1. Suicide Prevention

2. Credits: Barbara Bush, PsyD. Student Assistance Counselor - WAMS
Chad Gillikin, MSW, LCSW
Student Assistance Counselor - RHS

3. Overview Definition of Adolescent Suicide Prevalence / Statistics
Depression in Children – Signs
Depression in Adolescence - Signs
Youth Risk Factors
Warning Signs: FACT
General Guidelines for Intervention
BOE Policy
Confidentiality

4. Suicide
Definition
Suicide is the act of deliberately taking one's own life. Suicidal behavior is any deliberate action with potentially life-threatening consequences, such as taking a drug overdose or deliberately crashing a car.

5. Suicide
Suicide attempts that do not result in death far outnumber completed suicides. Many unsuccessful suicide attempts are carried out in a manner that makes rescue possible. They often represent a desperate cry for help.

6. Statistics
Each year 1 out of 5 teens seriously consider suicide and 1 in 12 attempt suicide.
Only 1/3 of depressed teens are identified
In 2002 approximately 1500 teenagers (15-19) died by suicide.
Suicide is the third leading cause of death for youth, the second for college students.

7. Statistics Continued…
There is no typical suicide victim.
Only 18% told a professional their intentions
20% of us will have a suicide within our immediate family.
60% of us will know someone who dies by suicide.

8. Depression: Recognizing a Risk Factor

9. Symptoms of Depression (Adolescents)
Depressive illnesses/anxiety may be disguised as, or presented as, eating disorders such as anorexia or bulimia, drug/alcohol abuse
Sexual promiscuity
Risk-taking behavior such as reckless driving, unprotected sex, carelessness when walking across busy streets, or on bridges or cliffs.

10. Symptoms of Depression (Adolescents)
Social isolation
Running away
Constant disobedience
Getting into trouble
Physical or sexual assaults against others
Failure to care about appearance/hygiene
No sense of self or of values/morals
Difficulty cultivating relationships
Inability to establish/stick with occupational/educational goals.

11. Adolescent Acting out or Depression
It is sometimes difficult to distinguish between teen rebellion and depression.
Sometimes teens engage in substance use to relieve depression.
Teen depression can mimic other disorders such as AD/HD, Substance Abuse, Oppositional Defiant Disorder (ODD), Bi-Polar Disorder and Post Traumatic Stress Disorder (PTSD).

12. Youth Risk Factors Previous suicide attempts Depression or Anxiety
Anger / Aggression
Substance Abuse
Family history of suicidal behavior
Conduct or disruptive disorders
Sexual orientation
Social isolation
Family / School Disenfranchisement
Access to firearms
Teen Pregnancy

13. Warning Signs v. Risk Factors
Warning signs suggest imminent danger
Awareness promotes early detection and intervention
FACT (Kalafat, O’Halloran, and Underwood, Lifelines, 2003)
Feelings Actions Change and Threats
Suicide warning signs= FACT

14. FACT warning signs Feelings: hopeless-things will never get better
Helpless: there is nothing I can do about it.
Worthless; everyone would be better off without me.
Guilt, shame, self hatred- “What I did was unforgivable
Pervasive sadness
Persistent anxiety
Persistent agitation
Persistent, uncharacteristic anger, hostility or irritability.

15. FACT warning signs Actions Uncharacteristic aggression Risk taking
Withdraw from friends/activities
Recent losses-death, divorce, relationship, job, status, self-esteem
Getting into trouble, discipline problems
Drug or alcohol use
Themes of death or destruction in talk, writing or websites

16. FACT warning signs Change
Personality-more withdrawn, low energy, apathetic, or more boisterous, talkative, outgoing.
Can’t concentrate on school, work, routine tasks.
Loss of interest in personal appearance, hygiene, neatness of personal items, space
Loss of interest in hobbies, work, sex
Marked decrease in work performance
Sleep, appetite increase or decrease
Sudden improvement after period of being down or withdrawn.

17. FACT warning signs Threats
Statements-talking about suicide directly or indirectly, e.g. “How long does it take to bleed to death”,written themes of death, preoccupation with subject of death
Threats- “I won’t be around much longer”, writing suicide note, making direct threat.
Plans- Give away prized possessions, making final arrangements-putting affairs in order, studying drug effects, obtaining a weapon
Sub-lethal gestures or attempts, e.g. overdose, wrist cutting

18. “Gatekeeper” General Guidelines One who recognizes suicidal behavior, how to respond appropriately and where to get help.
Listen with empathy
Know your limits and resources
ACT
Acknowledge, Care and Tell

19. When Listening, Don’t Panic Over react Under react
Patronize or offer premature caring
Preach
Abandon

20. Your Responsibility Response to potential suicide
Any indication of a potential suicide, whether personally witnessed or received by report from another, must be taken seriously and must be reported IMMEDIATLEY.

21. BOE Policy 5350
BOE directs all personnel to be aware of the warning signs of child and adolescent depression or potential suicide and to follow procedure
Signs shall be taken seriously and reported to the building principal, who shall notify the parents and other professional staff in accordance with BOE procedure

22. Teacher Confidentiality
If a student indicates they want to tell you something, but wants you to promise not to reveal the information; tell them you must share information if it involves harming themselves or others. Then follow BOE policy.
Do not discuss the student’s comments or situation with others, except within BOE policy.

23. Treatment Psychotherapy (CBT) and/or Medication
80% respond positively to treatment
Indicate that they feel better
Increased functioning
Early Intervention = Positive Results
CBT Cognitive Behavior Therapy

24. You Can Help Know the warning signs Report Immediately
Prevention may be a matter of a caring person with the right knowledge being available in the right place at the right time.

25. Resources Student Assistance Counselors at Ridge Chad Gillikin
Meghan Hoffman
Guidance Counselors
Mr Howlett or Mrs. Tenga
Your teachers
School Nurses