MENTAL HEALTH AND SUICIDE PREVENTION 101 Dr. Dan Reidenberg, PsyD Executive Director – SAVE “Suicide Prevention 101” is a quick snapshot including: A primer to look at the more recent history in the field of suicide prevention nationally and in the state what the public health approach is The scope of the problem of suicide in Minnesota – (DON’T USE FOR TTT – will be in Be-A-Link) What we can do to help in our communities

The Mental Health Continuum Skip from here to slide #36 when doing TTT or: Mental Illness Emotional Wellness

Mental Health Disorders Brain diseases are just like other medical diseases Affect everyone - no one is a specific target Can come on at any time Most common Mood disorders: depression, bipolar disorder Substance abuse disorders: abuse, dependency Anxiety disorders: many types Thought disorders: schizophrenia

Brain P.E.T. Scan Normal Depression Transaxial Sagittal The PET scan is kind of like an X-ray in that it allows us to see what is happening inside the brain. A PET scan shows the level of brain activity through different colors. As the slide says, Red indicates greater brain activity and blue indicates lesser brain activity. So if you look at the PET scan of the two images of the brain on the left you see more red area. That’s an image of a healthy brain. When you look at the brain on the right, you see more blue area. That’s a PET scan of a brain with depression. What happens when someone gets depression is that the chemicals in the brain that regulate how a person thinks, feels and acts, get out of balance. Transition: What causes this to happen? Sagittal Red indicates greater brain activity – blue indicates lesser

Educate Yourself on Depression Chemical imbalance in the brain which affects the whole body: Thoughts Feelings Behaviors Physical health The brain is the organ of the body that gets sick with depression. Depression slows the functioning of the brain processes which affects the whole body: thoughts, feelings behaviors, and physical health. It may be helpful to think about depression in this way: Depression = depressed brain activity. Transition: We can actually see this slowed brain activity on something called a PET scan.

Know the Symptoms of Depression  Persistently feeling sad, empty or numb; crying easily Sleeping more or less than usual; trouble sleeping Loss of energy, fatigued Feeling hopeless, helpless, worthless or guilty; pessimism Feeling angry, irritable or moody; fighting and arguing a lot Avoiding friends, withdrawal Loss of interest in things that used to be fun; isolating     In discussing the symptoms it can be helpful to have examples from someone you know who has depression.  

Know the Symptoms of Depression  Difficulty concentrating, remembering or making decisions Thinking about and/or planning or attempting suicide Eating disturbances; more of less than usual Recurring headaches, backaches, or stomachaches Alcohol or drug use to escape or mask feelings Feeling alienated or outcast; alone even when with friends    In discussing the symptoms it can be helpful to have examples from someone you know who has depression. Transition: Depression can also be a fatal disease.  

Depression is Treatable Depression is a treatable physical illness Over 90% of cases can be successfully treated Need to see a doctor or psychiatrist for diagnosis and treatment In more than 90% of cases, depression is treated successfully. People with depression can feel good again. Does anyone know how depression is treated? Depression is usually treated by antidepressant medications and/or talk therapy. Research has found that the combination of the two is most effective at treating the depression and reducing the likelihood of the disease returning. As with all diseases, your friend needs to see a doctor to diagnose depression. Transition: So how would a doctor determine if someone has depression?

Depression Can Be Fatal Most people who die by suicide have a brain illness (e.g., depression, schizophrenia, substance abuse) at the time of death. Suggestion: Discuss how media portrays suicide and the myths that have been created as a result. Most common myth is that life’s events cause suicide. The reality is that depression causes suicide in the vast majority of cases. Transition: Why is there this connection between depression and suicide?

But there is hope… However, most people with a brain illness do not die by suicide.

20-25 million people in the U.S. suffer from depression each year. 36,000 people in the U.S. die from suicide each year.

Suicide Factors Social Support Belonging & caring Key Risk Factors Mental Health Problems (family history of depression, substance abuse and/or suicide) Sexual orientation and/or identity issues Abuse; being teased, bullied, excluded or discriminated against Relationship Problems (school, work or the law) Stress of a new situation (beginning a new school, job or college, relocating to a new community) Impulsive or aggressive tendencies Loss of a loved one, relationship, home or security Easy access to lethal means Chronic or terminal physical illness Brain illnesses, particularly depression, schizophrenia, anxiety disorders and certain personality disorders Previous attempts Protective Factors Social Support Belonging & caring Effective Coping Skills Policies & Culture that: Approve/encourage help seeking behavior Protect those who seek help

Suicide MYTHS FACTS No one can stop suicide, it is inevitable Most suicidal people do not want to die, they want to stop the pain

Suicide MYTHS FACTS Talking about suicide will plant ideas in a persons head. Talking about suicide openly lowers anxiety, opens up communication and increases the chance that people will use help seeking behaviors.

Suicide MYTHS FACTS Suicidal people keep their plans to themselves. Most suicidal people communicate their intent sometime during the week preceding their attempt.

Know the Warning Signs of Suicide Suicidal people give Warning Signs to various people in their lives Your friend may have symptoms of depression, but not be suicidal. It is always important to watch for warning signs of suicide, just in case your friend might be having suicidal thoughts. And because suicidal people give warning signs to various people in their lives, it’s important to talk to others Transition: People like…

Warning Signs of Suicide Talking about wanting to die or kill oneself. Looking for a way to kill oneself, such as searching online or buying a gun. Talking about feeling hopeless or having no reason to live. Talking about feeling trapped or in unbearable pain. Talking about being a burden to others. Increasing the use of alcohol or drugs. Acting anxious or agitated; behaving recklessly. Sleeping too little or too much. Withdrawing or feeling isolated. Showing rage or talking about seeking revenge. Displaying extreme mood swings.

Direct Verbal Warning Signs “I’m thinking about suicide.” “I’m going to kill myself.” “I’m going to end it all.” “If (such and such) doesn’t happen, I’ll kill myself. Direct verbal warning signs are those that seem more obvious. Things like, “I wish I were dead.” Transition: However, your friend may say other, more subtle things that hint that he is thinking about suicide. “I wish I were dead.”

Indirect Verbal Warning Signs “I just want out!” “I shouldn’t have been born.” “I wish I were dead.” “I won’t be around much longer.” Indirect verbal warning signs are probably more common, but are usually not as obvious. Statements like, “I won’t be around much longer.” “My family would be better off without me.”

Find Someone Who Can Help Parents, guardian, or other family member School psychologist, social worker, counselor, or nurse Teacher Personal physician or nurse Personal clergy Your local hospital 1-800-273-TALK (8255) Another strategy that we know is important in any suicide prevention effort is to promote help-seeking behaviors: Let people know who they can turn to for help – (could introduce protocol worksheets here if appropriate to the audience and they won’t see them later in TTT) READ list