We all experience stress. And it's estimated that 59% of the population have experienced at least one personal stressor in the last 12 months. 

And 75% of adults have experienced a traumatic stress-inducing event at some point in their life, resulting in distress. 

And there's a growing body of literature suggesting that reactions to stressful life events may increase the risk of suicide-related thoughts or behavior. 

But research has found that we can buffer that journey from stress to distress to suicide. PeerSAFE is a trauma-informed situational distress and suicide awareness mentoring tool that buffers that journey from stress to distress to suicide that keeps your peer safe.

Stress can work for or against us. 

What you may not know about stress is that it's not all bad. 

In fact, we can experience eustress or positive stress just as frequently as we do negative stress. Eustress produces positive feelings of excitement, fulfillment, meaning, satisfaction, and well-being because we feel confident, adequate, stimulated by the challenge that we're experiencing from the stressor. 

Emotionally, eustress can result in positive feelings of contentment, inspiration, motivation, and flow. 

Psychologically, eustress helps us build our self-efficiency, autonomy, and resilience. 

Physically, eustress helps us build our body, so for example through completing a challenging workout. 

But eustress and distress are spread across a continuum. Unlike eustress, distress can make you feel overwhelmed because your resources, whether they be physically, mentally, or emotionally, are inadequate to meet the demands that you're facing. 

Stress is a response to a challenging new life event such as a job loss, exam, deadlines, finances, estrangement, alienation, separation, or divorce. 

Stress can be a state of worry or mental tension caused by a difficult, distressing, or traumatic situation. 

A distressing or traumatic situation is an event that overwhelms a person's ability to cope, resulting in situational distress and in some cases psychological injury. 

Retraumatization and prolonged stress responses can develop into maladaptive behavioral, hormonal, immune, and DNA function. Prolonged high-level stress can lead to physical symptoms like headaches, loss of appetite, increased blood pressure, chest pain, sleep problems, reduced immune function. It can also influence health conditions like heart disease, irritable bowel syndrome, depression, anxiety, and suicide-related thinking or behavior. 

And 75% of adults have experienced a traumatic stress-inducing event at some point in their life. According to Silva in 2014, trauma is an experience of extreme stress or shock that is or was at some point part of life.

How is stress and distress associated with suicide? 

According to Phoenix Australia in 2019, traumatic stress can contribute to depressive disorders, anxiety disorders, alcohol and substance disorders, and suicide-related thoughts and behaviours. 

And there is a growing body of literature suggesting that the reactions to stressful life events may increase the risk of suicide-related thoughts or behaviour. 

An Australian Bureau of Statistics National Study of Mental Health and Well-being from 2020 to 2022 found that one in six people aged 16 to 85 had experienced high or very high levels of distress. This kind of stress affects a person's level of functioning and interferes with daily living. It can also result in emotional dysregulation, negative views of their environment, others and themselves. This often appears, even temporarily, as depressive or anxiety disorders according to Andrews and Slade in 2001, which can be precursors to suicide-related thoughts or behavior.

We now know that the journey from stress to situational distress to suicidal thoughts typically passes through three stages. 

The first stage, hopelessness and isolation. 

The second stage, rumination and brooding. 

The third stage, depressive episodes. 

Research also indicates that there is a gender difference in that journey. 

Females tend to ruminate more and be more prone to emotional distress. Once they process the emotional distress, they are better able to face reflection and problem solving. 

Males tend to reflect more and be more prone to situational distress. Once they process the situational distress, they are better able to practically apply their reflection towards problem solving. 

But both males and females can and do pass through stages of rumination and reflection. 

Too much rumination inhibits reflection and increases likelihood of depressive episodes, which in turn increases the likelihood of suicidal related thoughts. 

Equally, too much reflection can increase isolation and hopelessness, which in turn increases likelihood of suicidal related thoughts. 

