1. LIFELINES: BUILDING A COMPETENT SCHOOL COMMUNITY FOR YOUTH SUICIDE PREVENTION Presented by: Judith Springer, Psy.D. Member, Clinical Advisory Board, SPTS

2.  Understand basic information about suicide  Review educators’ role in school’s suicide prevention strategy  Recognize students who may be at risk  Understand crucial, but limited, role of identification and referral Workshop Objectives

3. Each year, Each day Every 2 hours and 11 minutes one person under the age of 25 completes suicide. Each year, there are approximately 10 youth suicides for every 100,000 youth in the United States. Each day, there are approximately 11 youth suicides in our country. Every 2 hours and 11 minutes one person under the age of 25 completes suicide. One preventable death is one too many.

4. What about Elementary School Students? Suicide by children is very rare. About four children in every 500,000 kill themselves every year. The suicide rate for 10-14 year olds is on the rise.

5. A Personal Perspective The other side of facts and figures

6. Stephanie’s Story

7. Sean’s Story

8. SUICIDAL BEHAVIOR Attempt to solve a problem of intense pain with impaired skills

9. 1. Alternative 2. Crisis Thinking 3. Ambivalence 4. Irrational 5. Communication CHARACTERISTICS OF SUICIDE 9 (Shneideman, 1985)

10. Awareness Education about Identification Support and Response Suicide Prevention Strategies

11. Youth Suicide is a Preventable Mental Health Problem Research shows that clues or warning signs can be detected by others. Research has demonstrated that restriction of lethal means can reduce attempts. Clinical evidence identifies suicidal thinking as crisis thinking that can be altered by crisis intervention techniques. Evidence demonstrates the effectiveness of medication & cognitive behavioral treatment for symptoms of depression.

12. “ We’re All in This Together” A Competent School Community Prevention Plan

13. The School Essential Partner in Prevention: A Limited but Critical Role

14. Provide guidelines for crisis response of support, control & structure Demonstrate administrative commitment and support Outline a prepared and planned response POLICIES & PROCEDURES School-based Suicide Prevention Begins with Planning

15. Staff Responsibilities Understand the importance of your critical but limited role in the identification of students at-risk for suicide Familiarize yourself with school policies and procedures that address this issue Learn information that facilitates identification of at-risk students Listen to students, verbally and nonverbally, for warning signs Identify those students who may be at elevated risk based on that identification Refer those students to appropriate resources

16. Assessing Attitudes About Suicide Your First Step : Values Check

17. Questions to consider: 1. I think suicide is a rational choice. --------------------------------------------- NeverAlways sometimes

18. Questions to consider: 2. I think suicide should be prevented no matter what. --------------------------------------------- NeverAlways sometimes

19. Questions to consider: 3. Because it can be so hard to talk about, I think it is important to respect a student’s confidences about suicide. --------------------------------------------- NeverAlways sometimes

20. Questions to consider: ----------------------------------------------- I would do everything I could to prevent my teenager from dating someone who had attempted suicide. I would respect my child’s choice.

21. On a 1 to 10 scale, rank how comfortable you are talking about suicide. ----------------------+----------------------- 1510 Very UncomfortableVery Comfortable Talking About Suicide

22.  Identify  Risk Factors  Warning signs  Know referral resources  Enhance protective factors What educators need to be able to do

23. Red: Warning Signs Yellow: Risk Factors Green: Protective Factors

24. Risk Factors: Non-Clinical Age Sex Race Sexual Orientation “Giftedness” Family History of suicide Abuse Exposure To death of peer Recent Stressors Loss Trouble- E.g. being bullied or bullying others Change – transition Access to means 24

25. Clinical Risk Factors Psychiatric diagnosis Drug / alcohol use Previous attempt 25

26. Access to Means… Most Preventable Risk Factor 26

27. Risk Factors for Youth Suicide Demographic Family Stressors Clinical Exposure 27 Access to Means

28. F = Feelings A = Actions C =Changes T = Threats S = Situations Warning Signs

29. Feelings Hopelessness Anger Worthlessness Emptiness Excessive worry 29

30. Actions Trying to get access to guns or pills Risky or dangerous behaviors Increasing drug/alcohol use Getting into fights Writing suicidal messages on social networking sites 30

31. Changes One of the most significant warning signs in adolescents Changes in moods, actions or behaviors Recent prescription, change in psychiatric medication 31

32. Threats Specific verbal statements :I want to die, I want to kill myself Worrisome innuendos Themes of death /destruction in school assignments 32

33. Situations Situations that may serve as a trigger- when a student’s coping skills are really challenged, especially: Loss – e.g. family death or divorce; breakup Change Getting into trouble 33

34. Personal, behavioral, or situational characteristics that help students become resilient despite risks. Protective Factors

35. Caring relationship with at least one trusted adult Sense of connection/meaningful 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 Protective Factors

36. Fostering Protective Factors Teach students it is okay to ask for help. Give students permission to talk about traumatic events like suicide. Help students identify trusted adults. Encourage participation in school & community activities Acknowledge student efforts Be a good listener, as often as you can

37. Making it Real…

38. Pay attention to who your students are, not just how they perform academically Notice their appearance Observe their social skills / relationships Monitor their behavior changes Helping At-Risk Students

39. Making it Real… DEALING WITH AT-RISK STUDENTS BRAD James Elena Conner

41. Threatening suicide Looking for access to means Talking or writing about death, dying, suicide Previous attempt serious enough to require hospitalization Students at Higher Risk

42. Making it Real… DEALING WITH AT-RISK STUDENTS Brad JAMES Elena Conner

44. Talking with At-Risk Students LISTEN Acknowledge feelings in student’s terms Clarify Summarize Validate Know Your Limits (E.g., to ask about suicide directly?) Know Your Resources Act Follow-up

45. Making it Real … DEALING WITH AT-RISK STUDENTS Brad James ELENA Conner

47. What about suicide prevention for elementary students? 1. Don’t teach “Don’t tattle.’ 2. Do teach, “Ask for help if you or someone else is getting hurt” and “Friends help friends.” 3. Focus on promoting helpful behavior and preventing bullying and hurtful behavior. 4. Encourage children to identify least one trusted school adult. 5 Teach social emotional skills – e.g. self-calming and problem-solving skills.

48. Making it Real… DEALING WITH AT-RISK STUDENTS Brad James Elena CONNER

50. Educators’ Role in Review Learning signs of risk in students Identifying at-risk students Referring to appropriate resources 50

51. What About Parents? Understand school’s policies and procedures Recognize signs of trouble in their children Know what to do and where to go for resources Understand how to respond to other at-risk youth

53. Do Students Have a Role in Suicide Prevention? Awareness of warning signs Strategies for getting help personally Knowledge of ways to help peers Awareness of school and community resources Identification of caring adults

54. Are School Programs That Address Suicide Safe? Answering Common Questions

55. Is Talking about Suicide Just a Way for Someone to Get Attention?

56. Answering Common Questions Can Talking about Suicide Plant the Idea in the Minds of Vulnerable Teens?

57. Stacy’s Story

58. FREE Resources for the Competent Community Teacher training Online Parent video- “Not My Kid” Available at www.sptsusa.org

59. www.sprc.org Suicide Prevention Resource Center National resource www.afsp.org American Foundation for Suicide Prevention Printed materials & resources www.suicidology.org American Association of Suicidology Data, resources, links www.maine.gov/suicide Maine Youth Suicide Prevention Program Extensive resources and information on youth suicide Additional Resources

60. It’s in the Shelter of Each Other…