jennifer myers, ma coordinator of suicide prevention services [email protected] counseling...
TRANSCRIPT
Suicide Prevention Training
Jennifer Myers, MA Coordinator of Suicide Prevention Services
[email protected] & Human Development Center
Byrnes Building, 7th Floor803-777-5223
Take care of you.
Employee Assistance Program: 1800-822-4847
To educate about the signs of suicide To inform you of how to respond if you are
concerned a person may be suicidal or in emotional distress
To empower you to feel confident to intervene
To connect you with resources
Intro and Purpose
Exercise: Personalizing Crisis
Suicidal Ideation – Thinking about suicide Suicide threat – Stating intent to kill yourself Suicide attempt – Any act or behavior
intended to end your life Intentional self-harm – Behavior related to
self harm but absent of the intent to kill oneself Completed/died by suicide – suicide death Survivor of suicide – friend or family member
of deceased
Basic Terms & Definitions
In the past year, USC students:◦ 41% experienced hopelessness◦ 59% reported feeling very sad◦ 26% felt so depressed it was difficult to function◦ 4.6% seriously considered suicide (1,349 students
or 26 students per week)◦ 0.5 % attempt suicide (147 students or
approximately 3 per week)
Facts About USC Students (NCHA*)
*American College Health Association’s National College Health Assessment 2010
Felt things were hopeless
*American College Health Association’s National College Health Assessment 2010
Facts: Depression & USC Students*
Percent (%) Male Female Total
No, Never 43.6 36.9 39.0
No, not last 12 months
19.8 19.5 19.6
Yes, last 2 weeks 11.1 12.4 12.0
Yes, last 30 days 8.2 7.6 7.8
Yes, in last 12 months
17.3 23.6 21.6
Any time in the last 12 months
36.6 43.6 41.4
Felt very lonely
*American College Health Association’s National College Health Assessment 2010
Facts: Depression & USC Students*
Percent (%) Male Female Total
No, Never 27.6 21.0 23.0
No, not last 12 months
23.5 21.4 22.2
Yes, last 2 weeks 15.6 21.5 19.7
Yes, last 30 days 8.6 13.0 11.6
Yes, in last 12 months
24.7 23.1 23.5
Any time in the last 12 months
49.0 57.7 54.8
Felt very sad
*American College Health Association’s National College Health Assessment
2010
Facts: Depression & USC Students*
Percent (%) Male Female Total
No, Never 28.0 18.2 21.2
No, not last 12 months
22.2 18.6 19.9
Yes, last 2 weeks 14.8 22.5 20.1
Yes, last 30 days 8.6 14.8 12.9
Yes, in last 12 months
26.3 25.9 25.9
Any time in the last 12 months
49.8 63.2 58.9
Felt so depressed that it was difficult to function
*American College Health Association’s National College Health Assessment 2010
Facts: Depression & USC Students*
Percent (%) Male Female Total
No, Never 54.1 50.5 51.8
No, not last 12 months
20.5 22.5 21.8
Yes, last 2 weeks 5.3 7.8 7.0
Yes, last 30 days 4.9 5.0 4.9
Yes, in last 12 months
15.2 14.2 14.4
Any time in the last 12 months
25.4 27.0 26.4
Seriously Considered Suicide Percent (%)
Male Female Total
No, Never 83.2 86.7 85.7
No, Not last 12 months
12.7 8.5 9.8
Yes, last 2 weeks 1.2 0.4 0.6
Yes, last 30 days 0.4 0.4 0.4
Yes, in last 12 months 2.5 4.1 3.6
Any time within the last 12 months
4.1 4.8 4.6
Facts: Suicidal Thinking & USC Students*
*American College Health Association’s National College Health Assessment 2010
Intentionally Cut, Burned, Bruised, or otherwise injured yourself
*American College Health Association’s National College Health Assessment 2010
Facts: Self Harming Behaviors & USC Students*
Percent (%) Male Female Total
No, Never 90.6 88.8 89.4
No, not last 12 months
6.6 7.5 7.2
Yes, last 2 weeks 0.4 0.9 0.7
Yes, last 30 days 0.4 0.5 0.5
Yes, in last 12 months
2.0 2.3 2.2
Any time in the last 12 months
2.9 3.7 3.5
Attempted Suicide
*American College Health Association’s National College Health Assessment 2010
Facts: Suicide Attempts*
Percent (%) Male Female Total
No, Never 95.5 95.4 95.4
No, not last 12 months
3.7 4.3 4.1
Yes, last 2 weeks 0.4 0.0 0.1
Yes, last 30 days 0.0 0.0 0.1
Yes, in last 12 months
0.6 0.7 0.7
Any time in the last 12 months
0.8 0.4 0.5
Men are 4 times more likely than women to die by suicide
Women are 3 times more likely to attempt In college students, this gender difference is less
apparent
80% of those who die by suicide in college are not receiving treatment through the counseling center
90% had one or more mental disorder 50% had alcohol in their system at the time
of death
What we know about people who die by suicide
Feelings of hopelessness are more predictive of suicide than depression
Perceived burdensomeness Thwarted Belongingness Suicide is not chosen; it happens when pain
exceeds an individual’s resources for coping with pain
Why people die by suicide?