Rumination is characterised by prolonged inflexible and pervasive brooding or overthinking that interferes with reflection and practical problem solving, and can influence depressive episodes which can lead to suicide related thoughts. 

Reflection with a self-awareness and a solution focus is linked to practical problem solving. Prolonged reflection though, influenced by self-doubt or loathing, can influence increased hopelessness and isolation which can lead to suicide related thoughts. 

The key to buffering the journey from stress to distress to suicide is practical problem solving. 

Problem solving is forward thinking, generates solutions to move forward and change the current situation, creates inertia and hope. And that's one of the aims of PeerSAFE. 

This is why we meet our peer where they are at, why we take a trauma informed approach to keeping our peers safe. We don't ask what's wrong with you, we pay attention to what's happening or happened to you and how we can get your hands back on the wheel.

As a trauma-informed first responder with a peer on the path to distress or suicide, we need to keep the four R's in mind, and they are Realising, Recognising, Responding, and Retraumatisation. 

Realising that that trauma, situational distress and suicide has widespread impact across our communities and that prevention is better than intervention. 

Recognising the signs of stress, distress and suicide. In PeersWALK, we learn to identify the signs of suicide by identifying what we can see, hear and feel. 

Responding with a trauma-informed focus that creates opportunities for our peer to rebuild a sense of control. 

Retraumatisation is consciously prevented by a strengths-based focus. 

So what are the four signs of traumatic or situational distress? 

Arousal, high cortisol levels, hypervigilance and high emotions. 

Avoidance, avoiding recurring thoughts, avoiding social contact and avoiding feelings. 

Abandoning, abandoning responsibilities, beliefs and hope. 

Absent, absent-mindedness, absent capacity and absent energy. So what are some of the signs of suicide? 

In PeersWALK training, we learn to identify the signs of suicide by identifying what we can see, hear and feel with our peer. Here's a summarised list of some of the signs of suicide. When several are present, we start to pay real attention. Hopelessness, helplessness, overwhelming feelings of shame, guilt or burden. Changed eating or sleeping habits, loss of interest, self-neglect or lack of self-care, speaking directly of suicide, giving up no future plans, suddenly at peace or happy and finally withdrawal and isolation.

When we are stressed or distressed, our memory and recall is affected. 

Normal memory recall has a beginning, middle and end. 

Traumatic or distressed memory recall can't differentiate past from present and starts reliving sensory and emotional experiences in the present. 

This is because within the brain, the hippocampus, which files memory in narrative order, like a filing cabinet, becomes fragmented. Reliving is a sign of fragmented memory, trying to put the pieces of the puzzle back together in order to integrate something that was too stressful to file at the time. This is why trauma and distress memories are often not well organised, fragmented, have little to no context, lack time sequencing, little to no narrative, can appear frozen in time, and we have little to no control over triggers that relive or involuntarily retrieve those memories. 

In the span of our life, stress is fleeting. Suicide is final. 

The key to buffering that journey from stress to distress to suicide is practical problem solving. And with the right tools, mentoring or peer support, people experiencing distress can progress from rumination through reflection to problem solving and buffer suicide-related thoughts and behavior. PeerSafe is a trauma-informed situational distress and suicide awareness mentoring tool that buffers the journey from stress to distress to suicide and that keeps your peer safe. 

Remember, traumatic or distressed memory recall can't differentiate past from present and starts reliving sensory and emotional experiences in the present. Given a distress or trauma response can't always differentiate past from present, and fear circuitry in our brain triggers chemicals that impair the prefrontal cortex, meaning we experience tunnel vision under stress, we can't regulate our emotions, we fixate on specifics, and we can't see context or big picture. We can't then organize ourselves, our decisions, or even find the words to bring us from emotion to narration. 

So having a peer or mentor safely guide us to re-engage our prefrontal cortex and verbal or narrative centers of the brain to regain a sense of control in the moment can literally be life-saving.

