Barri Sky Faucett, MA

Every 12.8 minutes another life is lost to suicide, taking the lives of more than 41,149 Americans in Nationally 13 people per 100,000,in WV 17.4 people per 100,000 (323 Deaths) WV ranked 14th in the US in suicide rate for all age groups, 44 th for adolescents. Suicide is the 10th leading cause of death in America. For youth, years old, suicide is the second leading cause of death.

 In 2010, there were 4,600 reported youth suicides in the United States.  Each day there are approximately 12 youth suicides  Most common method is firearms followed by suffocations  Males complete 4 times more than females; females attempt four times more than males.

 1 out of every 53 high school students (1.9 percent) reported having made a suicide attempt that was serious enough to be treated medically (CDC, 2010a).  Approximately 1 out of every 15 high school students attempts suicide each year (CDC, 2010a).  For every completed suicide, there are attempts among adolescents. Suicide Attempts

 Research shows that most adolescent suicides occur school hours and in the teen’s homes  Most adolescent suicides are precipitated by interpersonal conflict  Within a typical high school classroom, it is likely that three students (one boy and two girls) have made a suicide attempt within the last year. Suicide in Adolescents

Barbour Berkeley Boone Braxton Brooke Cabell Clay Fayette Gilmer Grant Greenbrier Hampshire Hancock Hardy Harrison Jackson Kanawha Lewis Lincoln Logan McDowell Marion Mason Mercer Mineral Mingo Monongalia Monroe Morgan Nicholas Ohio Pendleton Pocahontas Preston Putnam Raleigh Randolph Ritchie Roane Summers Taylor Tucker Tyler Upshur Wayne Webster Wetzel Wirt Wood Wyoming JeffersonPleasants Dodd- ridge Cal- houn 4 (12.7) 7 (10.9) 11(27.8) Marshall 11 (4.2) 5 (26.6) 4 (18.9) 2 (10.4) 3 (15.5) 5 (43.8) 2 (13.2) 2 (16.2) 3 (19.9) 9(25.2) 4 (15.2) 2 (11.8) 15 (12.9) 2 (21.1) 3 (27.3) 18 (10.5 ) 3 (24.2) 44 (20.0 ) 6 (14.6 ) 1 (3.5) 14 (15.1 ) 3 (21.2) 2 (6.2) 10 (25.5) 4 (6.2) West Virginia Suicides by county Ages Rate per 100,000 Population WV Rate 13.7/100, Deaths by Suicide 14.6 – – 10.5 Suicide: A PREVENTABLE DEATH IN OUR STATE 3 (28.6) 14 (19.0) 4 (15.2) 2 (23.3) 2 (7.1) 0 (0.00) 5 (16.3) 7 (19.3) 2 (6.0) 4 (22.6) 1 (11.4) 14(24.9) 11 (13.2) 1 (3.6) 4 (11.1) 1 (3.4) 5 (13.3) 11 (17.9) 15 (17.1) 1 (6.6) 2 (28.3) 9 (8.8) 5 (9.8) 0 (0.00) 3 (17.2) 10.9 – (9.9)

 Increased school pressures as they progress through higher grades  First romantic relationships  Increased independence and identity  Experimenting with substance use  Puberty and Hormone fluctuation  Bullying

Erickson Developmental Stage- Learning Identity Versus Identity Confusion (Fidelity) Learning Intimacy Versus Isolation (Love) Adolescent Ego Imaginary Audience Personal Fable

 Adolescence is a time of profound brain growth.  Greatest changes to the brain that are responsible for impulse control, decision making, planning, organization, and emotion occur in adolescence (prefrontal cortex).  Do not reach full maturity until age 25.

