The Culture & Suicide Prevention Institute



Suicide Prevention Trainings

Effective suicide prevention training requires:
…infusion of culture & diversity across the suicide crisis continuum
…involvement of all stakeholders from community members to clinicians
Culturally -infused training
For stakeholders across the suicide crisis continuum
Culturally -infused training
For stakeholders across the suicide crisis continuum
Teachers,Peer specialists
Health& Behavioral Health Providers


Founded on Diversity,
Culture, & Suicide

CCPA’s culturally infused suicide prevention trainings are founded upon (and created by original authors of) leading empirical research on culture, diversity, and suicide, such as:
  • The Cultural Theory and Model of Suicide (for Adults and Youth)
  • The Cultural Assessment of Risk for Suicide measure
  • The Culturally Infused Curricular Framework (CICF) for Suicide Prevention Trainings
(see research citations in the relevant CSPI tabs above)
Culturally-infused trainings are needed to allow communities with multiple and intersecting cultural identities to access suicide prevention education and skills.
CCPA’s suite of culturally infused trainings address the diverse needs of communities with different race, ethnicity, gender, sexual orientation, rural, veteran, spiritual, and other identities, while streamlining available resources.

Training for Diverse Communities

Across Multiple Cultural Identities

Clinical Systems

Culturally Responsive Suicide Care

Consultation for Health & Behavioral Health Care Systems to Transform their Suicide Prevention & Management

CCPA utilizes one of the only culturally-infused frameworks to transform health and behavioral health systems, to provide suicide care and prevent suicide deaths for culturally diverse underserved individuals.

Individualized &

for Suicide Prevention
CCPA is an expert in downstream suicide prevention work for your diverse communities. We work with your organizational leaders and stakeholders to identify existing organizational barriers around suicide risk management and offer solutions that are implementable and sustainable for diverse clients and consumers. We are licensed mental health professionals / consultants who are published leading national experts in culture, DEI, and suicide, legal and ethical issues, and more
CCPA experts have developed and published numerous culturally-infused tools to the key components of suicide care. Engage with us to transform all clinical activities and processes:
  • Integration of evidence-based cultural suicide screening into your screening tools
  • Psychometrically validated assessment of cultural factors into your comprehensive assessment approaches and tools
  • Documentation templates with evidence-based cultural practices integrated, to save your staff and providers valuable time in their paperwork
  • Resources for culturally-infused safety plans, to account for the needs of youth, LGBTQ+, ethnic minority, and other diverse clients
  • Guidance for the infusion of evidence-based cultural and diversity considerations into suicide-focused treatments.
  • Culturally responsive needs assessment and program evaluation tools
  • Suicide prevention policies and procedures with attention to diversity, equity, and inclusion (DEI)

Culturally Infused Evidence-Based Clinical Tools

Culture & DEI-Infused Training

of Staff & Providers

CCPA has access to and has provided culturally-infused trainings to staff and providers across a health or behavioral care organization – from front desk staff to licensed providers. We aim to provide a system of training that is accessible whenever staff/providers need it, in self-paced and live online and in-person formats.

Suicide Warning Signs

Warning Signs for Suicide

Culturally-influenced signs in purple

Verbal Signs

  • “I just want out.”
  • “I won’t be around much longer.”
  • “I’m a burden to other people.”
  • “I want to go to sleep and never wake up again.”
Thinking Signs
  • Thinking life is not worth living, thinking about hurting yourself, or having suicidal thoughts.
  • Thinking others are better off without you.
  • Believing that no one understands you.
  • Thinking that you are a failure.
  • Believing that things will not get better.
  • Thinking that ending your life is the best solution for your problems.
Feeling Signs
  • Feeling hopeless, desperate, or trapped.
  • Feeling abandoned or betrayed.
  • Feeling no sense of purpose.
  • Sudden mood changes.
  • Feeling ashamed of who you are.
  • Feeling unbearable emotional pain.
Physical Signs
  • Trouble coping with health changes
  • Unbearable chronic pain
Behavioral Signs
  • Giving away prized possessions.
  • Doing reckless things that put you in danger.
  • Putting affairs in order.
  • Increased drug, alcohol use or other ways to numb pain.
  • Withdrawing and spending most of your time alone.
  • Not caring for personal hygiene or health needs.
Situational Signs
  • Conflict with or rejection from your family, support system, or community.
  • Exposure to trauma, such as abuse or bullying.
  • Financial stress.
  • Chronic or terminal illness.
  • Death or suicide of a loved one.
  • Discrimination or being treated unfairly because of who you are.
  • Not having others who understand you.
  • Failure to meet expectations.
  • Trouble adjusting to a new culture.
Definition: Culturally-influenced warning signs of suicide are defined as signs shown by research to be more common or more strongly related to suicidal thoughts and behaviors in cultural minority groups.

