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Writer's pictureRichard Ramsay

Wholistic Framework for Suicide-Safer Living:

Updated: Apr 16, 2021

Who to Engage, Who’s to Benefit



Here are brief examples of some of the many possible roles to familiarize us with the framework:


A suicide intervention caregiver who engages others for the benefit of the individual is still doing direct intervention work but engages others to help provide the benefit.

Quadrant A: A suicide first aider or ongoing suicide caregiver who engages an individual for the benefit of the individual will be providing direct first responder and/or ongoing recovery and growth work, using suicide intervention or other person directed interventions.


Quadrant B: A suicide intervention caregiver who engages individuals with similar problems to help them provide mutual support/aid and/or to press for societal reforms or changes to bring about a benefit to a whole category of people like them would be using self-help approaches and/or self-advocacy, grassroots movement approaches.


Quadrant C: A suicide intervention caregiver who engages others for the benefit of the individual is still doing direct intervention work but engages others to help provide the benefit, as in case advocacy with a landlord for example.


Quadrant D: A suicide intervention caregiver who engages others to bring about societal changes, reforms, etc. to benefit a whole category of people would use interagency coalitions and other forms of social change strategies to benefit particular categories of people, often not personally known to the caregiver.


4 suicide-safer living options


Looking at suicide through this framework, several kinds of people might benefit from using or understanding the 4 suicide-safer living options of the framework.


CTS - Persons with conscious thoughts of suicide DDS - Persons determined to die by suicide NSC - Natural support caregivers PSC - Professional support/treatment caregivers SS(S/O) - Persons who have survived suicide (self or others)


Quadrant A






1. CTS person engages Self to benefit Self with suicide in mind.


• life’s difficulties have generated mind pain of a minor to unbearable kind. • the seriousness of life’s difficulties are deeply personal but generally connected to social, spiritual and/or bio/physical difficulties. • one has seriously acknowledged that conscious thoughts of suicide (CTS) can lead to ‘no other way’ choices and consequent acts of deliberate self-harm with injury or death results. • one might intuitively try to surface ambivalent (turning point pros and cons) connected to wanting on one hand to get rid of the pain by suicide as the only way out and on the other wanting to counteract the pain by finding another way out … a suicide-safer way of living. • one might try to engage internal safety plan resources within one’s self to find another way out or through the engagement of self be able to acknowledge the social connection power/value of others as allies in resolving life’s difficulties, big or small.

2. DDS person engages in a pact with self not to share with others, convinced that suicide death will be a benefit to self (and perhaps others).


• consciously denies and/or refuses to acknowledge the connective nature of living systems; deeply believes in independent self-reliance and fear of being a burden on others. • deliberately and secretly engages in conscious thoughts, planning and actions that will result in death, notwithstanding the possibility that even this type of calculated action may result in a non-fatal injury or interrupted attempt.


3. NSC engages Individual with possible CTS) to benefit the Individual.


• uses intuitive, general awareness or perhaps specific suicide intervention knowledge to recognize ‘invitations to help’ and activate on-the-spot support and assistance until immediate danger is over or additional help is obtained. • provides ongoing supportive and caring assistance to the best of his/her ability; sometimes becomes overwhelmed and burdened by the stress of constantly walking on ‘thin ice’ of doing the wrong thing and the absence of support for the role they have taken on.


4. PSC engages Individual with possible CTS to benefit the Individual


• uses intuitive, general awareness, professional education foundation or perhaps specific crisis intervention knowledge to recognize ‘invitations to help’ and activate on- the-spot support and assistance until immediate danger is over or additional help is obtained. • uses professionally acquired training or additional continuing education training to provide other crisis intervention care and ongoing natural support and/or professional support. • uses ‘duty of care’ ethic to responsibly provide or arrange for quality follow up support. • sometimes becomes overwhelmed and burdened by the stress of constantly walking on ‘thin ice’ of doing the wrong thing and the stress of maintaining the mask of being the expert.


5. SS(S/O) person engages Self to benefit Self.


• uses personal resources to counteract the impact of suicide and/or to go through the experience of grieving in a private and often times secretive or isolated manner.

• faces the possibility of being someone with CTS again or for the first time as part of the impact of their own lived experience or another person’s suicide.



Quadrant B






6. SS(S/O)person engages Self and Others like him/her for mutual aid support and/or to press for societal changes, reforms that will benefit categories/groups of people like them.


