1. Region 11 K-12 Student Mental Health Initiative Suicide Prevention Ongoing Region 11 Training (SPORT) The California County Superintendents Educational Services Association’s Regional K-12 Student Mental Health Initiative is administered by the California Mental Health Services Authority (CalMHSA), an organization of county governments working to improve mental health outcomes for individuals, families and communities. Prevention and Early Intervention programs implemented by CalMHSA are funded through the voter-approved Mental Health Services Act (Prop 63). Prop 63 provides the funding and framework needed to expand mental health services to previously underserved populations and all of California's diverse communities.

2. National trends & California perspectives Youth Risk Behavior Surveillance Survey Staff role in suicide prevention Protective factors Risk factors & warning signs of youth suicide Intervening with suicidal students Staff Training Outline

3. After a Suicide: A Toolkit for Schools Preventing Suicide: A Toolkit for High Schools

4. US 38,364 all ages (12.0) 4867 youth aged 10- 24 (10.5) – 2941 20-24 (12.5) – 1659 15-19 (7.8) – 267 10-14 (1.3) Youth Suicide in the US: 2010 CALIFORNIA 3,913 (10.5) #44 in US – Steady increase since 2005 457 15-24 (7.4) #45 in US – Steady increase since 2007 28 (10-14) – More than doubled since 2007 SUICIDE is the 3 rd leading cause of death for youth age 10-24; boys & girls; across all ethnicities

5. Youth Suicide: Just the Facts In recent years more young people have died from suicide than from cancer, heart disease, HIV/AIDS, congenital birth defects, and diabetes combined. For every young person who dies by suicide, between 100-200 attempt suicide. Males are four times as likely to die by suicide as females - although females attempt suicide three times as often as males. The #1 environmental risk factor for suicide is the presence of a gun. In the US & CALIFORNIA the gun was the method most often used among youth. However, in Los Angeles the method most often used by youth was strangulation.

6. Youth Suicide: Just the Issues  Bullying Handout: Bullying and Suicide  Cyber-bullying Lesbian, Gay, Bisexual, Transgender Questioning Handout: Suicidal Behavior among LGBT Youth Non-Suicidal Self-injury Handout: Cornell NSSI Fact Sheet Social Media

7. Youth Suicide: Just the Issues Bullying Handout: Bullying and Suicide Cyber-bullying  Lesbian, Gay, Bisexual, Transgender Questioning Handout: Suicidal Behavior among LGBT Youth Non-Suicidal Self-injury Handout: Cornell NSSI Fact Sheet Social Media

8. Youth Suicide: Just the Issues Bullying Handout: Bullying and Suicide Cyber-bullying Lesbian, Gay, Bisexual, Transgender Questioning Handout: Suicidal Behavior among LGBT Youth  Non-Suicidal Self-injury Handout: Cornell NSSI Fact Sheet  Social Media

9. High School Students who Display Suicidal Behaviors

10. Youth Risk Behavior Surveillance Survey – 27.6% felt sad or hopeless (28.5 US) – 14.3% seriously considered suicide (15.8 US) – 13.6% made a plan (12.8 US) – 10.8% made one or more attempts (7.8 US) – 4.1% actually got to medical help (2.4 US) Youth Suicide in Los Angeles: 2011

11. Cultural Considerations: YOUTH White Males22.6 Alaskan Native/American Indian21.0 Black Males8.7 Asian/Pacific Islander6.2 Latino*5.3 Suicide Rate= # of deaths/100,000

12. Cultural Considerations Identify cultural-related needs of community. Obtain community resources to meet diverse needs. Have materials translated into native languages Have translators available. Preventing Suicide Toolkit, Tool 1.H, pgs. 50- 51 Know the traditions, rituals, and belief systems of your diverse population.