Is there a stereotypical “suicidal person”?◦ What would this person look like? What would
they wear? How would they act? How would they talk?
Myths about Suicide ◦ No one can stop a suicide, it is inevitable.
If people in a crisis get the help they need, they will likely never be suicidal again.
◦ Suicidal people keep their plans to themselves. Most suicidal people communicate their intent
sometime during the week preceding their attempt.
Discussion
Suicide Rates Among Persons Ages 10 Years and Older, by Race/Ethnicity and Sex, United States, 2002-2006,
Source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention
National Suicide Statistics at a Glance
Percentage of Suicides Among Persons Ages 10-24 Years, by Race/Ethnicity and Mechanism, United States, 2002-2006
Source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention
National Statistics at a Glance
Among American Indians/Alaska Natives ages 15- to 34-years, suicide is the second leading cause of death.
Suicide rates among American Indian/Alaskan Native adolescents and young adults ages 15 to 34 (20.0 per 100,000) are 1.8 times higher than the national average for that age group (11.4 per 100,000).
Hispanic & Black, non-Hispanic female high school students reported a higher percentage of suicide attempts (11.1% and 10.4%, respectively) than their White, non-Hispanic counterparts (6.5%).
Source: Centers for Disease Control and Prevention,National Center for Injury Prevention and Control
Racial & Ethnic Disparities
There is a range of cultural and spiritual beliefs about suicide
View regarding seeking psychological services
Pressures, support systems, coping mechanisms, psychological symptoms may vary
Additional Considerations
LGBTQ individuals are at higher risk for suicidal thinking There is no tracking system of sexual orientation or gender
identity in completed suicides Sexuality or gender identity does not create the
higher risk itself. Those who are at higher risk:
◦ Early disclosure of sexuality◦ Hiding sexuality◦ Lack of Family Acceptance◦ Bullying or Harassment◦ Conflict with Spiritual Beliefs ◦ Low self esteem, struggle with personal acceptance◦ Isolation
Special Population-LGBTQ
Markers for suicide risk are noticeably higher in student veterans than general student population
10 years of combat has resulted in increase in◦ Substance abuse◦ PTSD◦ Depression
An estimated 20% of Veterans have struggled with PTSD or depression
May not disclose suicidal thinking
Special Populations-Veterans
These are indicators that a person is suicidal
Someone threatening, talking about, or stating they intend to hurt or kill themselves
Someone looking for ways to kill themselves: Seeking access to pills, weapons, or other means
Someone talking or writing about death, dying, or suicide
Rehearsing a suicide attempt
Take all Warning Signs Seriously
Acute Warning Signs
“I’ve decided to kill myself.” “I wish I were dead.” “I’m going to commit suicide.” “I’m going to end it all.” “If (such and such) doesn’t happen, I’ll kill
myself.”
Direct Verbal Cues
“I’m tired of life, I just can’t go on.” “My family would be better off without me.” “Who cares if I’m dead anyway.” “I just want out.” “I won’t be around much longer.” “Pretty soon you won’t have to worry about
me.” “You won’t see me anymore.”
