1. Some Secrets SHOULD be Shared…
ACT® to Prevent
Suicide
Diane Santoro, LICSW
Screening for Mental Health, Inc. 1

2. Objectives Information about the SOS program
Warning signs of youth depression & suicide
View the SOS DVD
Importance of working as a team
What is the school protocol?
Available resources

3. Why? What? How? Why is it important? What is the SOS program?
Mortality from suicide increases steadily through the teens
Children and particularly adolescents who suffer from depression are at much greater risk of dying by suicide
What is the SOS program?
A program to help students recognize the symptoms of depression or warning signs of suicide in themselves or others
Teach them the appropriate action steps to take to get help by using ACT
How are we implementing the program at Southridge?

4. Depression & Youth
In 2007, 8.2% of adolescents (an estimated 2 million youth aged 12 to 17) experienced at least one major depressive episode in the past year (SAMHSA, 2009).
What is a Major Depressive Episode?
DSM-IV: a period of 2 weeks or longer in which there is either a depressed mood or a loss of interest or pleasure AND at least 4 of the following:
Increase or decrease in appetite
Problems with sleeping
Fatigue or energy loss
Feelings of worthlessness or excess guilt
Diminished ability to think or concentrate 4 4

5. Prevalence of Suicide Among Youth
Nationally, suicide is the 3rd leading cause of death among children ages (4,405 deaths in 2006) (CDC, 2004). Only accidents and homicides occurred more frequently.
Whereas suicides accounted for 1.4% of all deaths in the U.S. annually, they comprised 12% of all deaths among year-olds.
Adolescent suicidal behavior is deemed to be underreported because many deaths of this type are classified as unintentional or accidental (World Medical Association, 2004).
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (2004) [cited 2005 Feb 28]. Available from: URL:

6. In 2007, 8.2% of adolescents (1 in 12: an estimated 2 million youth aged 12 to 17) reported experiencing at least one major depressive episode in the past year (SAMHSA, 2009).
In children and adolescents, an untreated depressive episode may last between 7 to 9 months, potentially an entire academic year!
More than 90% of people who complete suicide have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder (NIMH, 2009). 6 6

7. By the Numbers… 2009 Youth Risk Behavior Survey found that:
26.1% felt so sad or hopeless for 2+ weeks that they stopped doing some usual activity.
13.8% seriously considered attempting suicide.
10.9% made a suicide plan.
6.3% attempted suicide.
1.9% of those who made an attempt required medical attention

8. Suicide – Risk Factors Risk factors are not necessarily causes.
Suicidal distress can be caused by psychological, environmental, and social factors.
The first step in preventing suicide is to identify and understand the risk factors.
The strongest risk factors for suicide in youth are depression, substance abuse, and previous attempts (NAMI, 2003).
Mental illness is the leading risk factor for suicide.
Over 90% of children and adolescents who die by suicide have a least one major psychiatric disorder (Gould et al., 2003). 8 8

9. Suicide Risk Factors Previous suicide attempt(s)
History of mental disorders, particularly depression
History of alcohol and substance abuse
Family history of suicide or child abuse
Feelings of hopelessness
Impulsive or aggressive tendencies
Barriers to accessing mental health treatment
Loss or interpersonal conflict (problems w/ school or the law
Physical illness
Easy access to lethal means, especially guns
Unwillingness to seek help because of the attached stigma
Local epidemic of suicide
Isolation
Incarceration or a pending disciplinary incident
Exposure to the suicidal behavior of others
History of physical and/or sexual abuse
Lesbian, Gay, Bisexual, Transgender youth

10. Suicide SUICIDE: A MULTI-FACTORIAL EVENT
Psychiatric Illness Co-morbidity
Personality Disorder/Traits
Neurobiology
Impulsiveness
Substance Use/Abuse
Hopelessness
Severe Medical
Illness
Suicide
Family History
Access To Weapons
Psychodynamics/
Psychological Vulnerability
Life Stressors
Suicidal
Behavior 10 10

11. Warning signs that demand immediate action
Talking or writing about suicide or death
Direct verbal cues
Less direct verbal cues
Isolation
Expressing the belief that life is meaningless
Giving away prized possessions
A sudden and unexplained improvement in mood
Neglecting appearance and hygiene
Dropping out of school or activities
Obtaining a weapon or another means

12. ACT
Acknowledge
Admit you are seeing the signs of depression or suicide in a friend and it is serious
Care
Let your friend know that your care about him/her, and that you are concerned that he/she needs help you cannot provide
Tell
Inform a trusted adult, with your friend or on his/her behalf

13. Myth or Fact
It’s normal for teens to be moody; teens don’t suffer from “real” depression
Teens who claim to be depressed are weak and just need to pull themselves together. There’s nothing anyone can do to help
People who talk about suicide won’t really do it
If a person is determined to kill themselves, nothing is going to stop them
People who commit suicide are people who unwilling to seek help
Talking about suicide may give someone the idea

14. Questions? Related Issues: Social Networking concerns
Cutting or Self-harming behaviors