1. Cameron Carico 15 years old 9 th grader Johnston Middle School

2. Typical Teenager Played Sports All A’s and B’s in school Attended Church Camp and Wednesday Youth Group (had thought about being a youth minister) Girlfriend (couple of girlfriends!) Moody Slept a lot (A LOT) Loss interest in basketball (maybe too much basketball traveling teams and year round) More time by himself Enjoyed playing video games by himself (Wii, xBox)

3. Is this typical? Broke up with girlfriend(happens to all of us) Didn’t want to play basketball(burned out?) Stopped having friends over (busy doing other things) Odd hours of sleeping (teenagers?!) Cried if you got after him (Sensitive kid since he was little) More isolation (sat by himself at ISU Basketball games) Was involved in a scuffle at school with a friend (actually had suspended him one other time)

4. The Hardest Part How do you know what is normal and what is not? What should I look for? What if I find something? How much should I ask? Do I tell someone even if I am not sure?

5. You are a gatekeeper 70-80% of teens with a mental health issue are identified in one of two places (doctor or school) Most of the medical referrals are due to lack of performance or concerns at school 60-80% of students with depression go undiagnosed 1 out of 4 that are referred for mental health actually arrive at the doctor’s doorstep.

6. Ok, but why should I worry? Suicide is the second leading cause of death for 15-24 year olds in the State of Iowa. Over 50% of mental health signs and symptoms will present themselves between the ages of 15-24. Nearly 14% of 8 th graders in the Iowa Youth Survey stated that not only had they thought about suicide but had a plan. For Waukee Schools that would be 91 8 th graders. Polk County had a slightly higher suicide rate than the rest of the State since 2008. Every 13 minutes someone in the USA has completed suicide.

7. 2012 Vital Statistics

8. Ok, so we get them help then what? Just because people are receiving treatment or are under the care of doctor does not mean they are not at risk. Most students will tell a teacher/caring adult their plan before they tell their therapist. – They connect the therapist to their parents-an extension – They do not connect teachers or other caring adults in a school setting as an extension to their family

9. What does it mean to be a gatekeeper? Lets start off by what it is NOT- you are not a counselor or mental health therapist You are not expected to be able to solve all of their problems You are not expected to do all of this by yourself You are not expected to diagnosis

10. You are supposed to! Be confident in your ability to identify students that are at risk of suicide and are displaying mental health warning signs Connect those students with the right resources in order for them to receive the help that they need and deserve

11. Look For These Signs and Symptoms IS PATH WARM? – Suicidal Ideation – does person report thoughts of wanting to kill themselves or die? – Substance Abuse – does the person use substances and to what degree? – Purposelessness – lacking future orientation or “reason to live” – Anger – is the person frequently irritable and easily rageful? – Trapped – is the person experiencing “tunnel vision” and sees no alternative to their pain? – Hopelessness – negative sense of self, they can see a future – but its hopeless. – Withdrawing – isolation. – Anxiety – agitated, unable to sleep, etc. – Recklessness – engaging in high risk behaviors. – Mood change – does the person report dramatic mood shifts – instability?

12. RED FLAGS !!!!! Do you know if the student has a history of depression or suicide ideation? Are there concerns of drug or alcohol use? Do you know if the student has access to lethal means of suicide? Any of these three are automatic to let someone know right away!

13. Won’t I upset them if I tell? Maybe they won’t ever trust me again! Most people who complete suicide have made statements or some form of comment in regard to their thoughts or plans Most people are undecided about dying or living they are suicidal ambivalent. A part of them wants to live; however, death seems like the only way out of their pain and suffering. They may allow themselves to "gamble with death," leaving it up to others to save them.

14. What if I do see the signs? Take any comments seriously Ask the direct question of “Have you considered completing suicide?” “Have you decided when?” Be willing and able to listen. Make sure your responses are “stability” v. “change” Stability is discussing long term goals, why they feel that way, what has be something that is different to make you feel this way? Change is statements like “You really don’t mean this” “Relax and this will get better” “Just calm down” “That is a stupid idea it will be better tomorrow”

15. Won’t I give them ideas about suicide if they were not already thinking about it? NO!!!! There is no research that indicates this is true. There is research on the contagion suicides so if there is a suicide in a school it is important that it is addressed and kids are listened to. http://www.kevinhinesstory.com/ The most powerful statement that he says in his interview “If just one person would have asked.”

16. Was it normal? Cameron spoke to his school counselor, the associate principal, his 9 th grade basketball coach and had written several essays and poems in English on his feelings of hopelessness and his wanting to meet God. Was this normal? No, and that is why we are here today to speak with you in regard to your role as a gatekeeper. You can be the difference in helping students who suffer in silence.

17. How you can help? Contact your legislator- Tell them that we need mandatory training for all teachers in mental health. Contact your school principal and ask for teacher training. Work with your youth organizations to ask for training for coaches, sponsors, and others that have contact with kids

18. Resources Suicide Prevention Lifeline - 1-800-273-8255 www.suicidepreventionlifeline.org National Institute for Mental Health www.nimh.gov American Foundation for Suicide Prevention www.afsp.org www.afsp.org National Center for Health Statistics www.cdc.gov/nchs Substance Abuse & Mental Health Services Administration – www.samhsa.govwww.samhsa.gov http://www.helpguide.org/articles/depression/teen- depression-signs-help.htm http://www.helpguide.org/articles/depression/teen- depression-signs-help.htm

19. Resources School Guidance & Student Service Professionals. UnityPoint Health Counseling & Psychiatry – 241-2300 Suicide Prevention Lifeline – 1-800-273-TALK (8255)

20. Video to leave you with https://www.youtube.com/watch?v=LiUqgL5u rWc https://www.youtube.com/watch?v=LiUqgL5u rWc https://www.youtube.com/watch?v=v4ksqykq et0 https://www.youtube.com/watch?v=v4ksqykq et0