1. Faculty and Staff Training

2. Workshop Objectives
Review your role in our school’s suicide prevention strategy
Help you better recognize students who may be at risk
Provide an effective initial response to these students
Clarify how to refer students for further help
The following training is adapted from the “faculty training module” of the LIFELINES school-based curriculum for youth suicide prevention. LIFELINES was created in the early 1980’s by Dr. John Kalafat and Maureen Underwood at a time when the rate for youth suicide had tripled in the preceding 30 years. The training, which also includes administrative consultation, a parent awareness component and a 4 class curriculum for students, was developed as part of a community mental health project with input from local educators. In the subsequent years, it has been adapted to reflect relevant research, and has been subjected to rigorous evaluation. A third author, Sue O’Halloran, has been instrumental in the implementation of LIFELINES as part of the state of Maine’s youth suicide prevention initiative. LIFELINES is currently listed by the Suicide Prevention Resource Center as a ‘promising’ prevention program.
NOTES ABOUT TRAINING:
The PowerPoint that follows provides an outline for a 2 hour training on suicide awareness for school personnel. In the ‘notes section’ under each power point frame, you will find explanatory material for that particular frame; as the trainer, you may choose to use this material as it is written or adapt it with your own experience and expertise. Depending on the size of the audience, you can open the training up to discussion questions and group participation, which obviously makes it more personal and helps you target it more specifically to individual needs and issues. While training content is generic enough for adaptation to almost any school situation, it is NOT applicable for schools that have experienced a suicide within the current academic year. We would consider these schools as ‘survivors’ and recommend training that is more rooted in ‘postvention’ than ‘suicide awareness’.
Embedded in the power point are video clips that explicate the didactic material and enhance the effectiveness of the training by adding an additional dimension to the training methodology. As you review the material, you may choose to skip certain video segments. (If you are working with a group that is especially engaged in the content and brings up a plethora of discussion topics, you may need to skip certain clips in the interest of time. That’s why it’s important to review the entire training module before you begin so you can anticipate how to save time if you need to do that.)
At the conclusion of the power point, you will find a list of web-based resource. You are encouraged to review these before you do a training; they include relevant, current resources that can help you prepare for your presentation. Even if you bring a lot of expertise to the topic, it is always prudent to be up to date on current information and research in the field. Often you may find members of the audience have reviewed these sources prior to the training and you’ll be better prepared to engage their questions if you’re on the same page. It might also be helpful to check into your state’s youth suicide prevention initiatives (which can be found on the site) so you can talk about this, too.

3. Why Talk about Youth Suicide?
Third-leading cause of death in adolescents
There are 50 to 200 attempts for every completion
Every day, there are approximately youth suicides
Every 2 hours and 11 minutes, a person under the age of 25 dies by suicide
How pervasive is the problem of youth suicide? Here’s a brief review of what national data tell us:
Nationally, between the years 2000 and 2004, 7,932 youths in this age group killed themselves. While a single suicide is a tragedy, it is estimated that for every adolescent completed suicide, there are between suicide attempts.
A recent survey of high school students found that almost 1 in 5 had seriously considered suicide, more than 1 in 6 had made plans to attempt suicide and more than 1 in 12 had made a suicide attempt in the past year.
The other part of the story - which we have heard Scott describe - is the terrible impact on those family members and close friends of the deceased, which is incalculable.

4. “ The School’s Role in Suicide Prevention
School systems are not responsible for meeting every need of their students, but when the need directly affects learning, the school must meet the challenge.”
Carnegie Task Force on Education

5. Lifelines Objectives
1. To increase the probability that persons who come into contact with potentially suicidal adolescents: a. can more readily identify them b. know how to respond to them c. know how to rapidly obtain help for them d. will be consistently inclined to take such action 2. To make sure troubled youth are aware of and have access to helping resources so that they are inclined to seek help as an alternative to suicide
1. You will know how to IDENTIFY, RESPOND, OBTAIN HELP, TAKE ACTION 2. To make sure troubled youth are aware of and have access to helping resources

6. Curriculum Learning Objectives
To present relevant facts about suicide
To alert students to signs of suicide risk in peers and encourage serious responses
To outline ways to respond to troubled peers
To demonstrate positive attitudes about intervention and help-seeking behavior
To identify resources
The counselors and I will be providing the lifelines program to all students.

7. The Competent School Community in Suicide Prevention
Provides an effective initial response to potentially suicidal students (do You know what to do?)
Knows where to refer students for additional assistance (do you know who to refer students to?)

8. Suicide Prevention Strategies
Identification
Support and Response
Education
It probably comes as no surprise to anyone who works with teens that parents are usually the last to know about something that is troubling their child. In one study of youthful suicide attempters, 86% said they never informed a parent about their suicide attempt. In fact, we know that if teens ARE going to share information about their emotional lives, the person they turn to first is usually a friend. Kids talk to each other about everything, which is why it’s so important to teach them how to respond to a suicidal confidence. No matter whom a kid tells about suicide, however, the response is always the same - talk to someone who is trained to know how to help.
Even if teens do say something about suicide, not all parents take these statements seriously. “I want to kill myself” has unfortunately become what we call a ‘throwaway’ statement for a lot of kids… it’s something they say without thinking to express frustration. Because it has become such a commonplace statement, even if kids say it and really mean it, adults may simply chalk it up to their child having a bad day. Both educators and parents need to be to encouraged to ask follow up questions when they hear a child say something about suicide. Even if it is said in exasperation, asking about it opens up communication about an important topic that is often off-limits between parents and teens.