 Lesbian, Gay, and Bisexual youth are 1 ½ - 7 times more likely to have reported ideation.  LGB Youth in multiple studies are found to be 3-4 times more likely to attempt suicide.  58% of LGB youth who had attempted suicide reported they really hoped to die vs. 33% of heterosexuals who attempted and reported really hoping to die.  Have elevated risk factors and lower protective factors

Risk Factors- characteristics that will may it more likely that an individual will consider, attempt, or die by suicide Invitations/Clues- behaviors that indicate signs of immediate risk Protective Factors- characteristics that make it less likely that individuals will consider, attempt, or die by suicide. Suicide: Factorst

IS PATH WARM?sk Factors- IS PATH WARM  Ideation  Substance Abuse  Purposelessness  Anxiety  Trapped  Hopelessness  Withdrawal  Anger  Recklessness  Mood Changes

 Prior suicide attempts  Mental health disorders  History of trauma or abuse  Family history of suicide  Lack of social support  Access to means

 Acquiring a gun or stockpiling pills  Talking about wanting to die or kill oneself  Impulsivity/increased risk taking  Giving away prized possessions  Self-destructive acts (i.e., cutting)  Increased drug or alcohol abuse  Talking about no reason to live

“ 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.”

 Treatment for MH/SA, physical disorders  Increased access to interventions  Restricted access to highly lethal means  Strong connections to family and community support  Strong problem-solving and conflict resolution skills  Cultural and religious beliefs that discourage suicide and support self-preservation

Listen and don’t show shock or disapproval Show that you care, it is more important than saying “the right thing.” Avoid trying to explain away the feelings…(saying things like “you have a lot to live for” or “you are just confused right now”)

“You know when people are as upset as you seem to be, they sometimes wish they were dead, I was wondering if you were feeling that way too.” “You look pretty miserable, I was wondering if you were thinking about suicide.” “Are you thinking about killing yourself?”

Listen to the problem and give them your full attention Remember, suicide is not the problem, only the solution to a perceived insoluble problem Do not rush to judgment Offer hope in any form Find the life side

Suicidal people often believe they can not be helped, so you may have to do more. The best referral involves taking the person to someone who can help. The next best referral is getting commitment from them to accept help. The third best referral is to give referral information and try to get a good faith commitment not to complete or attempt suicide. Any willingness to accept help at some time, even in the future is a good outcome.

 KEEP SAFE Agreement  Disable the suicide plan (if applicable)  Safety Contact (s)  Safety Plan  Notify Parents/Guardians  Safe/no use of alcohol and drugs  Link to resources  Link to services TO DO - Immediately

 Learn how to use the SAFE-T approach.  Explore interactive sample case studies  Quickly access and share information, including crisis lines, fact sheets, educational opportunities, and treatment resources.  Browse conversation starters that provide sample language and tips for talking with patients who may be in need of suicide intervention.  Locate treatment options, filter by type and distance, and share locations and resources to provide timely referrals for patients.

 Identify Risk Factors  Identify Protective Factors  Conduct Suicide Inquiry  Determine Risk Level/ Intervention  Document

 PHQ-9 ▪ 9 items ▪ Over the last 2 weeks ▪ Assessment of depression and suicidality  C-SSRS- Columbia Suicide Severity Rating Scale ▪ 6 Questions- Suicidal Thoughts and Ideations ▪ Free Web training  ASAP-20 ▪ Semi-structured clinical interview ▪ Assesses suicide risk and protective factors based on psychological interviews ▪ Gives guidelines/documentation of next steps.

 Signs of Suicide (SOS)  Evidence-Based Middle School and High School programs  Brief Introductory Training  25 minute Video  Guided Discussion  Screening Instrument  Lifelines  minute sessions  Teachers education  Prevention, Intervention, Postvention

 More Than SAD  Evidence-Based Middle School and High School programs  Brief Introductory Training  25 minute Video  High School TOOLKIT  Teachers education  Prevention, Intervention, Postvention  Guidelines

Patrick Tenney, BA Northern Regional Director ext Hope Siler, MA, LSW Southern Regional Director ext Barri Sky Faucett, MA Project Director ext