and relationships, promoting self-awareness and empathy.
A Journey to Build Resilience
The episode concludes with a powerful message about the potential of early values education in preventing mental health issues later in life. By building resilience early on, Sunny’s Values Scouts lays the foundation for stronger, more emotionally balanced young people—ready to navigate the complexities of life with confidence, kindness, and courage.
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Using Compassion-Focused Therapy for Staff Wellbeing in Mental Health Settings
In a podcast hosted by Dr. Manaan Kar Ray, Dr. Stan Steindl discussed Compassion-Focused Therapy (CFT) and its potential to enhance staff well-being in high-pressure mental health environments. Mental health professionals often face emotional challenges, and compassion can be a key factor in maintaining resilience.
The Importance of Self-Compassion
Dr. Steindl highlighted the three flows of compassion: compassion for others, from others, and self-compassion. Mental health staff often extend compassion to patients but struggle to receive or practice it for themselves. As Jack Kornfield said, "If your compassion does not include yourself, it is incomplete." Neglecting self-compassion can lead to burnout. CFT encourages a balanced approach, embracing compassion in all directions.
Understanding Resistance to Compassion
Dr. Steindl explained how professionals often feel discomfort, guilt, or shame when receiving compassion, fearing it signals weakness. Staff may also experience self-criticism, especially when outcomes, like a patient’s suicide, do not meet their hopes. CFT helps staff identify these blocks, fostering a culture of support and self-care, which is crucial to avoiding emotional distress.
The Three Systems: Threat, Drive, and Soothing
Dr. Steindl introduced the concept of three emotional regulation systems: threat, drive, and soothing. In high-stress environments, the threat system can become overactive, leading to anxiety. Compassion helps balance these systems, creating moments of calmness amid demanding work. Grounding exercises, compassionate self-talk, and soothing rhythm breathing are vital tools for mental health professionals to regain stability.
Practical CFT Techniques for Staff Wellbeing
Dr. Steindl outlined several CFT techniques:
- Body Posture: Stand with shoulders back, conveying strength. Small changes in posture can impact emotional states.
- Facial Expression: Softening facial muscles and adopting a faint smile signals calmness to the mind and body.
- Tone of Inner Voice: Using a kind, supportive inner dialogue rather than self-criticism fosters resilience.
- Soothing Rhythm Breathing: Controlled breathing activates the parasympathetic system, reducing tension and promoting calmness.
These techniques help staff make compassionate, thoughtful decisions in high-pressure situations.
Navigating the Complexities of Care
CFT helps staff navigate difficult decisions, particularly in crisis care. Compassion involves courage and doing what is best for the patient’s long-term well-being, even when it’s challenging. By fostering compassion, staff can avoid burnout and compassion fatigue, leading to better patient care.
Conclusion
Compassion-Focused Therapy offers a vital approach for mental health professionals to maintain resilience. By practicing self-compassion, addressing blocks to compassion, and balancing emotional regulation systems, staff can create a nurturing environment for themselves and their patients.
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In this special episode for World Suicide Prevention Day, Caroline Roodhouse shares an intimate and powerful reflection on her journey through grief following the loss of her husband, Steve, to suicide in 2018. With raw honesty and deep vulnerability, Caroline recounts her path from the darkness of despair to a place of hope and healing. She delves into the process of writing her book, Daddy Blackbird, a work that embodies the delicate balance between heartbreak and the promise of renewal.
Caroline offers profound insights into how she moved from the number four to three, a symbolic transition that led her to find peace in triangles. She beautifully describes how triangles, like pyramids, provide a sense of strength, balance, and solidity amidst the chaos of loss. Her reflections reveal the unexpected ways that grief can shape our understanding of the world, allowing new structures of resilience and meaning to emerge.
Throughout the conversation, Caroline emphasizes the importance of kindness—to oneself and others—as a vital force in navigating the turbulent waters of grief. She speaks about the unwavering power of community, illustrating how connection, compassion, and shared experiences are crucial to finding light in the darkest moments.
As we approach the launch of Daddy Blackbird on October 10th, this episode stands as a heartfelt tribute to the journey from sorrow to solace, offering listeners a beacon of hope, the strength in vulnerability, and the healing power of kindness and community.
More information at Daddy Balckbird
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In the lead up to World Suicide Prevention Day, we present an hour with John Bell in which he shares his journey of post traumatic growth.
In July 2020, John became a bereaved parent through the accidental suicide of his 15 year old son, Jake. He coped with the mental trauma of this experience by taking time out alone in the mountains, using his army training to push himself physically, in an effort to balance the psychological storms he endured. In this way John was able to build up his resilience and find a new place of peace; an approach which he is passionate about sharing with others.
To this end, in 2023, he and Chris, our Chair of Trustees, co-founded Walking 4 Hope with family members and friends so that others in similar situations could discover these coping strategies and ways of being for themselves.
