Every year, Montana ranks among the states with the highest rates of suicide in the country, and rural communities like ours carry more than our share of that weight. Many of us have felt that reality up close this year in ways that are hard to grasp.
September, National Suicide Prevention Month, is an invitation to talk about mental health as openly as we talk about physical health, and to remember that most of us are far more capable of helping someone in crisis than we think we are.
Livingston HealthCare has spent the past year building that capability into our own team through a training called QPR, which stands for Question, Persuade, Refer. Think of it as CPR for a mental health crisis. It is not therapy, and it does not require a clinical background. In about an hour, QPR teaches any community member, a nurse, a coworker, a neighbor, a coach, how to recognize the warning signs that someone may be struggling, how to ask directly and calmly whether they are thinking about suicide, and how to connect them with help.
In November 2025, we set multiple goals to strengthen our readiness to respond to those in crisis through our triennial Community Health Improvement Plan (CHIP). By the end of June, we accomplished our first one: training 50% of patient-facing staff in QPR. That did not happen because our staff had extra time on their hands. It happened because they understood how much this training matters, for our patients and for each other in our community.
The first phase of QPR is Question: Community members learn how to spot verbal, behavioral, and situational warning signs, and how to directly ask someone if they are thinking about suicide. This part matters more than people realize. Asking the question does not plant the idea. In fact, research shows the opposite. When someone is struggling, a direct conversation about suicide can provide relief, create connection, and open a door they may have been waiting for someone to open.
Persuade: Persuade is broken into 3 parts, and refers to learning how to listen without judgement, how to best show support, and encouraging the person to accept help. The goals of Persuade aren’t “fixing” or “debating”, rather communicating clearly, withholding judgement, and offering hope.
The last piece of QPR is Refer. Referring someone in crisis to real help, and one resource has made that step a genuine game changer: 988, the Suicide and Crisis Lifeline. Anyone can call, text, or online chat 988 any time, day or night, and reach a trained counselor, not a recording or a waitlist. It is also an amazing resource for concerned friends or loved ones. 988 serves anyone who has questions or concerns, and more people in Southwest Montana need to know it exists.
It feels important to emphasize that this is not about any one organization solving this alone. Local employers, coaches, and faith leaders can offer QPR trainings, and LHC is happy to help make that happen, whether that means connecting you with a local trainer or hosting a free training for your team. The more people who know how to recognize the signs and ask the question, the more lives we can reach.
If you or someone you know is struggling, reach out. Call or text 988.