1. 1 Suicide Prevention in MPS Gatekeeper Training for School Staff

2. 2 Goals for this presentation Present useful data Discuss risk factors Identify early and late warning signs Suggest an easy way to help suicidal students: ACT

3. 3 Why “Gatekeeper” Training? Describes a serious problem among kids Empowers staff to help Ends fear of taking action Increases ability to identify, support, refer

4. 4 Youth Risk Behavior Survey WI High School Students (12 months) Symptoms of depression 22% Seriously considered suicide 15% Made a suicide plan 10% Attempted suicide 7% Attempt required medical treatment 3% WI DPI, 2007

5. 5 Where does suicide rank among causes of death in WI youth? And, how many youth die by suicide every year? DHS WISH, 1999-2006, ages 10-19, www.dhfs.wisconsin.gov/wish/Mortality Module, accessed 10/30 & 31 2007

6. Is suicide very common? From 1999-2007 (9 yrs.) Number deaths 10-19 Car Accidents 1055 Homicide301 All Cancers 201 Drowning78 Accident/undetermined firearm 35 Fire/Smoke Inhalation 19

7. 7 Of all deaths among youth… In the U.S. Suicides are 12% Suicide is the third leading cause of death In Wisconsin Suicides >17% Suicide is the second leading cause of death WISQARS, Centers for Disease Control and Prevention, National Center for Health Statistics (NCHS), National Vital Statistics System, downloaded 3/19/08 for years 1999-2005, ages 10-19

8. 8 Risk Factors Risk factors raise risk something will occur The most important suicide risk factors: –A prior suicide attempt –Suicidal thoughts or plans –Exposure to suicide of friends, family, community, or in the media

9. 9 Other Risk Factors Serious depression, hopelessness Using drugs or drinking Teenage Crisis Risky behaviors School problems Trouble solving problems J. of Adolescence, 29 (2005) 75-87; Arch Pediatr Adolesc Med. 2005;159:513-519; J. School Health, 77, 2, 59-66

10. 10 Early Warning Signs Look for changes over time, including: –Spending more time alone (girls—isolated) –Major/frequent mood swings (boys—angry) –Difficulty concentrating –Decline in quality of school work –Change in eating or sleeping habits –Boredom –Physical symptoms related to emotions Youth Suicide Prevention School-Based Guide, 2003, Louis de la Parte Florida Mental Health Institute Goldstein, et. al, J Consulting Clinical Psychiatry, 2008 Feb; 76(1): 84-91

11. 11 Late Warning Signs Talking about suicide Impulsive violent or rebellious actions Refusing help, won’t accept praise Being cheerful after a period of depression Giving away favorite possessions Making a last will & testament Youth Suicide Prevention School-Based Guide, 2003, Louis de la Parte Florida Mental Health Institute

12. 12 ACT NOW! If you see any late warning signs, you should act immediately. –Don’t try to diagnose the problem. –Don’t worry about students getting attention. Myth: Asking them will give them ideas. Myth: They won’t tell the truth when asked. Myth: If they don’t do it now, will do it later.

13. 13 What else do we need to know? Suicide doesn’t just happen out of the blue—90% had treatable mental illnesses or drug/alcohol problems. Usually an impulsive reaction to “crisis” Firearms used in more than half of youth suicides in WI—safe storage is critical

14. 14 It might look something like this: You’ve noticed risk factors such as depression or exposure to suicide… and the student has become isolated… and they hinted about suicide or forever escaping their problems… it’s time to ACT! Right away! Don’t leave the student alone.

15. 15 ACT for suicide prevention A is “Acknowledge” signs and symptoms C is for showing “Care and Concern” for the person who is at-risk T is “Tell” a trusted adult who knows how to respond Signs of Suicide is the source of ACT, a program of Screening for Mental Health

16. 16 A is ACKNOWLEDGE “That sounds really tough, I’m sorry to hear it.” “You have some major challenges on your plate.” Don’t minimize their feelings by saying: –“You’ll get over it.” –“Time heals all wounds.” –“Stop worrying about it.” You don’t even have to ask questions!

17. 17 C is CARE AND CONCERN “I would hate for any harm to come to you.” “I don’t want this to get any worse. I’d really like to see you get some help.” “You’re an important part of my class and I want to be sure you stay safe.”

18. 18 T is TELL A TRUSTED ADULT “I know Mr. Jones in the Student Services office, and he works with many students who are facing challenges like this. Let’s go see him together.” Know your School Counselor, School Psychologist, School Social Worker, and School Nurse. Take the student to see one of them right away, even if you’re not sure if it’s a crisis. Do not leave student alone.

19. 19 State Law Protects You! WI 118.295 Suicide intervention; civil liability exemption. “…any (school) officer, employee or volunteer, who in good faith attempts to prevent suicide by a pupil is immune from civil liability for his or her acts or omissions in respect to the suicide or attempted suicide.” You are safe in trying to help students.

20. 20 What can schools do? Staff should be skilled at identifying and helping suicidal students Train all students (another law) Support staff (e.g., SSW, Psychologist, Nurse, Counselor) should be skilled at suicide risk assessment or have access to someone who is skilled in this area

21. 21 Remember All you need to do to stop youth suicide is: ACT –Acknowledge –Care –Tell The National Suicide Prevention Lifeline is always available at (800) 273-TALK

22. 22 Additional Resources DPI’s Suicide Prevention Web Page –www.dpi.wi.gov/sspw/suicideprev www.dpi.wi.gov/sspw/suicideprev Suicide Prevention Resource Center –www.sprc.org