LIFELINES: BUILDING A COMPETENT SCHOOL COMMUNITY FOR YOUTH SUICIDE PREVENTIONPresented by: Judith Springer, Psy.D.Member, Clinical Advisory Board, SPTS

Understand basic information about suicide

Review educators’ role in school’s suicide prevention strategy

Recognize students who may be at risk

Understand crucial, but limited, role of identification and referral

Workshop Objectives

Each year, Each year, there are approximately 10 youth suicides for every 100,000 youth in the United States.Each dayEach day, there are approximately 11 youth suicides in our country.Every 2 hours and 11 minutes Every 2 hours and 11 minutes one one person under the age of 25 completes person under the age of 25 completes suicide.suicide.One preventable death is one toomany.

What about Elementary What about Elementary School Students?School Students?

• Suicide by children is very rare.

•About four children in every 500,000 kill themselves every year.

•The suicide rate for 10-14 year olds is on the rise. 

A Personal PerspectiveThe other side of facts and figures

Stephanie’s Story

Sean’s Story

SUICIDAL BEHAVIORSUICIDAL BEHAVIOR

Attempt to solve a Attempt to solve a problem of intense problem of intense pain with impaired pain with impaired

skillsskills

Attempt to solve a Attempt to solve a problem of intense problem of intense pain with impaired pain with impaired

skillsskills

CHARACTERISTICS OF SUICIDE

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(Shneideman, 1985)

Awareness

Education about Identification

Support and Response

Suicide Prevention Strategies

Youth Suicide is a Preventable Mental Health Problem

Research shows that clues or warning signs can be detected by others.

Research has demonstrated that restriction of lethal means can reduce attempts.

Clinical evidence identifies suicidal thinking as crisis thinking that can be altered by crisis intervention techniques.

Evidence demonstrates the effectiveness of medication & cognitive behavioral treatment for symptoms of depression.

“We’re All in This Together”

A Competent SchoolCommunity Prevention

Plan

The School

Essential Partner in Prevention:

A Limited but Critical Role

Provide guidelines for crisis response ofsupport, control & structure

Demonstrate administrative commitmentand support

Outline a prepared andplanned response

POLICIES & PROCEDURES

School-based Suicide Prevention Begins with

Planning

Staff ResponsibilitiesUnderstand the importance of your critical but limited

role in the identification of students at-risk for suicide

Familiarize yourself with school policies and procedures that address this issue

Learn information that facilitates identification of at-risk students

Listen to students, verbally and nonverbally, for warning signs

Identify those students who may be at elevated risk based on that identification

Refer those students to appropriate resources

Assessing Attitudes About Suicide

Your First Step: Values Check

Questions to consider:

1. I think suicide is a rational choice.

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NeverAlways

sometimes

Questions to consider:

2. I think suicide should be prevented no matter what.

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NeverAlways

sometimes

Questions to consider:

3. Because it can be so hard to talk about, I think it is important to respect a student’s confidences about suicide.

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NeverAlways

sometimes

Questions to consider:

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I would do everything I could to prevent my teenager from dating someone who hadattempted suicide.

I would respectmy child’s choice.

On a 1 to 10 scale, rank how comfortable you are talking about suicide.

----------------------+-----------------------1 5 10Very Uncomfortable Very Comfortable

Talking About Suicide

IdentifyRisk FactorsWarning signs

Know referral resources

Enhance protective factors

What educators need to be able to do

Red: Warning Signs

Yellow: Risk Factors

Green: Protective Factors

Risk Factors: Non-Clinical Age Sex Race Sexual Orientation “Giftedness” Family

History of suicideAbuse

Exposure To death of peer

Recent StressorsLossTrouble- E.g. being bullied or bullying othersChange – transitionAccess to means

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Clinical Risk Factors

Psychiatric diagnosis

Drug / alcohol use

Previous attempt

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Access to Means…

Most Preventable Risk Factor

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Risk Factors for Youth SuicideDemographic

