The Six R’s Framework as Mindfulness for Suicide Prevention

Abstract

Abstract Suicide is a form of violence that affects not only the suicidal individual, but many others, and co-arises from many factors including personal, societal, and ecological conditions. Yet, most interventions target only individual level factors, failing to address these multiple dimensions of suicide risk. We begin by reviewing the literature on current, secular mindfulness-based interventions for suicide prevention, identifying strengths and limitations. Then, taking the theoretical position of Pratītyasamutpāda, or dependent origination, we suggest that suicide prevention requires an integration of psychological mindfulness, transcendent mindfulness, and critical mindfulness. Based on this, we propose a six R’s framework of suicide prevention, which includes the processes of remembering, redirecting, replacing, reflecting, resolving, and retracing. Our proposed approach encourages the unfolding of insight and compassion, for the patient, but is also concerned with the need to attend to community health and welfare, including the historical societal contexts that contribute to the emergence of suicide. The six R’s approach differs from secular mindfulness, which focuses on the independent practice of mindfulness, by also focusing on socio-ecological and cultural influences on suicide and on the collective, rather than solely the individual, nature of suicide. This broadened focus results in the development of wisdom, motivation, and compassion to end suffering, not just for the self, but also by addressing systemic issues, such as oppression and injustice, that contribute to suicide.