Indirect Verbal Cues
I Ideation S Substance Abuse P Purposelessness A Anxiety T Trapped H Hopelessness W Withdrawal A Anger R Recklessness M Mood Change
Take all Warning Signs Seriously
Additional Warning Signs
Previous Suicidal Behavior Impulsivity Significant substance use or dependence Family History of Suicide Previous History of Psychiatric Diagnosis Eating Disorder History of abuse (sexual, physical,
emotional) Chronic pain Recent Discharge from inpatient psychiatric
treatment
Risk Factors
Loss of any major relationship Death of a spouse, child, or best friend,
especially if by suicide Being fired, failing classes, rejection or
expulsion from a program Sudden unexpected loss of freedom/fear of
punishment Diagnosis of a serious or terminal illness
Situational Triggers
Some aspects of college are protective factors
These include:◦ Presence of Social Supports◦ Improved problems solving & coping skills◦ Access to treatment and other helpers◦ Hopeful about the future◦ Fear of social disapproval
The Good News
Common ways to ask:◦ “Are you thinking about suicide?”◦ “Do you want to kill yourself?”◦ “Sometimes when people are sad as you are, they
think about suicide, Have you been thinking about suicide?”
◦ “You look pretty miserable, I wonder if you’re thinking about suicide?”
◦ “You know, when people are as upset at you seem to be, they sometimes wish they were dead. I’m wondering if you’re feeling that way, too?”
◦ Note: If you cannot ask the question, find someone who can.
ASK Directly about Suicide
“You’re not suicidal, are you?”
How to NOT ask the Question
◦ “Have you been thinking about how you would kill yourself?”
◦ “How long have you been thinking about this?”
◦ If a person has stated the means they would kill themselves with, take steps to remove the means.
Follow up questions
Myths about suicide:
If you ask someone directly about suicide, you will put the idea in their head and might make them want to do it.
Truth is asking someone directly about suicide lowers anxiety, opens up communication, and lowers the risk of an impulsive act. Most suicidal persons indicate experiencing relief if
asked directly about suicide.
Discussion
If you observe any of the acute warning signs:◦ Between 8am to 5pm M-F: go with the student to
the Counseling and Human Development center 7th Floor Byrnes Building
803-777-5223 Another staff person should contact CHDC and inform
them of the situation
◦ After 5pm M-F or Saturday or Sunday, Contact the USC Police 911 (7-4215 for dispatch)
What to do
If you observe warning signs other than the acute warning signs◦CHDC Walk in hours 2-4pm M-F ◦Consult with CHDC 803-777-5223 or USC
Police, 911 or 7-4215, regarding the risk◦Refer the person to counseling
Assist them in calling & making an appointment
Walk with them to the appointment if needed◦Inform other staff in your department◦Follow Up with the person and pay attention
to additional warning signs.
What to do
Be willing to listen Be non-judgmental Be direct Be available Offer hope that options are available Be actively involved in getting the person
treatment Take action to remove lethal means Follow up (after they went to counseling
center or other intervention)
What to do
Role Play Exercise
Reports to file:◦ http://www.housing.sc.edu/bit/
Additional Resources:◦ http://www.housing.sc.edu/lasd/pdf/BAGGuide.pdf
Making a BIT report
Assist residents in recognizing their signs of stress, anxiety, and depression
Help them to develop positive coping skills Pay attention to isolated students and try to
engage them. Keep them on your radar screen
Be aware of relationship break ups and support residents as appropriate
Refer to counseling
Early Intervention
You are not the therapist You don’t have to make a safety plan with
the person. You can be one part of a safety plan
Do not keep a persons suicidal communications or signs a secret
Use CHDC staff for consultation, specifically Dr. Bob Rodgers, Jennifer Myers, Dr. Toby Lovell
Boundaries
Work together with others. Your role is not to “fix” the problem.
Set limits and boundaries on the amount of time you available or spend with a student
More is not always better
Boundaries
Take care of yourself Use your support systems Pay attention to your cues regarding stress Take time away as needed Know your positive coping mechanisms &
use them frequently Recognize and respect your limits Use supervision to address your needs Go to therapy for your own mental health
concerns
Self Care
Counseling and Human Development Center 7th Floor Byrnes Building www.sa.sc.edu/shs/chdc 803-777-5223
USC Police ◦ 7-911 or 803-777-4215
Thomson Student Health Center ◦ www.sa.sc.edu/shs 803-777-3175
Behavioral Intervention Team◦ www.sc.edu/bit 803-777-4333
Student Disability Services◦ 803-777-6142
Campus Resources
National Suicide Prevention Lifeline◦ 1-800-273-8255 (TALK)◦ www.suicidepreventionlifeline.org
Trevor Project (GLBT Youth) ◦ 1-866-488-7386◦ www.thetrevorproject.org
Additional Resources
Please complete the evaluation form
Thank you