Suicide Assessment & Intervention For Educators

1. Suicide Assessment & Intervention For Educators Crisis Support Services of Alameda County Cristina Rita, MA

2. Today’s Agenda • Agency Introduction • Understanding Adolescents • Youth Suicide Statistics • Depression Warning Signs • Suicide Warning Signs • Contributing Factors to Adolescent Suicide • Risk & Protective Factors for Suicide • Assessment; & Intervention • Community Education • Conclusion

3. Crisis Support Services Programs • 24 – Hour Crisis Hotline 1-800-309-2131 • Grief Counseling Program • Senior In-Home Counseling Program • Support Groups • Debriefing/Disaster Response • Stress Counseling Program

4. Adolescents: A time of transition The brain continues to develop until the middle 20’s Development of cognitive abilities Physical changes Changes in social roles & family roles Loss of innocence Lack of life experience Development of ego strength A time of transitions

5. Youth Suicide Statistics

6. More teenagers die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza and chronic lung disease COMBINED

7. Common Methods • Firearms accounted for 49% of all completed youth suicides • Most youth suicides occur at home after school • Typical adolescent attempter is female who ingests pills • Typical adolescent completer is male who dies by gunshot • Females attempt 3x as often as males • Males complete 4x that of females

8. General Symptoms of Depression Symptoms have been present during the same 2-week period and represent a change from previous functioning with at least one of the symptoms being depressed mood/or loss of interest or pleasure • Lack of pleasure and/or depressed mood, • Lack of interest in usual activities • Change in appetite • Change in sleeping patterns • Persistent sadness, emptiness, boredom • Low self-esteem

9. Depression Symptoms in Adolescents Increased agitation, restlessness Aggressive behavior Truancy Running away from home Incarceration Risk-taking Self harming behaviors Alcohol, drug use Energy fluctuations Excessive fear/anxiety/worry Changes in personality including behavior & dress Inability to concentrate Physical complaints Less tolerance for frustration Blaming oneself inappropriately, overly sensitive, Taking criticism hard Believing they are not good enough

10. Suicide Warning Signs Feelings Associated with Suicidal Behavior

11. Behaviors Commonly Associated with Suicide

12. Contributing Factors to Adolescent Suicide(What teens say about why someone their age commits suicide) • Family problems – divorce, abuse, substance abuse • Academic pressures • Relationship problems • Peer pressure • Feeling adults cannot be trusted • Feeling adults do not understand their problems • Poverty • Trauma • Loss & grief • Mental Illness • Substance abuse • Bullying • Loss of hope for a secure future

13. Risk & Protective Factors for Suicide Risk Factors Protective Factors Prior suicide attempt Family history of suicide Substance Abuse Sexual abuse Trauma history Sleep deprived Anxiety Gender (male, LGBTQ) Access to effective clinical care Restricted access to lethal means Family & community support Problem solving skills Cultural & religious beliefs Ambivalence

14. Check out the idea: Ask Directly If the answer is yes: “Do you feel so hopeless that you think about killing yourself?’ “You said that you feel like there is now way out, have you been thinking about suicide?” “Are you feeling suicidal?” “Do you have a plan?” “Do you have means available?” “Have you done anything to harm yourself before?” “If so when, what and how much?”

15. Building Rapport What is causing you to feel suicidal? How long have you been feeling this way? What are some positives in your life? Have you had a difficult time before, how did You cope with it? What has keep you going so far? What has stopped you from completing Your suicide plan?

16. Helpful Responses Acknowledge/validate feelings Try to understand what happened to make them question whether life is worth living Are there ways to deal with the pain without having to take your life Emphasize that most crises are temporary –death is permanent It is common for youth to be confused about whether they want to die or escape psychological pain Let them know you are taking this seriously and are concerned about them and want to help

17. Goals of Intervention Foster life-affirming part of student Indentify student support system Lend perspective Provide realistic hope Provide a caring presence Get appropriate professional/clinical help Follow school protocols

18. Community Education • Teens for Life • Mental Health First Aid – 12 Hour Workshop • Grief & Loss Workshops • Active Listening Workshops • Responding to a Crisis in A Educational Environment • Suicide Assessment for Parents, Mental Health Professionals & Educators • Bullying, Cyber-Bullying & Our Youth

19. Conclusion The most important question to a potentially suicidal person is not an inquiry about family history or lab tests but “Where do you hurt?” and “How can I help you?’ Edwin S. Shneidman

20. Resources Websites American Association of Suicidology – www.suicidology.org Society for the Prevention of Teen Suicide – http://sptsnj.org Suicide Prevention Resource Center - http://www.sprc.org Further Reading Why People Die by Suicide – Dr. Thomas Joiner Myths About Suicide – Dr. Thomas Joiner The Suicidal Mind – Edwin S. Shneidman

21. Contact Information Cristina Rita, MA PO Box 3120 Oakland, CA 94609 crita@crisissupport.org 510-420-3203