• uses the value of connecting with others who are in similar circumstances to counteract the mind pain and other difficult relationships connected to suicide. • uses the value of group strength to generate benefits for categories of people like them. e.g. grassroots movements that lead to public policy reforms.


7. CTS person engages with specific Other CTS persons out of concern for the entire category of people experiencing/suffering from the situation that these individuals typify.


• use their own counteractive energy or the assistance of a self-help facilitator to generate mutual aid support for themselves and specific others. • use their own counteractive energy or the assistance of a social change facilitator to press for societal changes, reforms that will benefit categories of people like them


8. NSC engages Others (PSC and/or NSC) out of concern for the entire category of caregivers experiencing the stress of providing inter supportive community and direct assistance to individuals with CTS and/or SS(S/O).


• use their own counteractive energy or the assistance of a community practice facilitator to generate mutual aid support for them and specific others. • use their own counteractive energy or the assistance of a community practice facilitator to press for community coordination and collaboration programs that will benefit entire categories of caregiver resources.


9. PSC engages Others (PSC and/or NSC) out of concern for the entire category of caregivers experiencing the stress of providing inter supportive community and direct assistance to individuals with CTS and/or SS(S/O).


• use their own counteractive energy or the assistance of a community practice facilitator to generate mutual aid support for them and specific others. • use their own counteractive energy or the assistance of a community practice facilitator to press for community coordination and collaboration programs that will benefit entire categories of caregiver resources.


Quadrant C







10. CTS person engages Others (help seeking) to benefit self.


• decides seriousness of their CTS needs to be shared with another person (NSC, PSC) who might be helpful. • discovers engagement with or of others (help provision) relieves constricting mind pain; helps redirect energy/efforts to deal with contributing life difficulties with a suicide-safer choice.

11. DDS person engages Others to further his/her determination to die by suicide.


• is consciously aware that the act of suicide is something that he/she cannot do without assistance (assisted suicide) or wants someone else to do it so it looks like a different mode of death (suicide-by-cop). • requires engaged others to confront and address their own attitudes and values about the justification of suicide under certain circumstances; the ethics of ‘patient’ and ‘caregiver’ right of self-determination meet in a conflictual context. • requires engaged others to recognize and address the dynamic of being drawn into the manipulations of a DDS person who wants to implicate others in his/her determination to die.


12. NSC engages Others to benefit CTS individual.


• decides seriousness of CTS needs the help/support of others to provide or mobilize life linking benefits. • recognizes the importance of engaging others to provide additional and ongoing support as a complement to the immediate help provided and promise of continuing support in keeping with their personal capacity and ability as a NSC.


13. PSC engages Others to benefit CTS individual.


• decides seriousness of CTS needs the help/support of others to provide or mobilize life linking benefits. • recognizes the importance of engaging others to provide additional and ongoing support as a complement to the immediate help provide and promise of continuing support in keeping with their professional capacity and ability as a PSC. • is not constrained by an attitude of ‘experts only’ are capable of helping someone with CTS.


14. SS(S/O) person engages Others for the benefit of self.


• recognizes the importance of engaging others to provide external support and assistance to complement their own counteractive efforts to avoid repeating or becoming a person with CTS. • decides the serious of the personal impact of suicide needs the help/support of others to provide or mobilize life linking benefits connected to the loss of one’s own will to live or the self-inflicted death of a close family member, friend or colleague.


Quadrant D






15. SS(S/O) person engages Others to press for societal reforms or changes for entire categories of people affected by suicide.


• use coalitions and influential leaders to press for national strategies, suicide safer community programs, etc.


16. CTS/DDS person engages others to press for reforms or changes to benefit entire categories of people affected by suicide.


• CTS person might use coalitions and influential leaders to press for changes in communities to protect CTS groups through changes to gun control legislation or changes to human rights legislation that excludes certain categories of people from discrimination protection. • DDS person might use coalitions and influential leaders to press for changes in legislation that would pave the way for the legalization of assisted suicide/medical assistance in dying.


17. NSC/PSC person engages other NSC/PSC, SS(S/O) concerned citizens, policy makers/legislators to press for changes to benefit entire categories of people affected by suicide.


• uses interagency coalitions, working together networks, etc. to press for development of national strategy guidelines, safe community endeavors, more funded research, etc.


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