National Conference 2015 We Need to Talk About Suicide: Coping with the Trauma of a Learner’s Suicide and Building Resilience Martin Gallen, Educational Psychologist, Donegal ETB

What influences our Mental Health…… Reaching Out; Awareness Training on Suicide Prevention in Ireland, 2010 Vulnerable mental health results in protective factors lessening and risk factors increasing for suicide

Social Support increases, decrease As age increases, self reported levels of social support decrease.

Presence of One Good Adult was a key indicator of how well a young person is connected, self- confident, future looking and can cope with problems Absence of One Good Adult was linked to higher levels of distress, anti- social behaviour and increased risk for suicidal behaviour One Good Adult

Creating a Coping, Supportive and Caring Ethos Physically Safe Environment Equip learners to deal with mental health problems and seek help for same (MINDOUT) SPHE programmes - Grief and Loss - Stress/Anger/Conflict Management; - Problem Solving - Communication Skills/Help Seeking - Decision Making - Alcohol and Drug Prevention (Foroige)

Psychological Safety Mentoring Programmes (One good Adult) Policies/Inclusion/Anti-bullying/Cyber bullying Restorative Practices In-centre Counsellor Books/Resources

Psychological Safety Liaison with external agencies (developing good communication pathways) Staff Training Mental Health Issues (JIGSAW – Level 1 & 2) Child Protection Training Suicide Awareness (ASIST and safeTALK training) Signs and Symptoms of stress/anxiety/depression

Risk Factors for suicide Reaching Out; Awareness Training on Suicide Prevention in Ireland, 2010  Vulnerable mental health  Hopelessness – no positive view of the future  History of suicidal behaviour  Suicide and/or DSH in a family member/relative or friend  Diagnosis of a serious illness e.g. terminal illness or long-term pain (presence of 4 key factors outlined below may increase the likelihood of impulsive deaths by suicide)   Stress – acute or prolonged which can result in a real or perceived sense of overwhelming loss or hopelessness which can trigger fleeting thoughts of suicide   Impulsivity – past behavioural patterns of acting without thinking about consequences   Past or current substance abuse or misuse   Access to means of suicide

PAGE 15 RESPONDING TO CI GUIDELINES IN YOUTHREACH AND CTCs Unexpected reduction in academic performance Change in mood and marked emotional instability, either more withdrawn, less energy or more boisterous, talkative, outgoing Withdrawal from relationships, separation from friends or break-up of a relationship Getting into trouble at the centre, discipline problems, suspension or expulsion; trouble with the law Loss of interest in usual pursuits, study, relationships Ideas and themes of depression, death or suicide Hopelessness and helplessness Giving away prized possessions Information about self-harm or intention to self-harm coming to centre staff attention Notes or online posts found about a desire for death, an ‘impossible situation’, or an end to problems A growing interest in death or death by suicide

Steps to take when concerns arise (PAGE 15 RESPONDING TO CI GUIDELINES) Concern is reported to the designated staff member, or a Guidance Counselling and Psychological Services Practitioner serving the centre A meeting takes place with the reporting staff member or learner A meeting takes place with learner* (see R15, R16 & R17), A judgement is made about the seriousness of the situation Where concern appears unfounded, feedback is given to the original referee and a monitoring plan is drawn up for the learner. After an agreed period, the situation is reviewed to ensure there are no underlying issues that need to be addressed Where a concern is confirmed, it is reported to the coordinator/manager, leading to a consultation with the Guidance Counselling and Psychological Services Practitioner (GP&PS), or with local Child and Adolescent Mental Health services Coordinator/manager informs parents or caregivers as a matter of urgency Coordinator/manager and guidance counsellor may seek a consultation with their local Child and Adolescent Mental Health Service Management plan, appropriate to the risk level is established, with onward referral to the family GP.

Forward Planning Key to managing is planning Quick and effective reaction Sense of control Normality returns as soon as possible Effects on learners and staff are limited. Avoids “helicopter or paratrooper syndrome” Documents Responding to Critical Incidents :Responding to Critical Incidents : Guidelines for Youthreach & Community Training Centres Responding to Critical Incidents :Responding to Critical Incidents : Resource materials for Youthreach & Community Training Centres Available at:

Develop a Critical Incident Plan Step 1 - Defining a critical incident Step 2 - Creation of a coping, supportive and caring ethos in the centre Step 3 - Creation of a critical incident management team Step 4 - Communication of Plan

What is a Critical Incident “A critical incident is any incident or sequence of events which overwhelms the normal coping mechanism of the centre” (NEPS 2014)

3 Levels of Incident  Death of a student or staff member who was terminally ill; death of a parent, or sibling; fire or damage to school property  Sudden death of a learner or staff member  Accident/event involving a number of students; a violent death; an incident with high media profile; event that involves a number of schools

What level? Suicide of a resource person/tutor Suicide of a former learner Suicide of a current learner Suicide of a learner with high media interest More than one suicide

What is the goal of a CI Plan? To return the centre to the pre-incident, normal state as soon as possible Reduce the immediate and long term detrimental impact on learners, tutors and families First 48 hours crucial/3 weeks vulnerability.

Selection of Members The success of the crisis management team can depend on the selection of members The roles can be rewarding but also considerable stress Review members of team regularly

Possible Roles Team Leader Staff Liaison Learner Liaison/Counsellor Parent Liaison Community Liaison Administrator Media

Role of Psychological Support Staff Planning Information & advice Support – best to come from familiar faces Screening

Role of HSE/NEPS HSE CI management team Involved when there is a significant impact in the wider community Psychosocial provision (Psychological First Aid) v service provision Referral pathways HSE/NEPS working group on the provision of psychosocial response

Short term actions Establish as many facts as possible Locate CI plan and NEPS publications Contact appropriate agencies (NEPS,ETB,HSE) Gather list of parent/guardian contact numbers and begin to text/ ring parents Possibly dedicate a room for parent drop in Nominate a staff member to stay in parent room Arrange cover for tutors on CI Team and convene a CI meeting and delegate tasks Inform all staff when possible Maintain routine for other learners

Medium term Staff meeting to outline schedule for the day, update staff on developments, assign roles Contact with bereaved family Decisions re: closure and funeral arrangements Support to staff Support to learners Return of learners

Guidelines following a suicide Terminology Age appropriate facts Inform close friends relatives separately Avoid glorifying the victim and sensationalising the suicide Encourage help-seeking behaviour

Key messages for learners Suicide is never a valid option No criticism of the person but separate the person from the behaviour Feeling low is temporary. Suicide is permanent Suicide is the intention to change life not to end it Suicide is the act of a person for which we cannot take responsibility.

Adolescents Adolescent’s concept of death becomes more abstract. Death is seen as irreversible and personal, mortality is acknowledged. May feel an array of emotions and death adds to confused emotions R11: Reactions to a critical incident

How to help Listen Reflect on justice/injustice, fate etc. May seek support from outside the family Allow them to express grief in their own way

General support to Learners Acknowledgement Communication Time to process information Make the loss real Develop emotional coping skills

Critical Incident Plans CI plans should be reviewed regularly Copies of plan readily available Personal copy – team members New/temporary staff alerted to plan Inform parents

Positives Greater awareness of Mental Wellbeing Greater numbers of young people seeking help