The Cultural Theory and Model
of Suicide

About the Cultural Theory and Model of Suicide

The Cultural Theory and Model of Suicide is regarded as one of the leading frameworks for diversity, culture, and suicide. It is an evidence-based framework of 4 culturally-influenced factors and concepts that guide the infusion of diversity and culture into suicide prevention work for youth, adults, and older adults.
The Cultural Theory and Model of Suicide shows that 95% of all empirical research showing cultural differences in suicide risk are encompassed by the “MISC“ factors:
Minority Stress
Idioms of Distress
Social Discord
Cultural Sanctions

Four (4) key concepts transform the way that suicide prevention work is done:

  1. “Culture” influences the types of stressors that lead to suicide
  2. “Culture” meanings or sanctions associated with stressors and suicide affect suicide risk
  3. “Culture” affects how suicidal thoughts and behaviors are experienced and expressed
  4. “Culture” affects the suicide help-seeking and resource connection process

Citations / Empirical Publications

The Cultural Theory and Model of Suicide for Youth
  • Chu, J., O’Neill, S. E., Ng, J. F., & Khoury, O. (2022). The cultural theory and model of suicide for youth. In Youth suicide prevention and intervention: best practices and policy implications (pp. 99-106). Cham: Springer International Publishing.
Expansion of the Cultural Theory and Model of Suicide to Community Help-seeking Processes and Resource Connection
  • Yang, L. H., Lam, J., Vega, E., Martinez, M., Botcheva, L., Hong, J. E., … & Lewis, S. E. (2018). Understanding the impact of community on the experience of suicide within the Lao community: An expansion of the cultural model of suicide. Asian American journal of psychology, 9(4), 284.
An Empirical Examination of the Cultural Theory and Model of Suicide Factors
  • Chu, J., Maruyama, B., Wickham, R., Batchelder, H., Goldblum, P., & Bongar, B. (2020). Cultural pathways for suicidal ideation and behaviors. Cultural Diversity and Ethnic Minority Psychology, 26(3), 367-377. doi: 10.1037/cdp0000307

The CARS Measure

(Cultural Assessment of Risk for Suicide)

About the CARS Measure

The CARS measure is a psychometrically valid instrument that assesses for the 4 theoretical constructs of the Cultural Theory and Model of Suicide. It can be used as a clinical tool to assess for the four major ways in which culture influences suicide risk across multiple cultural identities. It is available in a 39-item and 14-item version

Citations / Empirical Publications

The CARS Measure (39-item version)
  • Chu, J.P., Floyd, R., Diep, H., Pardo, S., Goldblum, P., & Bongar, B. (2013). A tool for the culturally competent assessment of suicide: The Cultural Assessment of Risk for Suicide (CARS) measure. Psychological Assessment, 25(2), 424-434.
The CARS-Screener (CARS-S) Measure (14-item version)
  • Chu, J., Hoeflein, B., Goldblum, P., Espelage, D., Davis, J., & Bongar, B. (2017). A shortened screener version of the Cultural Assessment of Risk for Suicide. Archives of Suicide Research, 22(4), 679-687.
By downloading the CARS manual, you agree to use it only in unmodified form. You may reproduce or insert the CARS into electronic medical records for your individual agency use. You agree to cite the original articles in any use of the tools. You also agree to use the tools consistent with the American Psychological Association ethical principles and code of conduct.
Contact Dr. Joyce Chu for any questions at

The Culturally Infused
Curriculuar Framework(CICF)

About the CICF

The Culturally Infused Curricular Framework (CICF) for Suicide Prevention Trainings establishes a set of empirically-based cultural competencies that should be included in suicide prevention community trainings. The Be Sensitive, Be Brave community trianings are based upon the competencies of the CICF.
The CICF can be used to guide efforts to incorporate diversity and cultural competencies into suicide prevention community training efforts.

Citations / Empirical Publications

  • Chiu, L., Corpus, G. H., Lien, M., & Chu, J. P. (2024). The culturally infused curricular framework (CICF) for suicide prevention trainings. Health promotion practice, 15248399241234064.
If you or someone you know is in suicidal crisis or emotional distress, please reach out for 24/7 crisis support: call of text 988