13. Intervening with Suicidal Students Guidelines for School Staff

14. Suicide Prevention: Staff Role Do not be afraid to talk to students about suicide Know the risk factors and warning signs of youth suicide Respond immediately: supervise student Have student escorted to crisis team Join the crisis team and provide valuable referral and background information HANDOUTS: SUICIDE PREVENTION FOR STAFF TEACHERS_SPRC

15. Suicide Prevention in the Schools Protective Factors Strong individual coping and problem-solving skills Strong sense of belonging and connection Interpersonal competence/success Family warmth, stability, support, and acceptance Positive connections at school Spirituality & religious involvement Access to mental health care & awareness of crisis hotline resources Preventing Suicide Toolkit, Tool 1.D, pgs. 37-40

16. Continuum of Self-Destructive Behavior Stressors: Chronic Mental Illness/Co-morbidity Warning signs ThoughtsBehaviors: Suicide attempts Self-injury Alcohol/substance abuse Stressors: Acute Precipitating Event

17. Risk Factors of Youth Suicide Alcohol/Substance Abuse Accessibility of means (i.e. guns, rope) Internal vulnerabilities – Psychiatric disorders Depression Conduct disorder – Previous suicidal behavior – History of loss/trauma/victimization External vulnerabilities (family/community) Hopelessness Impulsivity High-risk group Preventing Suicide Toolkit, Tool 1.D, pgs. 33-36

18. Risk Factors of Youth Suicide SITUATIONAL CRISES (Precipitating Events) Loss (Death, divorce, transience, romance, dignity) Victimization/exposure to violence School crisis (disciplinary, academic) Family crisis (abuse, domestic violence, running away, argument with parents) Suicide in community

19. Warning Signs of Youth Suicide Adolescents Suicide notes Threats Plan/method/access Depression (helplessness/hopelessness – Risk taking behaviors such as gun play, alcohol/substance abuse) Giving away prized possessions HANDOUTS: SUICIDE PREVENTION FOR STAFF TEACHERS_SPRC

20. Warning Signs of Youth Suicide Elementary Efforts to hurt self – Running into traffic – Jumping from heights – Scratching/cutting/marking the body Death & suicidal themes in writing/drawing Sudden changes in personality, friends, behaviors

21. Signs of Self-injury Frequent or unexplained bruises, scars, cuts, or burns. Consistent, inappropriate use of clothing designed to conceal wounds (often found on the arms, thighs, abdomen) Secretive behaviors, spending unusual amounts of time in the student bathroom or isolated areas on campus. General signs of depression, social- emotional isolation and disconnectedness HANDOUT: CORNELL NSSI FACT SHEET

22. Signs of Self-injury Substance abuse Possession of sharp implements (razor blades, shards of glass, thumb tacks, clips) Evidence of self-injury in work samples, journals, art projects Risk-staking behaviors such as gun play, sexual acting out, jumping from high places or running into traffic.

23. SUICIDE INTERVENTION IN THE SCHOOLS : Procedures SCHOOL SITE CRISIS TEAM Maintain Supervision throughout School Crisis Team Members: – Designated reporter – Administrator – Support personnel Assess risk and Advise Collaborate with law enforcement and local mental health resources HANDOUT: INTERVENING WITH SUICIDAL STUDENTS

24. SUICIDE INTERVENTION IN THE SCHOOLS : Procedures SCHOOL SITE CRISIS TEAM Assessment of risk Duty to warn/notify parent/guardian Duty to refer Documentation Caveat – Collaboration is your liability insurance

25. After a Suicide: A Toolkit for Schools Preventing Suicide: A Toolkit for High Schools

26. YOUTH SUICIDE: RESOURCES Suicide Prevention Resource Center http://sprc.org American Association of Suicidology http://suicidology.org American Foundation for Suicide Prevention http://afsp.org National Association of School Psychologists http://nasponline.org Centers for Disease Control http://www.cdc.gov/ViolencePrevention/suicide/

27. http://preventsuicide.lacoe.edu

29. QUESTIONS??? Contact us: SMHI@lacoe.edu