John treasures the love he will always have in his heart for Jake; this gives him the drive to do all in his power to be alongside young people, families and bereaved parents who are all contending with their own struggles, helping them to reap the benefits of spending time outdoors and building their own resilience through nature. More information at waling4hope.org
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This is a continuation of the 50th special episode of the PROTECT podcast. We are still giving away a beautiful PDF of all the key messages and images from the 17 PROTECT chapters. All you need to do is email us at admin@progress.guide or leave a comment or ask a question.
In this episode we cover ASPIRE and this will provide you a ready reckoner of the content.
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This is a special episode in which we are celebrating 50 episodes of the PROTECT podcast with a give away of a beautiful PDF of all the key messages and images from the 17 PROTECT chapters. All you need to do is email us at admin@progress.guide or leave a comment or ask a question.
In this episode we cover CORE and ASSESS and this will provide you a ready reckoner of the content.
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In this hour Ally shares insights from her personal journey, and messages that she might have given to her younger self and others in her life with the benefit of hind sight. Ally also talks about Mind Blank's innovative approach to Mental Health literacy, Wellbeing promotion and prevention efforts using their innovative forum theatre approach. The work they have done in schools and work places is truly inspiring, have a listen and do share the word.
About the guest:
Ally Kelly is the CEO & Founder of Mind Blank. As a child and teen, Ally served as carer for her suicidal mother. This experience led her to become a mental health advocate and dedicated to social justice. Throughout her career, Ally has worked with marginalised communities, the homeless, those afflicted by substance abuse and individuals needing mental health support.
A professionally trained singer, Ally married her love of the creative arts with her desire to provide early intervention opportunities to young people, resulting in the establishment of Mind Blank in 2011.
Mind Blank’s unique approach to teaching prevention and early intervention skills using interactive forum theatre has impacted over 50,000 people across Australia. Ally has won several awards, notably the Mental Health Matters Award for Mental Health Promotion, the Mental Health Services Award for Mental Illness Prevention and the Suicide Prevention Australia LiFE Award for Outstanding Contribution in Queensland.
Ally has a Bachelor of Creative Arts, Performance, Psychology from University of Wollongong, a Master of Arts, Social Justice, Social Inequality and Humanitarian Affairs from Griffith University and a Higher Degree Research in Program Evaluation, also from Griffith University.
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Dr Stan Steindl shares his wisdom on Compassion Focused Therapy in conversation with Manaan. The talk provides a broad overview of what CFT entails including little nuances that you can introduce in your practice today.
Stan is a Clinical Psychologist, respected author of books on compassion, Ted ex speaker and an amazing educator of both Motivational Interviewing and Compassion Focused Therapy. Above all he is a kind and humble person to whom you can listen to for hours.
Have a think about how you may incorporate some of Stan's advice into your daily compassion practice:
- Compassion towards others
- Receiving compassion from others
- Self compassion
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Given we have been very busy with our week long suicide prevention training in Malaysia, we have provided a recoding from the presentation at the 1st African Health Summit.
The content might feel repetitive, but it is a good recap. If you have already downloaded the app and have worked through different sections skip the first five minutes as I talk through the pragmatics.
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Paul Vittles is the Founder of Towards Zero Suicide CIC and the Chief Facilitator of Zero Suicide Society. Over an hour Paul shares personal insights from his journey of bringing together people on a journey and engaging them in the conversation TOWARDS ZERO. He shares innovative technological advances as well as inspiring personal stories of post-traumatic growth, people with incredible passion and energy who are making a difference in the community.
We all have a part to play and can make a difference. Every little matters, what we can we learn from Becky and Debbie that we can replicate in our own back yard.
Ending on a message of hope, Paul makes a plead to be ambitious, we can and we will make a difference to the numbers of lives lost to suicide. Join us on the path #TowardsZero. Connect with Paul and join the conversation.
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Key Message: "The journey of a thousand miles begins with a single step" ~ Laozi. It is time to live your values through actions in the here and now.
Download SAFE Life Guide from Apple App Store and Goolge Play Store. Also there are details for our Instagram page which has #KISS; Key Images Simple Statements
The proof of the pudding is of course in the eating, in life’s pursuits, living by our values involves taking action, values guided committed actions. To begin with the sphere of control may seem very small and the sphere of concern very large. However, outside the sphere of control is a sphere of influence that is larger than what can be directly controlled. The beauty of small steps is that once one begins to take actions, the sphere of control enlarges and things that were previously only in the sphere of influence come into the sphere of control and the sphere of influence eats into the sphere of concern.
In this episode, we discuss how to craft small, simple, realistic steps that you can take on a daily basis. We will also introduce you to the bulls eye technique to evaulate weekly whether you have been able to live by your values.
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Key Message: Underpin "What Matters to You" with Values. Align life goals with your core values using Safe Life Guide's HOPE Framework.
