Gatekeepers of Arkansas Providing Youth Suicide Prevention Awareness

Gatekeepers of Arkansas Providing Youth Suicide Prevention Awareness

Gatekeepers of Arkansas Providing Youth Suicide Prevention Awareness 5,264 were youths betwee n 10-24 years old More Americans die each year by Suicide than by Homicide 41,149 Suicides in 2013 1 IT IS UP TO US TO PROVIDE YOUTH SUICIDE PREVENTION H O

P E Portions of the slides prepared by Maine Youth Suicide Prevention Program. 2 Today We Will Cover: Language, Statistics, and Myths about suicide Warning signs and risk factors Basic intervention skills to use with suicidal behavior The aftermath of suicidal behavior 3

Language Considerations Must Avoid: successful suicide failed attempt Please USE: suicide or died by/of suicide non-fatal attempt Should Avoid: committed suicide completed suicide just a cry for help Please USE: died by/of suicide a suicide attempt 4

Common Words & Phrases Suicidal related communications include ideation - the direct communication of thoughts, talk, sharing of plans that may indicate a person is thinking about taking his/ her own life. Suicide Attempt: A self-inflicted, potentially injurious behavior with a nonfatal outcome for which there is evidence of intent to die. Suicide: A self-inflicted death with evidence (implicit or explicit) of the intent to die. 5 Suicide in Arkansas Suicide is the 2nd leading cause of death for Arkansas youth ages 15-24 (#1 is Accidents) Of every 5 suicides, 4 are males Of every 15 suicides, 9.5 are by firearm, 2.9 by hanging, 1.8 by poison, .8 by other 6

How Arkansas Ranks 2013 Rank 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

18 19 20 21 22 23 24 25 26 State Montana Alaska Wyoming New Mexico Utah Nevada Colorado Idaho Maine Vermont Oregon

North Dakota Arizona Arkansas West Virginia South Dakota Oklahoma Kentucky Missouri Tennessee Florida Alabama Wisconsin Washington Kansas South Carolina Deaths Population 243 1,015,165 171 735,132

129 582,658 431 2,085,287 579 2,900,872 541 2,790,136 1,007 5,268,367 308 1,612,136 245 1,328,302 112 626,630 698 3,930,065 128 723,393 1,163 6,626,624

516 2,959,373 323 1,854,304 147 844,877 665 3,850,568 701 4,395,295 960 6,044,171 1,030 6,495,978 2,928 19,552,860 721 4,833,722 850 5,742,713 1,027 6,971,406

425 2,893,957 696 4,774,839 Rate is # of suicides per 100,000 Rate 23.94 23.26 22.14 20.67 19.96 19.39 19.11 19.11 18.44 17.87 17.76 17.69 17.55 17.44

17.42 17.4 17.27 15.95 15.88 15.86 14.97 14.92 14.8 14.73 14.69 14.58 Rank 26 27 28 29 30 31 32 33

34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 State South Carolina Iowa Indiana

Pennsylvania New Hampshire Ohio Delaware Michigan North Carolina Virginia Mississippi Louisiana Rhode Island Minnesota Hawaii Georgia Nebraska Texas California Illinois Maryland Connecticut New York Massachusetts New Jersey

District of 51 Columbia Total Deaths Population 696 4,774,839 447 3,090,416 944 6,570,902 1,788 12,773,801 185 1,323,459 1,526 11,570,808 122 925,749 1,295 9,895,622 1,284 9,848,060 1,072

8,260,405 388 2,991,207 583 4,625,470 132 1,051,511 678 5,420,380 171 1,404,054 1,212 9,992,167 220 1,868,516 3,059 26,448,193 4,025 38,332,521 1,321 12,882,135 569 5,928,814 330 3,596,080

1,687 19,651,127 572 6,692,824 757 8,899,339 38 646,449 Rate 14.58 14.46 14.37 14 13.98 13.19 13.18 13.09 13.04 12.98 12.97 12.6

12.55 12.51 12.18 12.13 11.77 11.57 10.5 10.25 9.6 9.18 8.58 8.55 8.51 5.88 41,149 316,128,839 13.02 7 Attempted Suicides It is estimated that there are 25 attempted suicides for each death by suicide