Research indicates that having a peer or mentor safely guide us to re-engage our prefrontal cortex and the verbal or narrative centers of the brain to regain that sense of control in the moment can be enough of a buffer preventing that stress from escalating, or at least to keep us safe until we engage someone trained to walk across that road of situational distress or suicide, like someone who has been peersWALK trained. 

Before we apply the peerSAFE model is a basic quick mentoring and listening model called “SHUSH” from our friends at Samaritans in the United Kingdom. 

The S stands for show you care. 

The H stands for have patience. 

The U stands for use open questions. 

The S stands for say it back and 

The H stands for have courage.

PeerSAFE is a trauma-informed situational distress and suicide awareness mentoring tool that buffers the journey from stress to distress to suicide that keeps your peer safe. So how does the PeerSAFE model work? 

There are four steps in the PeerSAFE model and they are Stressors, Affect, Focus and Engage. These four steps, used in order, help mentor your peer back into the present time, back into their own sense of control and into life-saving practical problem solving. 

The S in safe stands for Stressors. So we start by asking your peer what's your biggest single stressor right now? To better understand the continuum of stress, Mihaly Csikszentmihalyi’s work on “flow” helps us understand whether it is helpful stress or hindering stress, whether it is eustress or distress and we can gauge this by the extent of the challenge and our peers ability to cope. 

The A in safe stands for Affect. We then ask your peer how is that stressor affecting you? We listen carefully for whether it could be affecting their head, meaning their thinking, their heart, meaning how they're feeling or their hand, meaning how they're acting or their behavior. We then listen carefully for whether it is hindering or helping and we reflect that. 

The F in safe stands for Focus. We then ask your peer where is your focus right now? and we listen for whether it could be hindering or helping. When they've clarified that we then ask where do you need it to be? This helps pull their focus into a problem solving mode and propelling them forwards. 

The E in safe stands for Engage. Lastly we ask your peer who or what do you need to engage right now? We listen for whether it could be something someone or something personal or professional and we listen for whether it is prevention or intervention problem solving. The key to buffering that journey from stress to distress to suicide is practical problem solving and that's the aim of PeerSafe.

The key to buffering that journey from stress to distress to suicide is practical problem solving. Problem solving is forward thinking. It generates solutions to move forward and change the current situation. It creates inertia and it creates hope. And that's one of the aims of PeerSAFE. 

This is why we meet our peer where they are at. Why we take a trauma-informed approach to keeping our peer safe. We don't ask what's wrong with you. We pay attention to what's happening or happened to you and how we can get your hands back on the wheel. 

PeerSAFE is situational distress and suicide awareness that can immediately be applied through peer-to-peer mentoring. You can also now build on PeerSAFE and step up to situational suicide prevention with PeerWalk. 

But first, how do we apply PeerSAFE in mentoring? Well, PeerSafe is a trauma-informed situational distress and suicide awareness mentoring tool that buffers the journey from stress to distress to suicide that keeps your peer safe. Combining the two models from this training, SHUSH, which was for listening, with SAFE, is a simple, pragmatic starting point for peer-based mentoring in your community. 

As a quick recap, SHUSH is 

S, show you care. 

H, have patience. 

U, use open questions. 

S, say it back. 

H, have courage. 

And from PeerSAFE, The SAFE model is 

S, stressors. What's your biggest single stressor right now? 

A. Affect. How is that stressor affecting you? 

F, focus. Where is your focus right now? Where do you need it to be? 

And E, engage. Who or what do you need to engage right now?

PeerSAFE is a trauma-informed situational distress and suicide awareness tool. But have you thought about being trained in situational suicide prevention? 

Did you know that 1 in 20 Australians have had thoughts of suicide? 

Do you know the signs? 

PeersWALK situational suicide prevention training gives you the confidence, skills and tools to walk one of your peers across the road of suicide or situational distress. 

If you want to become trained to walk your peer across that road of situational distress or suicide, enrol in the next PeersWALK training now.