Download SAFE Life Guide from Apple App Store and Goolge Play Store. Also there are details for our Instagram page which has #KISS; Key Images Simple Statements
Think about the people and pursuits that matter to you. As you touch the lives of your loved ones or follow your dreams, what values would you want to live in these relationships or the daily pursuit of your life goal? Values can lead you to your Ikigai, the sweet spot of your passion, mission, vocation and profession. Your plan de vida, soul’s purpose, values will provide with the WHY you wake up in the morning. It is the values that will help you stay on course and be the wind in your sails. Underpinning life goals with values is a bit like learning to use your sails, you cannot change the direction of the wind or the distance to the destination, but you can adjust your sail.
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Key Message: Values foster hope and healing, values gender joy and meaning. Explore your core values using Safe Life Guide's HOPE Framework.
Download SAFE Life Guide from Apple App Store and Goolge Play Store. Also there are details for our Instagram page which has #KISS; Key Images Simple Statements
When the fog descends, and one can’t see ahead, or the sand banks shift, values help us stay on course. In the midst of an emotional storm, values provide grounding and help us reconnect with our strengths. When a storm tips us into the water, values help us stay afloat and keep up the battle for survival. Values are like the sails that catch the wind and help us keep the momentum on the long road of life goals. Values guide us and give us a sense of direction, they anchor us amidst emotional turmoil and keep us safe and provide us the oomph to do the hard yards that life needs us to do.
Close your eyes for 30 seconds and think of a helpful action / step you have taken recently, and ask what values did they relate to? You will often find that the value anchored you or helped you move towards what matters to you.
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Key Message: Reflect on what helps and what harms, its a simple but powerful technquie that will make you pause before taking action.
Download SAFE Life Guide from Apple App Store and Goolge Play Store. Also there are details for our Instagram page which has #KISS; Key Images Simple Statements
As a principle, what we want you to do is ask the magic question, does it help or harm? For this to be an effective strategy you have to ask the question when things are calm, when you have the ability to see clearly what helps what doesn’t, if you ask it in the middle of an emotional storm, it will be tough to differentiate out the two, what harms in the long term might feel helpful in the short term as a way of coping with life challenges. This is what we call the action appraisal, ask the questions with curiosity and without judgement.
Post Mortem: Did it help or harm? Ask this question in the context of recent struggles as a post mortem to reflect on past actions.
Ante Mortem: Will this help or harm? Ask this question in the context of future struggles with “what if” scenarios in mind, so that you can plan out your course.
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Key Message: If we did respond to adversity through acceptance of reality, we have the power to transform unbearable suffering i.e. what reality feels like back into bearable pain.
Download SAFE Life Guide from Apple App Store and Goolge Play Store. Also there are details for our Instagram page which has #KISS; Key Images Simple Statements
In the HOPE framework you will go through four simple steps, you will be asking yourself what helps and what doesn’t, you will spend time identifying your values – the qualities you want to bring to your actions, you will think through the people who matter to you and the meaningful pursuits in your life and relate them to the values and then take small steps to live your life in keeping with your values while you pursue your life goals.
This episode introduces Acceptance as a concept and some of the interface features of the HOPE view Safe Life Guide application.
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Celebrating Men's Mental Health Month with the launch of - Safe Life Guide.
Download from Apple App Store and Goolge Play Store
the episode provides and overview of the 5 sections:
- Hope View: To support resilience and wellbeing through values
- Safe View: To support safety through contemporary safety planning
- Subs View: Subscription to Suicide Prevention Training and Safety Documentation Suite
- Logs: A range of trackers for a healthier life
- Resources: news, videos, blogs, podcasts, books
safelifeguide #progressguide #suicideprevention #suicideprentiontraining #suicideprentiontrainingprogram #suicideprentiontrainers #safetyplan #resilience #mentalwellbeing #mobileapplication #freesafetyplanningapp #safetyplanningapp #protect #safetyplanningapp #safetyplanningsaveslives #suicidepreventionawareness
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Connection
You may have picked up Healing for Healers because you are supporting a colleague who has lost a patient to suicide. Do not forget to offer your unconditional support. I am here for you, you can call me any day anytime if you want to talk things through or just a shoulder to lean on. Saying something doesn’t make it better, what makes it better is connection. If you have your own story to share, do so without making it about yourself. To be truly empathic one has to reach within and connect with that place that knows that feeling.
Everyone comes to work to do a good job. But sometimes bad things happen. When they do, its time to take time to H - E - A - L.
H - Hindsight Hurts
Hindsight strips away all the complexity and simplifies cause and effect. Thinking how did I not see this is unfair. Be kind to your self.
E - Event ~ Non-event
The significant event reminds us of the gravity of our work. Take time to remember the daily small wins when we steer people’s lives for the better. As “non-events” we generally take them for granted.
A - Accept, Affirm
The emotions you experience today are nature’s signal to you that you are a kind and compassionate human being, accept and affirm these feelings.
L - Look, Listen, Learn
Look after yourself, you cannot pour from an empty cup, listen to your colleagues, many have been on this journey and use this adversity to grow.
H - E - A - L your S - O - U - L is the combined wisdom of errors in judgement I, Assoc Prof Manaan Kar Ray, have made over two decades while supporting self and colleagues who lost a patient to suicide, mistakes you dont have to make...