Suicide Attempted Suicides 12,900 Ratio implies 1,028,725 suicide attemptsArkansans annually in US 8 Attempted Suicide by sex/gender Estimated that there are: 3 female attempts for each (1) male attempt 9 Attempted Suicide & Age Attempted Suicides

Suicides Young 100:1 65 & over 4:1 10 In the typical high school classroom: 1 male and 2 females have seriously considered or attempted suicide in the past year 11 After an Attempt

Support family/friends Acknowledge the impact, the fear Avoid judging, blaming Emphasize safety and removal of all lethal means from household Encourage appropriate help 12 Facts or Myths ? 1) True or False? People who talk about suicide do not actually die by suicide. 2) True or False? Suicide usually happens without warning signs. 3) True or False? Talking or asking someone about suicide may plant the idea and cause a suicide. 13 In Fact Youth suicide is a problem.

We all need to learn about it. Talking about suicide can save lives. 14 A Word About Young Children SOME young children (ages 5-14) do understand the concept of death, are capable of planning a suicide and able to implement the plan. It is a rare event, but we must not assume that children can not or do not die by suicide. They do! Some states have documented suicides in children as young as 8 years old. 15 Definitions Warning Signs - the earliest observable signs that indicate the risk of suicide for an individual in the near-term (within minutes, hours or days.)

Risk Factors - long standing conditions, stressful events or situations that may increase the likelihood of a suicide attempt or death. Protective Factors - personal and social resources that promote resiliency and reduce the potential of suicide. 16 Warning Signs Useful Mnemonic: Is Path Warm? I Ideation S Substance Abuse P A T H W A R M Purposelessness

Anxiety Trapped Hopelessness Withdrawal Anger Recklessness Mood Change 17 Early Warning Signs of Suicide Behavioral, Emotional & Physical Signs: Depressed / Anxious Increased alcohol/drug use Roller coaster moodiness

Changes in every day behaviors Overly pessimistic, hopeless Neglects self, friends, usual activities 18 Late Signs/Behaviors May Include: Talks of suicide, plans for how/when/where Refuses help Agitated, restless, picks fights Gives away favorite things, writes a will Shows SUDDEN improvement in mood (suicide euphoria) Increased isolation Uses instant messaging or phone to drop hints 19 Listen for Verbal Clues Direct I wish I were dead Im going to end it all Indirect Im tired of it all

Youll be better off without me Whats the point of living? 20 Risk Factors PREDISPOSING CONDITIONS PRECIPITATING CONDITIONS (Unchangeable) (of Serious Concern) (Acute) FAMILY Family

history of suicide, mental illness, substance abuse Race Gender Genetics Unrealistic Major expectations Abuse (emotional, physical, sexual) family conflict Exposure to suicide of family member Anniversary of death Moving often PERSONAL

BEHAVIORAL Loss through death, abandonment, divorce Previous suicide attempt Mental illness Substance abuse Extreme Perfectionism Poor coping/social skills Impulsive Current ENVIRONMENTAL SOCIAL Inconsistent,

Experience Active Risk Factors PERPETUATING CONDITIONS neglectful or abusive parenting Sexual orientation parental of repeated loss Chronic severe stress Ongoing harassment

acute Mental Illness Severe stress/anxiety Isolation Rejection Relationship break-up Increased use of substances suicide cluster in community Access to lethal means Bullying, harassment Loss of freedom (e.g., incarceration) 21 Risk Factors for Adolescent Suicide Depression, anxiety, or mood disorder Current or previous suicidal behavior Being a victim of sexual or emotional abuse

Conduct problems Access to lethal means 22 Protective Factors Supports - Supportive parents, friends, teachers & other caring adults Skills to think, communicate, solve problems, manage anger Purpose & value in life - hope for future Personal characteristics - good health, positive outlook, healthy choices Safe Environment restricted access to lethal means 23 Very Important to Remember There is a lot of cross-over between Risk Factors and Warning Signs! There is no particular set of risk factors that accurately predicts imminent danger.

