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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.

Connect with Assoc Prof Manaan Kar Ray on Linkedin
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