Suicide: Prevalence; Circumstance; and Interventions. Barri Sky Faucett, MA Occurrence Every 12.8 minutes another life is lost to suicide, taking the lives of more than 41,149 Americans in 2013. Nationally 13 people per 100,000,in WV 17.4 people per 100,000 (323 Deaths) WV ranked 14th in the US in suicide rate for all age groups, 44th for adolescents. Suicide is the 10th leading cause of death in America. For youth, 15-24 years old, suicide is the second Our Youth In 2010, there were 4,600

reported youth suicides in the United States. Each day there are approximately 12 youth suicides Most common method is firearms followed by suffocations Males complete 4 times more than females; females attempt four times more than males.

Suicide 1 out of Attempts every 53 high school students (1.9 percent) reported having made a suicide attempt that was serious enough to be treated medically (CDC, 2010a). Approximately 1 out of every 15 high school students attempts suicide each year (CDC, 2010a). For every completed

suicide, there are 100-200 attempts among adolescents. Suicide Attempts Suicide Suicidein in Adolescents Adolescents Research shows that most adolescent suicides occur school hours and in the teens homes Most adolescent suicides are precipitated by interpersonal conflict Within a typical high school classroom, it is likely that three students (one boy and two girls) have made a suicide

attempt within the last Suicide: West Virginia Suicides by county Ages 15-24 2002-2011 Rate per 100,000 Population Hancock 4 (12.7) A PREVENTABLE DEATH IN OUR STATE Brooke 4 (12.7) Ohio WV Rate 13.7/100,000

330 Deaths by Suicide 7 (10.9) Marshall 11(27.8) 3 (15.5) Tyler Pleasants Wood Ritchie 9 (8.8) 5 (43.8) Wirt 2 (28.3)

Jackson Mason 2 (6.0) 1 (3.4) 18 (10.5) 4 (15.2) 5 (9.8) 6 (14.6) 1 (3.6) McDowell 2 (7.1) Grant

0 (0.00) 2 (16.2) Hardy Upshur Randolp h4 (11.1) Webster Nicholas Pocahontas 2 (21.1) Fayette Summers 3 (21.2) 14 (19.0)

4 (15.2) 3 (27.3) 3 (24.2) Mercer Tucker Hampshire 1 (11.4) Greenbrier 10 (25.5) 14 (15.1) Wyoming

9(25.2) Pendleton Raleigh Mingo Mineral Berkeley 15 (12.9) 5 (13.3) Braxton 14(24.9) Logan

7 (19.3) 3 (19.9) 5 (16.3) Boone 2 (11.8) Preston 4 (18.9) 3 (17.2) 44 (20.0) 1 (3.5) 2 (6.2)

Cal houn 2 (13.2) 2 -(23.3) Clay Kanawha Lincoln Wayne Harrison Taylor Dodd- 11 5 (26.6) ridg (13.2) 1e(9.9) Barbour Gilmer 2 (10.4) 4 (22.6)

Putnam Cabell 11 (17.9) 15 (17.1) Lewis Roane 11 (4.2) Marion 3 (28.6) 0 (0.00) Morgan Monongalia Wetzel

Monroe 1 (6.6) 14.6 43.8 10.9 13.3 0.00 10.5 Jefferson 4 (6.2) What do teens deal with? Increased school pressures as they progress through higher grades First romantic relationships

Increased independence and identity Experimenting with substance use Adolescent Development Erickson Developmental StageLearning Identity Versus Identity Confusion (Fidelity) Adolescent Ego Imaginary Audience Learning Intimacy Versus Isolation (Love)

The Teenage Brain Adolescence is a time of profound brain growth. Greatest changes to the brain that are responsible for impulse control, decision making, planning, organization, and emotion occur in adolescence (prefrontal cortex). Do not reach full