There is no typical suicidal person - there are ALWAYS varying degrees of risk factors. 24 From a Suicidal Persons Point of View Crisis point has been reached Distress/torment/anxiety seems unbearable Solutions to problems seem unavailable Rational Thinking is affected Ambivalence exists between wanting to live and wanting to end the psychological pain Strong need to communicate pain! 25 Invitations to Help FEELINGS Desperate Angry Guilty

Worthless Lonely Sad Hopeless Helpless THOUGHTS All of my problems will end soon No one can do anything to help me now I wish I were dead Everyone will be better off without me I wont be needing these things anymore I cant do anything right I cant think straight ACTIONS Giving away possessions Withdrawal (family, friends, school, work) Loss of interest in hobbies Abuse/use of alcohol, substances

Reckless behavior Extreme mood swings Increased Impulsivity Self-Injury (maybe) PHYSICAL Lack of interest in appearance Changes in appetite, weight Change in sleep patterns 26 Intervention--Why People Hesitate Inability/lack of knowledge Worry about doing/saying the right thing Feelings of inadequacy Belief in myths of suicide 27 What is NOT Helpful

Ignoring or dismissing the issue Acting shocked or embarrassed Challenging, debating or bargaining Giving harmful advice 28 What IS Helpful 1) Show You CareListen carefullyBe genuine Im concerned about you . . . about how you feel. 2) Ask the QuestionBe direct, caring and non-confrontational Are you thinking about suicide? 3) Get HelpDo not leave him/her alone Youre not alone. Let me help you. 29 Practice Helpful Steps! Use handout: What Is Helpful 3-Step Intervention

1. Think up & write 1 or 2 phrases or ways that YOU would use to show you care. 2. Write two other ways you might ask the question about suicide. 3. List two ways you would try to convince someone to get help and name two resources. 30 Resources for Help Phone numbers National Suicide Crisis Hotline 1-800-273-TALK (8255) Or 1-800-SUICIDE (1-800-784-2433) En Espaol 1-888-628-9454 TTY capability 1-800-799-4TTY (4889) 31 Resources for Help - Websites

National Suicide Prevention Lifeline In Spanish: http :// MYSPP Web Site: SAVE: Suicide Awareness Voices of Education Online Crisis Chat: 32 School Resources for Help School Counselors School Administrators Teachers & School Staff School Nurses & Health Services Social Workers School Crisis Team School Resource Officer

Any Trusted Adult 33 Our school protocol is When Any Concern Is Raised Contact: Principal & School Counselor School Crisis Team Parent or Guardian Have a Suicide Risk Assessment Administered 34 Number of Suicide Survivors It is estimated that there are for each death by suicide 6 survivors A suicide survivor is someone who has lost a loved one to death by

suicide 3096 Arkansa ns in 2013 Ratio implies 246,894 new survivors of suicide annually 35 Survivors of Suicide Struggle to make meaning of the loss Suffer from overwhelmingly complicated feelings May take a long time to grieve Need understanding and support Youth survivors have special issues 36 How you can help after a suicide

Acknowledge the loss Share a special memory/story Use the name of the deceased Share your presence Acknowledge the good things Stay in touch Call local hospice center for grief support groups 37 Factors Used in Estimating the Risk of Suicide Age: Certain ages more than others. Gender: One gender more than the other. Stress: Troubling experiences that

challenge the persons ability to cope. Warning Signs: Behaviors that can be observed (Aggression, Sadness, Drug or Alcohol Abuse) 38 Additional Factors Used in Estimating the Risk of Suicide Current Suicide Plan: Whether or not there is a plan and any details of that plan Prior Suicidal Behavior: Personal history of suicide or suicide attempt(s): including modeling by family, friends or others Resources/Protective Factors: Physical and emotional resources which the person feels are helping, caring or supportive 39 Estimate the Risk of Suicide Your Rank Rank ___ Age

___ Gender ___ Stress ___ Warning Signs ___ Current Suicidal Plan ___ Prior Suicidal Behavior ___ Resources/Protective Factors 40 Responders Take Care of Yourself! Acknowledge the intensity of your feelings Seek support, de-brief Share your feelings Avoid over involvement Know that you are not responsible for another persons choice to end their life* 41 A LIFE SAVED The story on video we are about to see is true. It concerns a suicide intervention that occurred only days after the end of a suicide prevention learning

unit done at a Maine middle school health class. It is told by the real student and guidance counselor involved. No scripts were used, no rehearsals held and no special lighting or sound systems. A high school student did the actual digital filming. 42 Before You Leave Any Questions? Thank You . . For learning about suicide prevention ADE Support: [email protected] [email protected] 43

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