1. Psychiatric Disorders and Suicide Assessment Woodbridge Township School District First-year Teacher Training Program University Behavioral HealthCare University of Medicine and Dentistry of New jersey

2. Understanding the Magnitude 29,000 people in the US die by suicide every year 6-10 people are intimately and profoundly affected by each death It is the 3 rd leading cause of death for people 15-24 years of age 86% of parents are unaware of their child’s suicidal behavior

3. Recently in NJ There have been 3 successful suicides of 6 th graders The greatest increase of suicide has been in children ages 10-14

4. Importance to Teachers CDC survey found that training of teachers clearly delineates the roles and responsibilities of the educator to identify and refer. Educators have a large role in identifying students at risk- we see the kids every day! Training increases teacher confidence in recognizing suicidal students.

5. Part A- Suicide Risk Factors Part B- Warning Signs

6. A. Suicide Risk Factors Psychiatric Disorder Biology Family History & Genetics Personality Traits Life events/Chronic Illness Social/Cultural Influences

7. 3 Psychiatric Disorders that put youth at a higher risk for suicide… 1. Bipolar Disorder- alternating mania and depression. Symptoms of mania: excessive confidence, racing thoughts, increased talking, distractibility, irritability, aggression, risk- taking, etc. Symptoms of depression are the same for those of major depression disorder.

8. 3 Psychiatric Disorders that put youth at a higher risk for suicide… 2. Major Depressive Disorder- Symptoms of depression : sadness, tearfulness, decreased motivation, low self esteem, anxiety, absences from school, change in eating or sleeping patterns, high risk behaviors, irritability, anger, suicidal thoughts and behaviors, hopelessness, etc.

9. 3 Psychiatric Disorders that put youth at a higher risk for suicide… 3. Conduct Disorder- deficient skills in problem solving, emotional regulation, and relating to those around them. Symptoms of Conduct Disorder: bullies others, initiates fights, engages in illegal behaviors, lies for benefit or to avoid obligations.

10. Suicide Risk Factors Psychiatric Disorder Biology Family History & Genetics Personality Traits Life events/Chronic Illness Social/Cultural Influences

11. Biology Brain biochemistry: neurotransmitter dysfunction may lead to the 3 disorders previously discussed. Effects of drugs and alcohol.

12. Suicide Risk Factors Psychiatric Disorder Biology Family History & Genetics Personality Traits Life events/Chronic Illness Social/Cultural Influences

13. Family History & Genetics Family psychopathology Previous familial suicide attempts or suicidal behavior Environmental influence (imitation)

14. Suicide Risk Factors Psychiatric Disorder Biology Family History & Genetics Personality Traits Life events/Chronic Illness Social/Cultural Influences

15. Personality Traits Aggression Impulsivity Extreme sensitivity

16. Suicide Risk Factors Psychiatric Disorder Biology Family History & Genetics Personality Traits Life events/Chronic Illness Social/Cultural Influences

17. Life Events/Chronic Illness Relational or social loss Increase in negative experiences (bullying, legal or disciplinary problems, school problems) Extreme sensitivity Physical or sexual abuse Ongoing witness to violence Prolonged illness

18. Suicide Risk Factors Psychiatric Disorder Biology Family History & Genetics Personality Traits Life events/Chronic Illness Social/Cultural Influences

19. Lack of social support Barriers to accessing mental health and substance abuse treatment Stigma or help seeking Access to firearms

20. B. Warning Signs Risk factors tell us to pay attention Warning signs tell us to call for help Warning signs will often persist for more than 2 weeks (although some youth may act impulsively)

21. List of Warning Signs Substance abuse (excessive or increased) Purposeless (no reason to live) Anxiety (agitation/insomnia) Trapped (feeling no way out) Withdrawal (from friends, family, society) Anger (rage/revenge) Recklessness (risky acts, impulsive behaviors) Mood changes

22. More Warning Signs Threats of suicide Statements about hopelessness, worthlessness. Making last will and testament Putting things in order/ giving away possessions Hinting- verbal, written, artwork Sudden cheerfulness after previous depression

23. Referral Procedures Know your school’s procedure for suicidal youth. Never promise or make deals about confidentiality Never leave a suicidal youth alone Alert crisis team and school administration