1. MENTAL HEALTH AND SUICIDE PREVENTION 101
Dr. Dan Reidenberg, PsyD
Executive Director – SAVE
“Suicide Prevention 101” is a quick snapshot including:
A primer to look at the more recent history in the field of suicide prevention nationally and in the state
what the public health approach is
The scope of the problem of suicide in Minnesota – (DON’T USE FOR TTT – will be in Be-A-Link)
What we can do to help in our communities

2. The Mental Health Continuum
Skip from here to slide #36 when doing TTT or:
Mental Illness
Emotional Wellness

3. Mental Health Disorders
Brain diseases are just like other medical diseases
Affect everyone - no one is a specific target
Can come on at any time
Most common
Mood disorders: depression, bipolar disorder
Substance abuse disorders: abuse, dependency
Anxiety disorders: many types
Thought disorders: schizophrenia

4. Brain P.E.T. Scan Normal Depression Transaxial Sagittal
The PET scan is kind of like an X-ray in that it allows us to see what is happening inside the brain. A PET scan shows the level of brain activity through different colors. As the slide says, Red indicates greater brain activity and blue indicates lesser brain activity. So if you look at the PET scan of the two images of the brain on the left you see more red area. That’s an image of a healthy brain. When you look at the brain on the right, you see more blue area. That’s a PET scan of a brain with depression.
What happens when someone gets depression is that the chemicals in the brain that regulate how a person thinks, feels and acts, get out of balance.
Transition:
What causes this to happen?
Sagittal
Red indicates greater brain activity – blue indicates lesser

5. Educate Yourself on Depression
Chemical imbalance in the brain which affects the whole body:
Thoughts
Feelings
Behaviors
Physical health
The brain is the organ of the body that gets sick with depression. Depression slows the functioning of the brain processes which affects the whole body: thoughts, feelings behaviors, and physical health. It may be helpful to think about depression in this way: Depression = depressed brain activity.
Transition:
We can actually see this slowed brain activity on something called a PET scan.

6. Know the Symptoms of Depression
Persistently feeling sad, empty or numb; crying easily
Sleeping more or less than usual; trouble sleeping
Loss of energy, fatigued
Feeling hopeless, helpless, worthless or guilty; pessimism
Feeling angry, irritable or moody; fighting and arguing a lot
Avoiding friends, withdrawal
Loss of interest in things that used to be fun; isolating    
In discussing the symptoms it can be helpful to have examples from someone you know who has depression.  

7. Know the Symptoms of Depression
Difficulty concentrating, remembering or making decisions
Thinking about and/or planning or attempting suicide
Eating disturbances; more of less than usual
Recurring headaches, backaches, or stomachaches
Alcohol or drug use to escape or mask feelings
Feeling alienated or outcast; alone even when with friends   
In discussing the symptoms it can be helpful to have examples from someone you know who has depression.
Transition:
Depression can also be a fatal disease.  

8. Depression is Treatable
Depression is a treatable physical illness
Over 90% of cases can be successfully treated
Need to see a doctor or psychiatrist for diagnosis and treatment
In more than 90% of cases, depression is treated successfully. People with depression can feel good again.
Does anyone know how depression is treated? Depression is usually treated by antidepressant medications and/or talk therapy. Research has found that the combination of the two is most effective at treating the depression and reducing the likelihood of the disease returning.
As with all diseases, your friend needs to see a doctor to diagnose depression.
Transition:
So how would a doctor determine if someone has depression?

9. Depression Can Be Fatal
Most people who die by suicide have a brain illness (e.g., depression, schizophrenia, substance abuse) at the time of death.
Suggestion: Discuss how media portrays suicide and the myths that have been created as a result. Most common myth is that life’s events cause suicide. The reality is that depression causes suicide in the vast majority of cases.
Transition:
Why is there this connection between depression and suicide?

10. But there is hope…
However, most people with a brain illness do not die by suicide.

11. 20-25 million people in the U.S. suffer from depression each year.
36,000 people in the U.S. die from suicide each year.

12. Suicide Factors Social Support Belonging & caring
Key Risk Factors
Mental Health Problems (family history of depression, substance abuse and/or suicide)
Sexual orientation and/or identity issues
Abuse; being teased, bullied, excluded or discriminated against
Relationship Problems (school, work or the law)
Stress of a new situation (beginning a new school, job or college, relocating to a new community)
Impulsive or aggressive tendencies
Loss of a loved one, relationship, home or security
Easy access to lethal means
Chronic or terminal physical illness
Brain illnesses, particularly depression, schizophrenia, anxiety disorders and certain personality disorders
Previous attempts
Protective Factors
Social Support
Belonging & caring
Effective Coping Skills
Policies & Culture that:
Approve/encourage help seeking behavior
Protect those who seek help

13. Suicide MYTHS FACTS No one can stop suicide, it is inevitable
Most suicidal people do not want to die, they want to stop the pain

14. Suicide
MYTHS
FACTS
Talking about suicide will plant ideas in a persons head.
Talking about suicide openly lowers anxiety, opens up communication and increases the chance that people will use help seeking behaviors.

15. Suicide MYTHS FACTS Suicidal people keep their plans to themselves.
Most suicidal people communicate their intent sometime during the week preceding their attempt.

16. Know the Warning Signs of Suicide
Suicidal people give Warning Signs to various people in their lives
Your friend may have symptoms of depression, but not be suicidal. It is always important to watch for warning signs of suicide, just in case your friend might be having suicidal thoughts. And because suicidal people give warning signs to various people in their lives, it’s important to talk to others
Transition:
People like…

17. Warning Signs of Suicide
Talking about wanting to die or kill oneself.
Looking for a way to kill oneself, such as searching online or buying a gun.
Talking about feeling hopeless or having no reason to live. Talking about feeling trapped or in unbearable pain.
Talking about being a burden to others.
Increasing the use of alcohol or drugs.
Acting anxious or agitated; behaving recklessly.
Sleeping too little or too much.
Withdrawing or feeling isolated.
Showing rage or talking about seeking revenge.
Displaying extreme mood swings.

18. Direct Verbal Warning Signs
“I’m thinking about suicide.”
“I’m going to kill myself.”
“I’m going to end it all.”
“If (such and such) doesn’t happen, I’ll kill myself.
Direct verbal warning signs are those that seem more obvious. Things like, “I wish I were dead.”
Transition:
However, your friend may say other, more subtle things that hint that he is thinking about suicide.
“I wish I were dead.”

19. Indirect Verbal Warning Signs
“I just want out!”
“I shouldn’t have
been born.”
“I wish I were dead.”
“I won’t be around much longer.”
Indirect verbal warning signs are probably more common, but are usually not as obvious. Statements like, “I won’t be around much longer.”
“My family would be better off without me.”

20. Find Someone Who Can Help
Parents, guardian, or other family member
School psychologist, social worker, counselor, or nurse
Teacher
Personal physician or nurse
Personal clergy
Your local hospital
TALK (8255)
Another strategy that we know is important in any suicide prevention effort is to promote help-seeking behaviors:
Let people know who they can turn to for help – (could introduce protocol worksheets here if appropriate to the audience and they won’t see them later in TTT)
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