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In the third recap episode for ESF, we cover the STEPS model, the Validity techniques of Shawn Shea, the Narrative method and the B4Now approach from PROTECT.
In conversation with Tracey Chitty, the AWARE framework has been contextualised into the educational setting in this podcast episode.
The recap begins with a discussion on rational vs rationalising and then goes into each of the factors:
- Anxiety
- Weighting
- Agenda
- Resources
- Experience
In particular the agendas of parents and principals are discussed in details. Clearly all parties want the same in terms of a flourishing young person, but their approach might be different and there are different balancing acts to be aware of.
A special episode to mark the 10th of September - World Suicide Prevention Day.
Humor Heals #LOL @the Sound of Hope provides 3 exercises of therapeutic humour.
- Pile ‘o Punchlines
- The Comedy of Complaints
- The Comedy of Contradictions
Its a collaboration with Mallori DeSalle and Lodge McCammon. By brining humour to one of the most serious of topics, "suicide", they are providing an avenue for people who work in mental health care to fill their cups. Supporting people in suicidal distress over a lifetime is a marathon, not a sprint, humor may be one of the answers to maintain energy in the long run and even a way to connect with a person in deep distress. Sounds risky, but is rewarding. Give it a try. I did...
A bit about our invited guests:
Mallori DeSalle, MA, LMHC, NCC, CMHC, MATS, CPS, CHP
Therapist, Trainer, Humorist, Indiana University
**Mallori DeSalle is a licensed mental health counselor, an internationally certified prevention specialist,motivational interviewing trainer and a certified humor professional. As a speaker and trainer, she has sparked curiosity in both the young and young-at-heart. Her passion for creating a lasting impact led her to the public health field and for the past 14 years she has worked at Prevention Insights, a center within the School of Public Health at Indiana University, Bloomington. Mallori works with people all over the world. She served on the Board of Directors for the Association for Applied and Therapeutic Humor and in 2021 became a TEDx speaker. Her credentials don’t impress her family, but occasionally her corny jokes do make them laugh. https://malloridesalle.com/
Lodge McCammon, PhD**
Humorist, Musician, Educator, Speaker
Dr. Lodge McCammon is a therapeutic humorist, instructional designer, author, musician, and international education consultant who provides professional services, including keynote speeches, workshops, curriculum development, and a variety of training programs. He works with school districts, universities, nonprofits, and businesses (e.g., Palm Beach Schools, University of the West Indies, Discovery Education, Microsoft, Amazon). Most recently, Lodge facilitated a month of therapeutic humor for the Nourished Teachers Community, which is a Facebook-funded initiative focused on helping educators cope with work stress and avoid burnout. He uses a program that he designed called “Laugh It Off!" to help his clients transform their daily frustrations into humor. https://lodgemccammon.com/
In the second of the Recaps we go through the four chapters in the CORE module and pin down the key messages:
- Care Compass - Risk vs Recovery - without risk there is no recovery, with the right care the person has more control
- Optimise Pain Relief - Dig deep to establish the need and interests that lie beneath the position of dying, help them see that they want to be pain free and our role is to help them be pain free.
- Risk Rethink - High - Medium - Low are static categories to characterise risk which is inherently dynamic, move to a more nuanced approach of thinking about risk in terms of longitudinal risk, cross sectional risk and unaddressed risk - that will help us formulate an opinion on clear and / or imminent risk.
- Empathy in Action - Move from what's the matter with you to What matters to you, use the equation of Empathy in Action
In the first of this sequence of guest episodes with Tracey Chitty, we share ESF's (Hong Kong) whole of school approach to suicide prevention after an intensive four days of training for school counsellors and teachers.
In the upcoming episode, we will be summarising the key messages from the training for the attendees to recap what was taught and how they could incorporate into their practice the theoretical constructs they have gained.
A unique perspective to establish common ground between the Health Regulators and the practitioner under investigation is the basis for this episode. It builds on the previous episode of why Health Regulators need to be trained in Suicide Prevention and how Doctors and Nurses and Allied Health are an ultra high risk group when a notification happens.
In this episode, Manaan shares how the practitioner considers the Health Regulator to be the problem where as the Health Regulators consider themselves to be the solution. These positions are incredibly divergent and the interests are different too, but at the needs level the doctors or the nurse wants to be a doctor or a nurse again and the health regulators role is to help them be one and practice safely in the long run. There is common ground to be found but the role of the health regulator in an investigation needs to be clearly articulated.
Joiner's model of desire and capability is used to explain the high risk period that health practitioners face when they have had a notification to AHPRA (any health regulator for that matter). Manaan explains the training that is on offer for health regulators in this episode.
We also take the opportunity to welcome listeners from the English Schools Foundation in Hong Kong as we start a 12 month journey to support 22 schools embellish their suicide prevention pathway through skills training for school counsellors, Principals, Heads of Years and Teachers.
