Reflections from Hope-focused 3 “R” (HF3R) Suicide Prevention Training
In July 2013, I survived a suicide attempt that led to my first inpatient psychiatric hospitalization. A few months later, I was diagnosed with bipolar disorder, a turning point that reshaped my understanding of mental illness and suffering. My family was affected again in November 2022 when my cousin lost his life to the illness at age 23. That grief deepened my commitment to speaking with suicide survivors and with families who had lost loved ones, because I understood the pain, confusion, and unanswered questions that follow such tragedies. These experiences formed the foundation of how I entered conversations about suicide and shaped the way I approached education, prevention, and compassionate support.
As I worked through the HF3R certification training, I was reminded of how complex suicide risk truly is and how essential it is to understand its many layers. The training explained that mental illness is the strongest predictor of suicide, even more significant than family history or peer pressure. A family history of attempted or completed suicide was identified as a historical factor, showing how past events can influence current vulnerability. The section on health factors highlighted that serious or terminal illness, degenerative disease processes, chronic pain, or chronic medical conditions all increase risk. From 2000 to 2018, the most common methods of suicide were firearms, suffocation, and poisoning, and each method was emphasized so participants could recognize national patterns and understand the impact of access to lethal means.
One of the most important parts of the training focused on recognizing verbal warning signs. Phrases such as “I feel like a burden,” “I feel trapped,” and “I have no reason to live” were identified as clear indicators of distress that require immediate compassion and attention. As we learned the 3 R’s — Recognize, Respond, and Refer — the first step became the foundation. In step one, recognize, we were taught to understand the problem of suicide itself, identify the risk factors involved, and become aware of the warning signs that may appear in daily conversations. The training emphasized that warning signs can be mood-related, such as depression, loss of interest, and rage, as well as behavioral, including increased drug or alcohol use, searching for ways to take one’s life, or acting recklessly. It also highlighted that adults ages 45 to 64 currently experience the highest suicide rates, a reminder that risk is often hidden behind responsibility and outward composure.
Learning how these elements connect strengthened my ability to recognize patterns, respond with clarity, and support people with confidence. Step two, respond, covered what to say and do when intervening with someone who is suicidal, guiding us toward compassionate and direct communication. Step three, refer, reinforced the need to get immediate help for the individual through appropriate services or emergency support. Understanding the full structure of the 3 R’s equipped me to engage in difficult situations with steadiness and care, bringing together knowledge, empathy, and practical action.
As a future mental health coach and someone who hopes to become a Certified Peer Recovery Specialist, I often reflected on Viktor Frankl’s teachings in Man’s Search for Meaning. Frankl wrote that people find purpose through meaningful work, genuine love for others, and the courage shown during difficult circumstances. These three sources of meaning shape how individuals build purpose in their lives. When supporting someone who is hurting or considering suicide, one of the first steps is simply being willing to walk alongside them without fear. Many successful interventions happen because someone cared enough to speak up, ask questions, and offer their presence. People struggling with suicidal thoughts often find hope through connections with family, friends, pets, community, and faith, as well as through rediscovering the parts of life that once brought fulfillment. Encouraging someone to reconnect with what gave them meaning can serve as a powerful protective factor.
One of the most effective questions in crisis intervention is, “Do you really want to die, or do you just not want to live the life you are currently living?” This question helps a person differentiate between wanting an end to life and wanting an end to pain. The distinction matters deeply. Faith communities can also play a significant role in suicide prevention. One of the strongest steps a church can take is to address mental health openly rather than avoiding the topic. Silence creates stigma, but openness creates space for healing.
Understanding crisis response also includes knowing available resources. The long-standing number for the National Suicide Prevention Lifeline is 800-273-8255, although people today can also dial 988. Many individuals hesitate to ask directly, “Have you thought about hurting or killing yourself?” The presenter noted that this hesitation usually comes from fear of the answer. However, courageously asking the question can be lifesaving. Understanding suicide risk also includes recognizing the concept of perceived burdensomeness, the painful belief that others would be better off without them. This distortion is often central to suicidal thinking, which is why connection, reassurance, and presence matter so much.
Supporting someone who is suicidal or grieving a suicide requires awareness, compassion, and a commitment to safety. One of the strongest teachings from the presenter was that every threat of suicide must be taken seriously, no matter how small or indirect it may seem. When determining urgency, we were taught to assess three key indicators: a plan, the means to carry it out, and access to those means. If all three are present, the risk increases dramatically and must be addressed immediately. Because safety outweighs confidentiality, the presenter emphasized that the threat of suicide always overrides secrecy, even when taking action feels uncomfortable. And for those who survive the crisis, ongoing support is essential because recovery does not end when the moment of danger passes.
Empathy and good listening are essential in supporting those who are struggling. An empathetic question such as “What has been the most difficult thing about losing ____?” can create space for honesty and connection. Good listening includes allowing the person to talk when they are ready, respecting silence when they are not, engaging in everyday conversation, and accepting emotions without trying to fix or judge them. At the same time, some statements must be avoided entirely. Comments that blame, shame, or imply spiritual punishment only deepen hurt and create barriers to healing.
Suicide grief is unique and often more complex than other forms of grief. Survivors may wrestle with guilt, shame, confusion, and unanswered questions that persist for years. They may encounter stigma, social avoidance, or people who simply do not know what to say. Because of this, it becomes even more important to respond with presence, empathy, and nonjudgmental support. Curiosity must give way to compassion, and assumptions must give way to connection. HF3R reinforced that understanding, clarity, and courageous communication form the foundation of effective suicide prevention and support.
To learn more about my journey and the lessons I’ve gained along the way, I invite you to explore the rest of my writing and follow the ongoing work I share to support mental health, healing, and rehabilitation with hope. These lessons can be found on my Pillar Posts page.