Some Secrets SHOULD be Shared… ACT® to Prevent Suicide Diane Santoro, LICSW Screening for Mental Health, Inc. 1

Objectives Information about the SOS program Warning signs of youth depression & suicide View the SOS DVD Importance of working as a team What is the school protocol? Available resources

Why? What? How? Why is it important? What is the SOS program? Mortality from suicide increases steadily through the teens Children and particularly adolescents who suffer from depression are at much greater risk of dying by suicide What is the SOS program? A program to help students recognize the symptoms of depression or warning signs of suicide in themselves or others Teach them the appropriate action steps to take to get help by using ACT How are we implementing the program at Southridge?

Depression & Youth In 2007, 8.2% of adolescents (an estimated 2 million youth aged 12 to 17) experienced at least one major depressive episode in the past year (SAMHSA, 2009). What is a Major Depressive Episode? DSM-IV: a period of 2 weeks or longer in which there is either a depressed mood or a loss of interest or pleasure AND at least 4 of the following: Increase or decrease in appetite Problems with sleeping Fatigue or energy loss Feelings of worthlessness or excess guilt Diminished ability to think or concentrate 4 4

Prevalence of Suicide Among Youth Nationally, suicide is the 3rd leading cause of death among children ages 15-24 (4,405 deaths in 2006) (CDC, 2004). Only accidents and homicides occurred more frequently. Whereas suicides accounted for 1.4% of all deaths in the U.S. annually, they comprised 12% of all deaths among 15-24-year-olds. Adolescent suicidal behavior is deemed to be underreported because many deaths of this type are classified as unintentional or accidental (World Medical Association, 2004). Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (2004) [cited 2005 Feb 28]. Available from: URL: www.cdc.gov/ncipc/wisqars.

In 2007, 8.2% of adolescents (1 in 12: an estimated 2 million youth aged 12 to 17) reported experiencing at least one major depressive episode in the past year (SAMHSA, 2009). In children and adolescents, an untreated depressive episode may last between 7 to 9 months, potentially an entire academic year! More than 90% of people who complete suicide have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder (NIMH, 2009). 6 6

By the Numbers… 2009 Youth Risk Behavior Survey found that: 26.1% felt so sad or hopeless for 2+ weeks that they stopped doing some usual activity. 13.8% seriously considered attempting suicide. 10.9% made a suicide plan. 6.3% attempted suicide. 1.9% of those who made an attempt required medical attention

Suicide – Risk Factors Risk factors are not necessarily causes. Suicidal distress can be caused by psychological, environmental, and social factors. The first step in preventing suicide is to identify and understand the risk factors. The strongest risk factors for suicide in youth are depression, substance abuse, and previous attempts (NAMI, 2003). Mental illness is the leading risk factor for suicide. Over 90% of children and adolescents who die by suicide have a least one major psychiatric disorder (Gould et al., 2003). 8 8

Suicide Risk Factors Previous suicide attempt(s) History of mental disorders, particularly depression History of alcohol and substance abuse Family history of suicide or child abuse Feelings of hopelessness Impulsive or aggressive tendencies Barriers to accessing mental health treatment Loss or interpersonal conflict (problems w/ school or the law Physical illness Easy access to lethal means, especially guns Unwillingness to seek help because of the attached stigma Local epidemic of suicide Isolation Incarceration or a pending disciplinary incident Exposure to the suicidal behavior of others History of physical and/or sexual abuse Lesbian, Gay, Bisexual, Transgender youth

Suicide SUICIDE: A MULTI-FACTORIAL EVENT Psychiatric Illness Co-morbidity Personality Disorder/Traits Neurobiology Impulsiveness Substance Use/Abuse Hopelessness Severe Medical Illness Suicide Family History Access To Weapons Psychodynamics/ Psychological Vulnerability Life Stressors Suicidal Behavior 10 10

Warning signs that demand immediate action Talking or writing about suicide or death Direct verbal cues Less direct verbal cues Isolation Expressing the belief that life is meaningless Giving away prized possessions A sudden and unexplained improvement in mood Neglecting appearance and hygiene Dropping out of school or activities Obtaining a weapon or another means

ACT Acknowledge Admit you are seeing the signs of depression or suicide in a friend and it is serious Care Let your friend know that your care about him/her, and that you are concerned that he/she needs help you cannot provide Tell Inform a trusted adult, with your friend or on his/her behalf

Myth or Fact It’s normal for teens to be moody; teens don’t suffer from “real” depression Teens who claim to be depressed are weak and just need to pull themselves together. There’s nothing anyone can do to help People who talk about suicide won’t really do it If a person is determined to kill themselves, nothing is going to stop them People who commit suicide are people who unwilling to seek help Talking about suicide may give someone the idea

Questions? Related Issues: Social Networking concerns Cutting or Self-harming behaviors