In the third of the 5 Critical Crisis Conversations, Manaan explores how the person's agenda of ensuring short term safety through admission may be quite different to the long term focus of resilience for the professional.
Both want safety but the route to it is different. Being able to show the similarity of the overarching goal amidst the dissimilarity of the immediate outcome is a critical conversation to have with the person in distress. If they are able to understand that the professional is not rejecting their needs or abandoning them and on the contrary is selecting a much longer harder route to walk with them one can bring the person on board for safety planning and taking charge of maintaining their safety. Or else a person with BPD will feel the pressure to prove the professional that they are in deep distress and the risk will escalate as the threats to harm oneself intensifies.
The second of the Borderline AWARE conversations relates to Weighting (Diagnosis, Course, Social Causation - how these factors may influence the weighting that we put on a person's suicidality). The conversation is named Empowerment vs Containment. The episode builds on the Advice vs Action conversation and goes a step further providing the listener a thorough understanding of the different approaches to take and when to take those approaches.
Based on whether the presentation is acute, chronic or acute on chronic the professional needs to make an informed and mindful approach regarding the focus of therapeutic action. Essentially they need to answer the question, is this a situation that needs containment or is it one where my focus needs to be on empowering the person to believe that these suicidal urges can be navigated.
In this sequence of nuanced conversations, listeners will be guided through some of the most sensitive issues that they will have to navigate while supporting a person in suicidal distress. This episode captures the essence of Advice vs Action. The advice we give - face your fears, applies to us as well when we make decisions regarding whether we admit or not. We must role model the advice we provide to have credibility.
Listeners will learn the in-parts conversation to put on the table the dilemma that the mental health practitioner is facing. This is part of the Borderline Conversation AWARE program that is taught as an advanced training for mental health practitioners.
Jill presents to the Emergency Department in a suicidal crisis, she has Borderline Personality Disorder and believes that the only way her safety can be maintained is through an inpatient admission. This is not an infrequent occurrence for those working in an ED setting. Dr Kar Ray talks you through the different AWARE factors that can influence the decision you make.
Also learn about the criterion for Borderline Personality Disorder in this episode.
Understanding splitting is essential to supporting people in Borderline Personality Disorder (BPD), particularly when they are in suicidal crisis. In this episode Dr Kar Ray shares some foundational constructs as well as some practical tips that can help a health care professional or even family members provide the most appropriate support.
Following two days of 7 SAFE Steps training, we caught up with our four professional actors who brought to life Sandeep in the simulations. They are the fabulous 4: Tegan Braithwaite, Charlie Baz, Sami Afuni and Kyra Thompson. This is an opportunistic recording of the debrief and the feedback they provided.
7 SAFE STEPS is a 7 session safety protocol for mental health inpatient wards and community settings. The theoretical underpinning and practical skills are from the PROTECT suicide prevention training framework.
An overview of the conversations
Conversation 1: What Matters to Me (HOPE)
· Identify source of pain
· Identify source of hope
Conversation 2: Scenario Planning (Safe)
· Identify upcoming challenging scenarios
· Use risk response balance sheet to navigate difficulties
Conversation 3: Access to Means, Alcohol and Other Drugs (sAfe)
· Identify means availability, lethality and restriction feasibility
· Use risk response balance sheet to reduce access
Conversation 4: Family, Friends, Follow up (saFe)
· Conduct the LOVE exercise to firm up support
· Identify difficulties for disclosure and how to navigate them
Conversation 5: Emergency Plan (safE)
· Populate the coloured components of the safety plan
· Provide guidance on how to fill in the rest
Conversation 6: Make SAFE SAFER
· Identify Scenarios (Triggers)
· Identify Appraisals (Early Warning Signs - Thoughts)
· Identify Feelings (Early Warning Signs - Moods)
· Identify Endurance strategies (Internal - External)
· Identify Response (Actions – Behaviour)
Conversation 7: 1-2-7 Safety Conversation
· Connect the dots of from all the work that has been done so far
· Crosscheck safety plan to ensure that the person can maintain their safety.
In the lead up to a case study, Manaan delves deep into Personality Disorders and talks about all 10 conditions covering clusters A, B and C in this episode.
Cluster A
These personality disorders are characterized by odd or eccentric behaviour. People with cluster A personality disorders tend to experience major disruptions in relationships because their behaviour may be perceived as peculiar, suspicious, or detached.
Cluster B
The cluster B personality disorders are characterized by dramatic or erratic behaviour. People who have a personality disorder from this cluster tend to either experience very intense emotions or engage in extremely impulsive, theatrical, promiscuous, or law-breaking behaviours.
Cluster C
Cluster C personality disorders are characterized by anxiety. People with personality disorders in this cluster tend to experience pervasive anxiety and/or fearfulness.
Yvette Bonilla, LMSW, is the Owner and CEO of Suicide Care Consulting Services. She has seen firsthand the fateful effects of the revolving door effect and how it can rattle the lives of clients, the work and motivation of providers, the cost labor for leaders, and the reputation of the hospital system.