9. Characteristics of Suicide
1. An alternative to what is seen as an unsolvable problem
2. Thinking is in crisis mode
3. Considered to be a means of communication
Unsolvable problem: they may not actually want to end their life, but they don’t know any solutions
Life Skills are very important
Social skills, communication, decision making, goal setting, anger and stress management.

10. Your Role
as Educators
Identifying Risk Factors, Warning Signs, and Protective Factors
Identification: you spend more time with teens in a structured environment than their parents do. You may spot changes that indicate these problems.
Support and response: you contacts with students enable you to have supportive relationships which can more readily notice problems or be approached by a student for help. You don’t have to be a counelor to the students; you can imply provide a supportive initial response and get additional help for the student.

11. Risk Factors Demographics Psychiatric history Drug/alcohol abuse
Previous suicide attempt
Family history of suicide
Exposure to another’s suicide
Experience of stressful life events
Personality factors
Access to means
DEMOGRAPHIC FACTORS
Age
Sex
Race
Sexual Orientation.
When we’re talking about age, youth between 15 and 19 years of age, white males have the highest suicide rates and African American females have the lowest. As was noted earlier, with children ages 10 – 14, the suicide rates have increased 51% between 1981 and 2004.
CLINICAL FACTORS
Psychiatric History
Drug Alcohol Use - obviously, youth who have been diagnosed with some type of emotional problem or have a history of drug or alcohol abuse are in a more vulnerable category, and
Previous Attempt - a previous attempt one of the most important risk factors, especially when its combined with other risk factors also elevates risk.
FAMILY HISTORY
A personal history that includes physical or sexual abuse elevates risk as does a family history that includes suicide.
RECENT EXPOSURE
Exposure to another’s suicide, even if it’s through media reports, also fits into this category.
RECENT SEVERE STRESSORS
In combination with these other factors, the experience of stressful life events can also exacerbate risk.
NOTES TO TRAINER - FOLLOWING INFORMATION IS NOT ON THIS SLIDE BUT CAN BE PART OF THE DISCUSSION
CERTAIN PERSONALITY FACTORS CAN ALSO ELEVATE RISK. Students who are impulsive, immature or anxious worriers tend to have the poor judgment and compromised problem solving skills which can increase risk. We also need to be concerned about kids who display aggressive behavior, especially outbursts of rage.
ACCESS TO MEANS is the most preventive risk factor. A study in Illinois determined that removing access to lethal means, especially guns, was effective in lowering the rate of youth suicides, (Source: University of Illinois at Chicago, Institute for Juvenile Research).
With younger adolescents, it’s also recommended to remove access to the over the counter medication acetaminophen, since it is one of the most common medications used in overdoses. And while it isn’t always fatal, one of its unrecognized consequences is serious liver damage.

12. Warning Signs
F = Feelings A = Actions C = Changes T = Threats S = Situations
Facts
Hopelessness
Worthlessness
Despair
Emptiness
Feeling anxious or trapped
Actions
includes things like:
trying to get access to a gun or pills
reckless behaviors
increasing drug or alcohol use
fighting.
Change
Look for CHANGES in student’s
previous attitude, moods or behaviors.
Threats
Some students actually make “Threats”,
verbal statements of intent like “I ‘m tired of living” or “I’m thinking of killing myself”
or worrisome innuendos in writing, art, or other class assignments, etc. Whether specific or vague, what these threats tell us is that the student is thinking about death or suicide, and that is what escalates our level of concern.
“threats” may be specific or vague.
Situations
situations that may serve as triggers for the suicide.
trouble at home, in school, or with legal authorities
personal losses of things like relationships, opportunities, self-esteem or hopes for the future
life change for which the student feels overwhelmed or unprepared like moving, or the transition after high school graduation.

13. Remember
Every threat should be taken seriously

14. What to Do about Warning Signs Counselors Intervention Specialist LSSP
Consult with school
resource staff
Counselors
Intervention
Specialist
LSSP
Be familiar with school policies and procedures that address this issue
The Medical/Psychiatric section of the FWISD Safety Management Procedures Manual

15. Talking with Students Listen Know your limits Know your resources
Follow up
LISTEN:
Acknowledge feelings in student’s terms
Clarify
Summarize
Validate
Know Your Limits:
Are you comfortable talking about suicide?
Remember to refer
Know Your Resources:
Counselors
Intervention Specialist
LSSP
Hotlines

16. Protective Factors
Personal, behavioral, or situational characteristics that contribute to resiliency and serve as a buffer against risk

17. Protective Factors Caring relationship with a trusted adult
Sense of connection or participation in school
Positive self-esteem and good coping skills
Access to care for emotional/physical problems, substance abuse
Cultural/religious beliefs that discourage suicide and promote self-preservation
The competent school community engages all members in suicide prevention activities
The competent school community can increase the effectiveness of responses to at-risk teens, their families, and friends

18. Putting It All Together
The competent school community engages all members in suicide prevention activities
The competent school community can increase the effectiveness of responses to at-risk teens, their families, and friends

19. Additional Resources
Society for the Prevention of Teen Suicide Focuses on resources for the competent school community
Suicide Prevention Resource Center National resource
American Foundation for Suicide Prevention Printed materials & resources
American Association of Suicidology Data, resources, links
Maine Youth Suicide Prevention Program Extensive resources and information on youth suicide 
Maine Teen Suicide Prevention Resources and information for teens