Catherine R. Grizinski, M.Ed., LSW, CIRS Suicide Review – Youth Catherine R. Grizinski, M.Ed., LSW, CIRS Associate Director Help Network of NEO

Objectives To review current statistics To discuss the facts of Youth Suicide To review bullying factors To review risk/core components To discuss interventions

Statistics 2015 – 2nd leading cause of death for young people 10-14, 15-19 and 15-24 Suicide accounts for 1.6% of all deaths but it comprises 13.6% of all deaths among 15-24 Ten suicides for every 100,000 youths Twelve youth suicides occur daily Every one hour – 36 minutes a person under the age of 25 completes suicide

Statistics Access to firearms is a significant factor for increase For every completed suicide there are 100-200 attempts 2015 Youth Risk Behavior Surveillance Survey reported 8.6% of 9-12th graders attempted suicide in the previous 12 and 2.8% had to be treated. Prior Suicide attempt is a risk factor for possible completion

Statistics 17.7% of students seriously considered suicide 14.6% made plans for an attempt

Facts Suicide occurs after school hours in the home Profile of a nonfatal is usually female who ingests pills Profile of a fatal is usually male who completes with a firearm Deliberate self harm is considered serious and youth in need of evaluation

Facts Most are precipitated by interpersonal conflicts Hope to effect a change in others Or as a way to cope with stresses Most give definite signs of their intentions Talking with a youth about suicide does not cause someone to be suicidal Suicide Is preventable. Youth just can’t see any alternatives to their problems

Facts Four times as many males kill themselves as compared to females Three times as many females attempt as compared to men Suicide cuts across all age, economic, social, and ethnic boundaries Firearms are the most used method with asphyxiation/suffocation being second. Survivors of a suicide of a loved one may be at risk for suicide and ongoing grief issues

Facts Studies have found that LGBTQ Youth attempt suicide more frequently than straight peers Risk factor is previous attempts Victimization Family rejection Protective Factors – Family, safe schools, limited access to firearms, cultural competence training for staff

Bullying 1 out of 4 kids are bullied 43% are cyberbullied Forms: Physical, Verbal, Emotional, Sexual, Cyber Effects: fear, depression, loneliness, anxiety, low esteem, skip school, illnesses. Effects could become cumulative for kid to think about suicide as an option

Core Components of Risk Desire Capability Intent Buffers/Connectedness

Desire Ideation Psychological pain Hopeless Helpless Perceived Burdon Trapped Intolerably alone

Capability History of attempts Exposure to suicide History of violence towards others Available means Intoxicated Substance Abuse Acute symptoms of Mental Illness Dramatic mood changes Out of Touch with reality Increased anxiety Decreased sleep Acts of aggression

Intent Attempt in Progress Plan to hurt self Method known Prepatory behaviors Expressed intent

Buffers Immediate Support Social supports Plans for future Engaged with helper Ambivalence Core Beliefs Sense of Purpose

Signs Presence of a Psychiatric Disorder – depression, AOD, Behavior or Conduct D/O Communicates Thoughts or Intent Impulsive or aggressive Frequent expressions of rage Increase Of AOD Exposure to another’s suicidal behaviors Recent stressors – Family Instability or conflict

Warning Signs – IS PATH WARM I – ideation S-Substance use P-Purposelessness – no hope A-Anxious T-Trapped H-Hopeless – depression

Warning Signs - W – Withdrawal – Burdon A-Anger – rage R- reckless – Risky – Rehearsal M- Mood changes – dramatic – happy-sad or sad to happy

Ways to Help Be Aware – Learn the Warning Signs Get involved – become available – show interest and support Ask if youth is thinking about suicide Be direct – talk openly and freely about suicide Be willing to listen. Allow for expression of feelings

Ways to Help Accept the Feelings Be non-judgmental. Don’t debate whether suicide is right or wrong. Don’t lecture on the value of life Don’t dare them to do it. Don’t give advice Ask what triggered their emotions – stay away from why Offer empathy

Ways to Help Do not be sworn to secrecy – get help Be warm and caring – don’t show your shock Offer hope that alternatives are available, giving glib advice only proves you don’t understand Take action – remove means, get help Follow Crisis Plans and Policies Refer to community resources for ongoing assistance

IT is okay to ask for Help and to give Help. Caregiver issues are to: Facilitate an understanding of their feelings of the event Expose the narrowness of their choices Help Make better choices Align self as a resource You Can Make a Difference in a Young Person’s Life!

What to Do? Awareness of risks/warning signs is key to prevention ACT do not under react or overreact Once identified – engage the youth Listen – reflect words and feelings QPR – Question, Persuade , Refer

What to do?-Question Ask the suicide question – sometimes young people who express themselves as you have are often thinking about suicide. Are you thinking about suicide? Are you thinking about killing yourself? Have you ever wanted to stop living? If the answer is yes- find out if there is a plan.

What to Do? If yes – how would they carry out the plan. Do they have the means and are they accessible. Do they need to get them later The more specific the plan and the available the means creates a serious situation requiring immediate attention

Persuade Listen Let them talk through their emotions if imminent risk is not assessed. Stay calm Be reassuring Never leave them alone – may need to engage family and friends

Persuade/Refer Link to counselor if in therapy or refer for therapy Problem solving techniques HALT Safe Plans Medication – work with the DR regarding changes in symptoms

Safe Plans Written list of coping strategies and sources of support that teens can use before or during a crisis Develop one with the teen 1. Identify stressors, 2. ways to ease pain/cope, 3. Disable the means/remove 4. ID social settings to distract 5. Persons to call 6. Professional resources

Safe Plans Assess – what barriers there could be to implement Where to keep the plan – make copies Evaluate to make sure it meets new stressors Review – make changes or add to it.

Resources Local mental health/addiction agencies Help Network NEO Hotline Family Physician Private Therapist Religious Leader Hospital Police – when risk is imminent

Resources Help Network NEO Hotline – 211 or Help Network NEO website to search online local resources

Sources American Association of Suicidology National Center for Injury Prevention & Control National Suicide Prevention Lifeline 1-800-273-8255 (TALK) 211 –resources for Suicide, mental health, addiction, youth programs or call 330-747-2696 or 1-800-427-3606

Thank You Comments Questions