Mrs. Bonilla is a thought leader in the suicide care space, a keynote speaker at mental health summits about post-crisis responses, an active contributor to the state of Connecticut Zero Suicide Learning Community, and an Advisory Board Member of her local region's Community Crisis Response Team.
In the 5th of our Guest Episodes Yvette share with our listeners her own lived experience and how her insider knowledge shapes the work she does with transitions from inpatient care, perhaps the most high risk period in a person's recovery journey.
Building on the qualitative theme of Experience in the AWARE framework is the phenomenon of Creep Crash Crawl. The episode describes how risk taking gradually creeps up due to suicide being a rare event, rare events cause confirmation bias, what I decided clinically was the right decision...
This results in a Creep up of risk taking which is inevitably followed by a Crash down of risk taking when an untoward incident happens, after that risk taking Crawls along for a while. Reflective practice and mindful supervision of one's risk taking is the key grounding one's risk threshold.
Experience is the final AWARE factor. In this episode Manaan explores in detail the different ways in which experience generalises:
- Experience of the same patient over time
- Experience of a diagnostic group
- Experience of a demographic group
- Experience of supporting people in suicidal distress
In the final half Manaan shares how the professional or personal experience of losing a patient to suicide impacts counsellors, psychologists, psychiatrists etc.
Dr Miguel de Seixas, Head of Psychiatry at Family Medical Practice in Vietnam shares valuable insights from his journey (Cambridge to Saigon).
Miguel talks about how Psychiatric practice in Cambridge and Saigon are similar but also different. The foundation of our practice i.e. connecting with kindness and compassion with the pain that the person is suffering with does not change wherever in the world a mental health professional may be. He talks about the impact of COVID and some of the nuances of telehealth and how once can support someone experiencing a suicidal crisis irrespective of modality (telehealth or face to face).
Are you eliciting an agenda in the referrer, patient or carer? And whatever you elicit is that impacting the way in which you listen to the person's story i.e. does it affect your clinical decision. Agenda is the third of the five AWARE factors and it was quite obvious that assessors were responding to agendas they perceived, sometimes positively but often negatively as well.
Resources is the fourth AWARE factor and rationalizing resource led decisions was a key theme that came out in the AWARE study. One may arrive at the same decision in a rational way but the journey to the decision is very different. Learn all about it in the fourth of the AWARE framework podcasts.
For more information visit us at https://www.progress.guide
Episode 16 explores how assessors rate suicidality in different kinds of presentation i.e. weighting. The AWARE study established that the weighting of suicidality could be impacted by:
- Diagnosis (Personality Disorder and Substance misuse counted for less)
- Course (Acute trumped acute on chronic, which trumped chronic)
- Social Causation (Carried less weight than biological presentations)
These factors influenced the way in which the professionals would view the person's suicidality and ultimately impact clinical decision making and care allocation
Neurodivergent people in a neurotypical world face unique challenges when navigating a suicidal crisis. The busy, bright, noisy Emergency Department does not serve as a safety scaffolding, if anything could perpetuate the crisis or actually cause a melt down while waiting. Shazzy shares many such insights both from her lived and carer experience as well her quarter century of professional expertise.
Shazzy Tharby is a UK trained and credentialed Counselling Psychotherapist and Mental Health Nurse. Shazzy is autistic and ADHD herself and has autistic and ADHD children and therefore understands the neurodivergent (ND) experience from both a personal and professional point of view from many angles. Shazzy works from a neurodivergent affirming perspective. Learn more about Shazzy and her services at https://positivelyliving.com.au/
We apologize for the poor sound quality at certain parts of the recording but we have retained it in the podcast given the strength of the content. The episode teases out different approaches in crisis care that professionals ought to take when supporting Autistic people.
This episode introduces the listeners to a key concept, the 2 mental spaces in which an assessor operates in an assessment.
Rational - facts followed by decision
Rationalizing - decision followed by fact selection
Manaan uses a range of practical examples to elaborate decision making processes including Festinger's original research from 1954 and the fascinating story of scientology believers. Listen in :)
Professionals need a good understanding of self before they can understand others.
AWARE protects against undue influences in the act of clinical decision making. Intended to make practice safer, its use in clinical supervision or multidisciplinary case reviews should bolster practice by making individuals and/or teams who assess people in suicidal crisis, mindful of the implicit effect of the AWARE factors.
The five factors are:
Anxiety (generated/diffused in):
●Patient
●Family/carer/friend
●Referrer
●Triaging/assessing practitioner
Weighting (of symptoms elicited):
●Diagnosis (comorbidity - personality disorder/alcohol or substance misuse)
●Course of illness (acute/chronic/acute on chronic)
●Factors considered outside core remit (relationships/finances/accommodation/employment/family - carer availability)
Agenda (elicited in):
●Referrer
●Patient
●Family
●Practitioner
●Team
Resources (identified or not):
●Beds
●Home treatment capacity
Experience (generalised from):
●Same patient to different presentation
●Other patients from the same diagnostic group
●Other patients from the same demographic profile
●Past adverse events
These episode dives deep into Anxiety and discusses why we see what we want to see.