Family

Stressors

Clinical

Exposure

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Accessto Means

F = Feelings A = Actions C =Changes T = Threats S = Situations

Warning Signs

Feelings

HopelessnessAngerWorthlessnessEmptinessExcessive worry

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ActionsTrying to get access to guns or pills

Risky or dangerous behaviorsIncreasing drug/alcohol useGetting into fightsWriting suicidal messages on social networking sites

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Changes

One of the most significant warning signs in adolescents

Changes in moods, actions or behaviors

Recent prescription, change in psychiatric medication

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ThreatsSpecific verbal statements :I want to die, I want to kill myself

Worrisome innuendosThemes of death /destruction in school assignments

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SituationsSituations that may serve as a trigger- when a student’s coping skills are really challenged, especially:Loss – e.g. family death or divorce; breakup

ChangeGetting into trouble

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Personal, behavioral, or situational characteristics that help students become

resilient despite risks.

Protective Factors

Caring relationship with at least one trusted adult

Sense of connection/meaningfulparticipation in school

Positive self-esteem and good coping skills

Access to care for emotional/physical problems, substance abuse

Cultural/religious beliefs that discourage suicide and promote self-preservation

Protective Factors

Fostering Protective Factors

Teach students it is okay to ask for help.

Give students permission to talk abouttraumatic events like suicide.

Help students identify trusted adults.

Encourage participation inschool & community activities

Acknowledge student efforts

Be a good listener, as often as you can

Making it Real…

Pay attention to who your students are, not just how they perform academicallyNotice their appearanceObserve their social skills / relationshipsMonitor their behavior changes

Helping At-Risk Students

Making it Real…DEALING WITH AT-RISK STUDENTS

BRAD

James

Elena

Conner

Threatening suicide

Looking for access to means

Talking or writing about death, dying, suicide

Previous attempt seriousenough to requirehospitalization

Students at Higher Risk

Making it Real…DEALING WITH AT-RISK STUDENTS

Brad

JAMES

Elena

Conner

Talking with At-Risk StudentsLISTEN

Acknowledge feelings in student’s termsClarifySummarizeValidate

Know Your Limits(E.g., to ask about suicide directly?)

Know Your Resources

Act

Follow-up

Making it Real…DEALING WITH AT-RISK STUDENTS

Brad

James

ELENA

Conner

What about suicide prevention for elementary students?

 

1. Don’t teach “Don’t tattle.’

2. Do teach , “Ask for help if you or someone else is getting hurt” and “Friends help friends.”

3. Focus on promoting helpful behavior and preventing bullying and hurtful behavior.

4. Encourage children to identify least one trusted school adult.

5 Teach social emotional skills – e.g. self-calming and problem-solving skills.

Making it Real…DEALING WITH AT-RISK STUDENTS

Brad

James

Elena

CONNER

Educators’ Role in Review

Learningsigns of risk in students

Identifyingat-risk students

Referringto appropriate resources

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What About Parents?

Understand school’s policies and procedures

Recognize signs of trouble in their children

Know what to do and where to go for resources

Understand how to respond to other at-risk youth

Do Students Have a Role in Suicide Prevention?

Awareness of warning signs

Strategies for getting help personally

Knowledge of ways to help peers

Awareness of school and community resources

Identification of caring adults

Are School Programs That Address Suicide Safe?

Answering Common Questions

Answering Common Questions

Is Talking about Suicide Just a Way for Someone to Get Attention?

Answering Common Questions

Can Talking about Suicide Plant the Idea in the Minds of Vulnerable Teens?

Stacy’s Story

FREE Resources for the Competent Community

Teacher training OnlineParent video- “Not My Kid”Available at www.sptsusa.org

www.sprc.orgSuicide Prevention Resource CenterNational resource

www.afsp.orgAmerican Foundation for Suicide PreventionPrinted materials & resources

www.suicidology.orgAmerican Association of SuicidologyData, resources, links

www.maine.gov/suicideMaine Youth Suicide Prevention ProgramExtensive resources and information on youth suicide 

Additional Resources

It’s in the Shelter of Each Other…