Part A

SOS Pre-conversation Checklist

Instructions:

Low: Tick this box if the situation is assessed as low risk.

Medium: Tick this box if the situation carries some risk, and proceed with caution or seek advice.

High: Tick this box if the situation is high risk. Seek assistance from a fellow SOS Altruist, colleague or management/ security.

Always proceed with caution.

The Environment

Is the environment private and free from distractions?

Low

Medium

High

Comments

Have steps been taken to create a calm and non-threatening atmosphere?

Low

Medium

High

Comments

Familiarity

Are you familiar with the individual's background, concerns, and current situation?

Low

Medium

High

Comments

Have you reviewed any relevant information or notes before the conversation?

Low

Medium

High

Comments

Location

Is the location safe and comfortable for both you and the individual?

Low

Medium

High

Comment

Have you considered if the location supports an open and honest dialogue?

Low

Medium

High

Comments

Positioning

Are you seated or positioned in a way that is non-confrontational and promotes equality?

Low

Medium

High

Comments

Have you ensured that your body language is open and inviting?

Low

Medium

High

Comments

Confrontation

Have you prepared to avoid any confrontational language or tone?

Low

Medium

High

Comments

Are you ready to manage potential conflicts with empathy and understanding?

Low

Medium

High

Comments

Assumptions and Comments

Have you set aside any preconceived assumptions about the individual’s situation?

Low

Medium

High

Comments

Are you mindful of avoiding judgmental comments or phrases?

Low

Medium

High

Comments

Body Language

Is your body language congruent with a supportive and empathetic approach?

Low

Medium

High

Comments

Are you aware of the individual’s body language, and ready to respond appropriately?

Low

Medium

High

Comments

Dealing with The D.A.G.S.

Are you prepared to identify and address the compounding risk factors that D.A.G.S. present?

Low

Medium

High

Comments

Have you considered how D.A.G.S. may be affecting the individual’s cognitive and critical thinking abilities, and are you ready to approach the conversation with this understanding?

Low

Medium

High

Comments

Be aware of the signs and impacts of D.A.G.S., such as impaired decision-making, financial stress, and potential for violent outbursts?

Low

Medium

High

Comments

Safety

Have you considered both physical and emotional safety for you and the individual?

Low

Medium

High

Comments

Is there a plan in place if the conversation leads to immediate concerns about safety?

Low

Medium

High

Comments

Ensure you have the closest access to the door and maintain a safe distance, especially when dealing with individuals influenced by substances?

Low

Medium

High

Comments

Introductions

Have you prepared a warm and clear introduction to set the tone for the conversation?

Low

Medium

High

Comments

Are you ready to establish rapport by introducing yourself, your role, and the purpose of the conversation?

Low

Medium

High

Comments

Part B

SOS Safety Checklist

Instructions:

Low: Tick this box if the situation is assessed as low risk.

Medium: Tick this box if the situation carries some risk.

High: Tick this box if the situation is high risk. Note: If multiple elements are marked as Medium or High, particularly those related to Access to Means and Mental Health History, it is critical to engage support services. If access to support services is not achieved contact emergency services.

Ensure that the individual understands the confidential nature of the information shared and that it is used solely for their benefit and the improvement of support services.

Ideation Time Frame

Have you established the time frame of the individual's suicidal ideation (e.g., recent, ongoing)?

Low

Medium

High

Note time frame of thought, regularity. Houry-Daily- WeeklyDoes the individual indicate any escalation in suicidal thoughts over time?

Low

Medium

High

Triggers and Stressors

Note-Has there been a recent significant life event (e.g., loss of job, bereavement)?Are there identifiable triggers or stressors (e.g., relationship issues, financial problems)?

Low

Medium

High

Has there been a recent significant life event (e.g., loss of job, bereavement)?

Low

Medium

High

Mental Health History

Does the individual have a history of mental health issues (e.g., depression, anxiety)?

Low

Medium

High

Note- Yes/ No How many times- How long ago-Have there been any previous suicide attempts?

Low

Medium

High

Support Systems

Note Support Network- Include with engaging services.Does the individual have access to a strong support system (e.g., family, friends, mental health professionals)?

Low

Medium

High

Note- Contact for engaging servicesIs the individual currently connected with any mental health services or professionals?

Low

Medium

High

Substance Use

Is there evidence of substance use (e.g., drugs, alcohol) that could impair judgment?

Low

Medium

High

Is substance use affecting the individual's mental state or exacerbating suicidal thoughts?

Low

Medium

High

Access to Means

Does the individual have access to means of suicide (e.g., firearms, medication)?

Low

Medium

High

Note time frame.Has the individual made any plans or preparations to carry out a suicide attempt?

Low

Medium

High

Protective Factors

Are there protective factors present (e.g., sense of responsibility to family, future plans)?

Low

Medium

High

Has the individual expressed any willingness to seek help or safety?

Low

Medium

High

Emotional State

Assess the current emotional state: is the individual calm, agitated, or withdrawn?

Low

Medium

High

Is there a noticeable change in mood or behavior during the conversation?

Low

Medium

High

Confidentiality and Data Use

Have you informed the individual that the information shared is confidential and used for statistical gathering only?

Low

Medium

High

Have you obtained consent for collecting and sharing this data with relevant support services?

Low

Medium

High

Encouragement

Have you taken time to congratulate the individual for being courageous and thanked them for sharing with you?

Yes

Have you reminded them about the SOS Stance?

Yes

Part C

SOS Debrief Section - Interviewee Feedback

This debrief section is crucial for gathering detailed feedback from both the interviewee and the SOS Altruist. It ensures that the conversation process is continually improved and that all participants feel supported, heard, and empowered.

Instructions:

Rating System: Use the scale from 1️⃣ (Very Poor) to 5️⃣ (Excellent) to rate each element.
Open Feedback: Provide any additional comments or suggestions in the open feedback sections.

Confidentiality Note: The feedback provided in this debrief is confidential and used solely to improve the support services offered. It ensures that both the interviewee and SOS Altruist are fully supported and that the process is effective, empathetic, and empowering.

Section 1: Interviewee Feedback

Suggestions for ImprovementPlease provide any suggestions for improving the process.

Section 2: SOS Altruist Feedback

Areas for ImprovementWhat areas do you feel need improvement for future conversations?