Episode 13 introduces the ASSESS module and provides a broad overview of the 6 chapters in ASSESS. It then dives into attitudes towards suicide. The key messages to remember are:
Stop – PauseAttitudes towards suicide influence decisions,
Attitudes towards suicide influence rapport and empathy,
Attitudes towards suicide influence care and support we offer.
Reflect – RewindRecognise your attitudes
Recognise how these might have influenced decisions and care you have provided
Engage in open, candid discussion within your team, be prepared to learn from the past
Start – PlayIf your attitudes are adversely influencing care provision seek help
Personal therapy
Additional supervision
Monitor through ongoing reflective practice
Dr Stan Steindl is an Australian clinical psychologist with over 20 years experience as a therapist, trainer and researcher. He is has an active clinical practice and is passionate about motivational interviewing (MI) and compassion focused therapy (CFT). And he teaches and presents on these topics around the world!
Stan shares some deep insights about Motivational Interviewing and how it can be used to navigate the delicate ambivalence that exists in the mind of a person in suicidal distress, the fight between reasons for living and reasons for dying. Stan talks about advanced listening and how some of the core MI skills of Open Questions, Affirmations, Reflections and Summaries can be used evoke change talk.
You can learn more about Stan at Clinical Psychologist | Dr Stan Steindl
In this episode Manaan reveals the 3 practice shifts that lie at the foundation of a new program called 7 SAFE Steps. The are:
- Prediction to Prevention
- Past to Future
- Deficits to Assets
These 3 shifts will bring progress to the practice of care provision for those in suicidal distress, they are an automatic consequence of the mindset shift from top to TAP.
Meet Ashley P Evans, Psychiatric Mental Health Nurse Practitioner from Waco, Texas.
Here is a bit about Ashley in her own words:
I am from Auburn, Alabama...WAR EAGLE! I received my Bachelors degree from Florida State University...GO 'NOLES! When I initially went to college, I was Pre-Med Psychology, but it didn't take me long to convince myself that I was not "good enough" in math and science, so I quickly changed my major to something completely different - International Affairs with a minor in Religion.
I moved back to Alabama after graduation and began working in the insurance industry. I convinced myself that climbing the corporate ladder was "good enough" for me, so I obtained a Masters in Healthcare Administration to make myself more marketable for the company. After changing roles several times within the company, I noticed that something was gnawing at me. Something deep inside my heart was yearning for something far greater than what my employer could offer me. My heart wanted to care for people. I wanted to truly touch lives from a clinical perspective. Read more at https://www.psychlifeteeco.com/
The episode brings together the key messages from all 10 episodes. It can be used as a refresher or for someone new to PROTECT it will provide a quick overview of the CORE module
Episode 10 will be diving deep into the 5 values of Relational Safety:
- Courage
- Curiosity
- Compassion
- Collaboration and
- Commitment
and translating these values into action.
Episode 10 is full of catch phrases, some of the highlights are, patient is not in the way, patient is the way, listen with fascination, mind open – mouth shut, cant walk through water without getting wet, an explicit promise of recovery, things will get better and soon. What was yours? Get in touch at www.progress.guide .
Part 2 of Empathy in Action introduces the Values of Relational Safety:
- Courage: to be present and suspend the desire to help
- Curiosity: in taking the time to listen and recognizing reasons and emotions
- Compassion: in sharing the person’s darkness without judgement
- Commitment: to reframe suicidal thoughts and acts as a desire to be pain-free
- Collaboration: to coproduce the journey ahead based on mutual respect
The listener also learns about the Equation of Empathy in Action and the Pain Relief Dialogue
In part 1 of Empathy in Action, the listener is introduced to the key mindset shift that underlies Relational Safety, from TOP to TAP. This supports a transition from attempting to establish "what's the matter with you" to "what matters to you".
Providing healthcare professionals contemporary knowledge about how the forms they fill can actually serve the real function for which they were designed is crucial in suicide prevention. Remember paperwork for proper work. The real function is to guide a conversation, a conversation that is at the heart of relational safety. This can be achieved by moving from top to tap. Don’t seek to establish what’s the matter with you, rather what matters to you. You can be a vector for spreading this knowledge at your work, do share the podcast. You can access all the information at www.progress.guide. We would love to hear your thoughts, email us at admin@progress.guide.
The episode provides a novel way to describe risk and steers professionals away from high, medium and low risk stratification. The listener will be introduced to:
- Longitudinal Risk
- Unaddressed Risk
- Cross-sectional Risk
On the way to formulating an opinion of clear and imminent risk. This is a far more nuanced approach and a meaningful attempt at conducting a person centered risk assessment.
The listener will also be presented with the evidence base which leaves very little doubt about the futility of risk categorisation.
