2014 suicide prevention, intervention, and postvention
TRANSCRIPT
2014
Suicide prevention, intervention, and postvention
Young people who talk about suicide never attempt or complete suicide.
Fact: Talking about suicide can be a plea for help and a late sign in the progression toward a suicide attempt.
Attempted or completed suicides happen without warning.
Fact: The survivors of a suicide often say that the intention was hidden, however it is more likely that the intention was not recognized.
A survivor of a suicide attempt is likely to make future attempts.
Fact: Adolescents typically make 8-10 attempts before they actually die by suicide
People who really want to die will find a way, it won’t help to try to stop them.
Fact: Most of the time suicidal people are ambivalent about the decision. They are torn between wanting to die and wanting to live. Most suicidal individuals don't want death, they just want the pain of living to stop.
Suicidal youth cannot help themselves.
Fact: While contemplating suicide, young people may have distorted perception of their actual life situation and what solutions are appropriate for them to take. With support, young people can gain full self-direction and self-management of their lives.
Most suicidal youth seek or ask for help with their problems.
Fact: Evidence shows that they often tell their school peers of their thoughts and plans. Adolescents are more likely to “ask” for help through non-verbal gestures than to express their situation verbally to others.
People who threaten suicide are just seeking attention.
Fact: All suicide attempts must be treated as though the person has the intent to die. It is likely that the person has tried to gain attention and, therefore, this attention is needed.
Not every death is preventable.
Fact: No matter how well intentioned, alert and diligent people’s efforts may be, there is no way of preventing all suicides from occurring.
One should not try to discuss suicide with depressed people, it might give them the idea or upset them enough to put them over the edge.
Fact: Many severely depressed individuals have already considered the option of ending their lives. Discussing suicide openly helps the suicidal person sort through problems, and provides a sense of relief and understanding.
PrevalenceEvery 4 hours in America a child commits
suicide3rd leading cause of death 15-24 year-olds (2nd
for 11-19 year olds)25% of high school students at risk at any
given timeU.S. has highest suicide rate among 26
industrialized nations (double the rate)
Prevalence300% increase since 1950 (youth suicide)Approximately 5,000 annuallyApproximately 100-120 attempts per
completed suicideSuicide rates are gross underestimates (many
reported as accidents)
Doing something places school in less jeopardy than doing nothing
Legal IssuesDistrict did not:
Warn Parents ImmediatelyProvide Adequate Student SupervisionProvide Training to Staff
Issues:ForeseeabilityNegligence
Court Cases:Wyke v. Polk County School Board (11th Cir., 1997)“Are School Psychologists Liable,” 1994Montgomery County, Maryland, 1988
Comprehensive Processes for Suicide and/or Violence Prevention Include:PREVENTIONINTERVENTIONPOSTVENTION
Comprehensive programs are built over years!
It is the policy of the Governing Board that all staff members learn how to recognize students at risk, to identify warning signs of suicide, to take preventive precautions, and to report suicide threats to the appropriate parental and professional authorities.
Administration shall ensure that all staff members have been issued a copy of the District's suicide prevention policy and procedures. All staff members are responsible for knowing and acting upon them.
Part of the strategic plan for Clermont County’s Suicide Coalition
Established in October 2003Funded by the Clermont County Mental
Health and Recovery Board through levy dollars
513-528-SAVE (7283)
Provides supportive services to individuals experiencing mental health crisis
Primary purpose is to provide suicide prevention services to callers
Dedicated to reducing suicide attempts, saving lives, and restoring hope through education, advocacy and collaboration in suicide prevention
Residents of Clermont County of all ages
24 hours a day, 7 days per weekUnique feature – Mobile phone Hotline3 responders – highly qualified
GatekeeperIndividuals who by the nature of their job, their
special interest in people, or in their personal relationships and friendships are in a position to observe high-risk behaviors and warning signs and take action when necessary
Gatekeeping describes the protective functions in the process of using his or her critical skills in recognizing, responding to, and helping suicidal persons get the help they need
The process by which individuals acquire basic suicide prevention and intervention skills
Participants are not intended to be an “expert” at the conclusion
Not intended in any way to replace counseling or mental health services
Intended to offer hope through positive action
Talk about suicideAsk about suicideListenKeep youth safe.Get help.
Recognize risk factors/warning signs
When following-up with the youthEncourage expression of feelingsListen without passing judgmentMake empathic statementsDo not offer reassurances that may not be trueDo not offer simplistic solutions (e.g., “all you
need is a good night’s sleep”)Explore options for support in the environmentGet parents involved with the youth’s
knowledge
Assess lethalityIs the individual making threats? Don’t be
afraid to ask.Does the individual have a plan?How specific is the plan? (e.g., time frame,
details, chance of intervention)Does the individual have access to means that
would assist in carrying out the plan?Has the individual made any previous suicide
attempts?
Collaborate with othersStudentFamily – it is imperative to involve the
PARENT/GUARDIAN!!!!School Personnel (e.g., principal, counselors,
psychologists, mental health workers, and other school professionals)
Community Agencies
Referral for professional helpWhen risk is present (e.g., specific plan,
available means)Know your community resourcesMaintain collaboration with treating agency to
conduct on-going assessment
Risk FactorsVariables that signal the need to look for
warning signs of suicidal thinking.
Warning SignsVariables that signal the possible presence
of suicidal thinking.
Suicide notes Direct & indirect suicide threats Making final arrangements Giving away prized possessions Talking about death Reading, writing, and/or art about death Hopelessness or helplessness Social Withdrawal and isolation Lost involvement in interests & activities Increased risk-taking Heavy use of alcohol or drugs
Abrupt changes in appearanceSudden weight or appetite changeSudden changes in personality or attitudeInability to concentrate/think rationallySudden unexpected happinessSleeplessness or sleepinessIncreased irritability or crying easilyLow self esteem
Dwindling academic performanceAbrupt changes in attendanceFailure to complete assignmentsLack of interest and withdrawalChanged relationshipsDespairing attitude
Postvention= the provision of crisis intervention, support and assistance for those affected by a completed suicide
Primary Goal= Prevent further suicides
Create a Crisis Fact SheetInclude Risk Factors and Warning SignsInclude local sources of assistance
When Suicide is Confirmed:Educate staff about suicide “contagion”Provide suicide postvention
recommendations
Encourage the use of the Clermont County Crisis Response Team
20 years of experience assisting schools and communities in the aftermath of tragedies
70-80 active members comprised of mental health professionals working throughout Clermont County
This could be the most important role for any educator
While remediation of reading and math skills is a worthwhile endeavor, and improving behavioral concerns is certainly helpful, they are not a matter of Life and Death!
Information presented today was the tip of the iceberg; your challenge is to seek out further information, training, and experience!