1. HEALING AFTER SUICIDE IN A SCHOOL COMMUNITY: A Complicated Death, A Complicated Grief Maureen M. Underwood LCSW

2. To live in this world, you must be able to do three things: to love what is mortal, to hold it against your bones knowing your own life depends on it, and when the time comes to let it go, to let it go. To live in this world, you must be able to do three things: to love what is mortal, to hold it against your bones knowing your own life depends on it, and when the time comes to let it go, to let it go. Mary Oliver

3. The Value of Community Mourning “Community gathers as an effective group to do the work for each other that it would take an individual working alone much longer to do” John O’Donohue

4. The School as a “Competent Community” In our school we care about the welfare of every member Our commitment starts at the top and includes everyone associated with the school We know where to get help for each other if we need it

5. A School Community’s Response to Suicide: The Process of “Postvention”

6. Why Postvention Is Important Because suicide is a rare occurrence, ‘response’ set is not within personal coping repertoire Grief responses after suicide can be complicated Suicide contagion is a concern with adolescent population

7. Effective Postvention Response Is proactive Speaks to common reactions Offers calm reassurance Anticipates challenges Can be adapted to emerging needs Includes debriefing and honest evaluation

8. THE PLACE TO START: Understanding Our Own Reactions To Death

9. What Affects Our Reactions to a Death? The circumstances Our relationship with the deceased Our personal loss history Our current life experience Social permission & support for our grief Personal ability to grieve

10. Why Students’ Grief is Different Immature cognitive development/understanding of death Limited ability to verbalize feelings Perception of time different from adult: focus on proximal past & future

11. Death in Adolescence Directly confronts developmental tasks Can disturb sense of life purpose Defies adolescent omnipotence Reactivates other losses

12. Understanding Our Reactions to Suicide Shock and disbelief An ‘exaggerated sense of responsibility’ Search for the reasons Blame or scapegoating Confusion generated by gossip and rumors

13. Understanding Our Reactions to Multiple Suicides/Deaths Disbelief/ sense of unreality Fear Worry/anxiety Numbness

14. What Makes Grief After Suicide Complicated: No opportunity to anticipate Outside the range of common experiences Defies “survival instinct” There are never clear or simple answers- remains ‘unexplainable’ Challenges personal values Creates “unexpected environmental demands”, especially in school setting

15. Understanding General Student Body Postvention Needs Limited information about the death Guidance for responding to rumors Reminders about their role in ‘competent community’ Encouragement to be watchful and supportive of peers Reinforcement about the importance of help- seeking Information about school, community, web- based resources

16. Suicide Contagion Concerns Imitation risk highest in adolescence Can occur after any type of death Risk appears higher when deaths are sensationalized, romanticized Speaks to the importance of identifying & reaching out to ‘vulnerable’youth

17. What Makes Youth ‘Vulnerable’? Close relationship with the deceased – siblings, neighbors, dating, best friends Witnessing the event Contact with deceased- (positive or negative)- teammates, classmates, friends of siblings Previous history of losses/exposure to suicide Personal history Previous suicide ideation/attempts Drug/alcohol use Mental health treatment

18. Identifying Vulnerable Youth Deceased Close friends, enemies Teammates, neighbors Classmates, friends of siblings

19. Identifying Vulnerable Youth Deceased#1 Close friends, ‘enemies’ Teammates, neighbors Classmates, Friends of siblings Deceased#2 Close friends, ‘enemies’ Teammates, neighbors Classmates, Friends of siblings

20. Needs of Vulnerable Students To discuss reactions to the deaths To be assessed by school resource staff To be referred as necessary to mental health resources To be ‘watchfully supported’ in school

21. Steps To Help You Deal With Student Reactions…. 1.Understand that there are no answers- don’t feel pressured to have the ‘right answer’ 2.Realize you may not understand student reactions 3.Expect some students to have no reaction or delayed reactions 4.If you are concerned about student reactions, consult with resource staff

22. What To Say To Students If asked, provide limited facts about the events Refocus from circumstances of death to meaning of loss Reiterate safety concerns for all student body members

23. What To Say To Students Remind students of the importance of caring for each other. If they hear a friend or peer talk about suicide, they need to immediately inform a trusted adult. Ask students to silently review the names of the people they consider to be ‘trusted adults’ Encourage students to add names to that list over the school year

24. What To Say To Students Address issues related to suicide Acknowledge that sometimes the suicide of another person can make us think about suicide ourselves Validate that these thoughts can be upsetting/scary Reinforce the importance of sharing these thoughts with one of their trusted adults

25. What To Say To Students Remind students about in-school resources Discuss “curriculum reminders’’ and empower students to address them with faculty “Sometimes classroom content will remind us of upsetting things in our lives, like this event. If that happens, approach your teacher and explain your reactions. If necessary, ask for an alternate assignment.”