Proactive Detection of Clear and Imminent Risk of SuicideIn the first past of Risk Rethink, the listener is introduced to Shneidman's cubic model and the three psychological forces of: Psychache - Press - Perturbation
This lays the foundation for a discussion about the continuum of risk. Listeners are also urged to allow their knowledge of warning signs to trump those of empirical risk factors and focus on clear and / or imminent risk rather than longer term risk
Optimise Pain Relief introduces a pain based narrative as a conversational strategy to discover common ground. The person in suicidal distress wants to be pain free and the professional wants to help them be pain free. Despite this common ground why do so many professionals end up in a power struggle with the person they are supporting?
The episode will guide professionals through the positional statements, interests and needs and a way of digging deep to see the other person's perspective and truly empathise with their pain and in the process create relational safety.
The episode describes the different ways in which the Care Compass can be used:
- To capture hope
- To gain a better understanding of risk and safety
- To find common ground when there is a difference of opinion
- To address culture
The episode finishes with a discussion on the challenges of recovery oriented care in community mental health care and how the care compass can be used to conceptualize recovery as well as circumvent some of the challenges.
Episode 03 introduces the Care Compass, a conceptual visual conversation aid to talk about recovery and current care delivery.
The difficult balancing act between risk and recovery intensifies many folds in a suicidal crisis. This can only be struck in partnership with the person and their family and to get them on board and to understand the finer nuances of recovery oriented practice we recommend using the Care Compass, it’s a theoretical construct with a number of practical uses that helps in finetuning “Control in Care”.
The Care Compass has two axes: x represents resilience in the distressed individual (East or the right end of the axis: resilient; +5 and West of the left end: fragile; -5), and y represents the principal focus of care delivery for the professional (North or the top end: self-reliance; +5 and South or the bottom end: safety: -5). The numbers + or – 5 does not indicate right or wrong, it is just to graphically demonstrate the degree of resilience in the person on the y axis and the clinician’s primary focus on the x axis. The two axes gives rise to four care quadrants, bottom left or south west: Prudent Care, top right or north east: Permissive Care, bottom right or south east: Prescriptive care and top left or North West: Precarious Care.
Episode 02 introduces the four chapters in the CORE Module and the nautical metaphor: Navigating Rocky Waters
Navigating Rocky Water is about recovery. We all need hope, it is central to our mental health and well being. Recovery for those with mental illness (depression, anxiety, schizophrenia, bipolar disorder, anorexia, bulimia, borderline personality disorder) has its ups and downs but with the right support at the right time people can captain their own lives.
There is a fundamental contradiction at the heart of mental health services between care and control. In the first chapter in CORE, Care Compass we grapple with this dilemma, this is particularly the case when supporting someone in suicidal distress. Worldwide mental health services have been guided by the recovery philosophy on their transformation journey. Capturing hope, creating agency and realizing a life beyond illness underlie all that we do. We are acutely aware that there is no place for force in recovery. However the use of force continues, we believe that proactive systems of care can help us navigate through the choppy waters of the care and control contradiction. PROTECT stands for PROactive deTECTtion. We led a project called PROMISE to collate and replicate all such proactive initiatives and make the use of force redundant. Navigating Rocky Waters was written as part of that project. We have come to believe that seemingly binary positions like risk and recovery or care and control are part of a spectrum, without risk there is no recovery, with the right care the person in distress will have more control. So to help our colleagues draw inspiration from individual recovery journeys of our patients we have used a nautical analogy. This brief film is full of life jackets, lifeboats, anchors, lighthouses, maps, compasses, etc. So, we hope you enjoy being at sea.
Episode 01 introduces Relational Safety, the golden thread through PROTECT:
A person with suicidal ideation is often trapped in an overwhelming sense of despair (Beck, 1986). Stemming from entrapment, suicide may become the salient solution to life circumstances (O’connor, 2011) and intense psychological pain (Shneidman, 1993). Suicide is a major public health problem, with over 800,000 people dying annually worldwide, and for each completed suicide, there may have been 20 other attempts (World Health Organization, 2014). To support those in suicidal distress, professionals, families and friends strive to establish new and alternative ways of coping (Jobes, 2006, p. 122; Owens et al., 2011). However, there is a dissonance between the reality of those experiencing a crisis, for whom suicide is the perceived solution, and those that are caring, who view suicide as the problem (Duffy, 2006). Reconciling these positions is difficult as professionals have to understand the person’s pain before they can form a collaborative partnership on the road to recovery (Michel & Jobes, 2011). In a serious suicidal crisis, recovery-oriented practice is often sacrificed on the altar of safety, and care becomes prescriptive. In our previous work in reducing coercion in care in the acute setting (PROMISE), staff and patients highlighted the difficulties in striking this balance. They described the restrictive practice as “it never is very nice… but it is a necessary evil” (Wilson, Rouse, Rae, & Kar Ray, 2017). 86% of study participants highlighted the importance of enhancing relationships through empathic communication as a way of overcoming the challenges posed (Wilson, Rouse, Rae, & Kar Ray, 2018).