Sexual Identification Lesbian, Gay, and Bisexual youth are 1 - 7 times more likely to have reported ideation. LGB Youth in multiple studies are found to be 3-4 times more likely to attempt suicide. 58% of LGB youth who had attempted suicide reported they really hoped to die vs. 33% of heterosexuals who attempted and reported really hoping to die. Have elevated risk factors and lower protective factors Suicide: Factorst Risk Factors- characteristics that will may it more likely that an individual will consider, attempt, or die by suicide Invitations/Clues- behaviors that indicate signs of immediate risk Protective Factors- characteristics that make it less likely that individuals will

consider, attempt, or die by suicide. IS PATH WARM?sk Factors- IS PATH WARM Ideation Substance Abuse Purposelessness Anxiety Trapped Hopelessness Withdrawal Anger Recklessness Mood Changes Increased Risk Prior suicide attempts Mental health disorders History of trauma or abuse Family history of suicide

Lack of social support Access to means Invitations/Clues: Acquiring a gun or stockpiling pills Talking about wanting to die or kill oneself Impulsivity/increased risk taking Giving away prized possessions Self-destructive acts (i.e., Indirect or Coded Verbal Clues:

Im tired of life, I just cant go on. My family would be better off without me. Who cares if Im dead anyway. I just want out. I wont be around much longer. Pretty soon you wont have to worry about me. Protective Factors Treatment for MH/SA, physical disorders Increased access to interventions Restricted access to highly lethal means Strong connections to family and community support

Strong problem-solving and conflict resolution skills Cultural and religious beliefs that What to do Be Genuine Listen and dont show shock or disapproval Show that you care, it is more important than saying the right thing. Avoid trying to explain away the feelings(saying things like you have a lot to live for or you are just confused right now) Question: Direct Approach You know when people are as upset as you seem to be, they sometimes wish they were dead, I was wondering if

you were feeling that way too. You look pretty miserable, I was wondering if you were thinking about suicide. Are you thinking about Tips for asking the question Persuade How to persuade someone to stay alive Listen to the problem and give them your full attention Remember, suicide is not the problem, only the solution to a perceived insoluble problem Do not rush to judgment

Offer hope in any form Refer Suicidal people often believe they can not be helped, so you may have to do more. The best referral involves taking the person to someone who can help. The next best referral is getting commitment from them to accept help. The third best referral is to give referral information and try to get a good faith commitment not to complete or attempt suicide. Any willingness to accept help at some time, even in the future is a good outcome. Safety PlanTO DO Immediately KEEP SAFE Agreement

Disable the suicide plan (if applicable) Safety Contact (s) Safety Plan Notify Parents/Guardians Safe/no use of alcohol and drugs Apps Suicide Safe by SAMHSA Learn how to use the SAFE-T approach. Explore interactive sample case studies

Quickly access and share information, including crisis lines, fact sheets, educational opportunities, and treatment resources. Browse conversation starters that provide sample language and tips for talking with patients who may be in need of suicide intervention. Locate treatment options, filter by type and

distance, and share locations and resources to provide timely referrals for patients. SAFE-T Identify Risk Factors Identify Protective Factors Conduct Suicide Inquiry Determine Risk Level/ Intervention Document Screenings/Assessments PHQ-9 9 items Over the last 2 weeks Assessment of depression and suicidality

C-SSRS- Columbia Suicide Severity Rating Scale 6 Questions- Suicidal Thoughts and Ideations Free Web training ASAP-20 Semi-structured clinical interview Assesses suicide risk and protective factors based on psychological interviews Gives guidelines/documentation of next steps. For More Information

www.sprc.org www.wvaspen.com www.preventsuicidewv.org www.afsp.org www.zerosuicide.com www.wvsuicidecouncil.org www.jasonfoundation.org www.jedfoundation.org Offerings Signs of Suicide (SOS) Evidence-Based Middle School and High School

programs Brief Introductory Training 25 minute Video Guided Discussion Screening Instrument Lifelines 4- 45 minute sessions Teachers education Prevention, Intervention, Postvention Offerings More Than SAD Evidence-Based Middle School and High School programs Brief Introductory Training 25 minute Video

High School TOOLKIT Teachers education Prevention, Intervention, Postvention Guidelines Contact Information Patrick Tenney, BA Northern Regional Director 304-296-1731 ext. 4197 [email protected] e.org Hope Siler, MA, LSW Southern Regional Director 304-341-0511 ext. 1690 [email protected] Barri Sky Faucett, MA Project Director 304-341-0511 ext. 1691

[email protected] rg

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