CRISIS INTERVENTION & SUICIDE PREVENTION

1. CRISIS INTERVENTION&SUICIDE PREVENTION RA Training Fall 2009 Bernadette Peters, Ph.D. Assistant Director Licensed Psychologist Counseling Services s

2. Why Learn about Crisis Intervention? Scary but Real • According to a 2007 study by the American College Health Association, 43% of students reported having felt "so depressed it was difficult to function" at least once in the prior year. • Other studies, based on student surveys, suggest that 1 in 5 undergraduates reported having an eating disorder, 1 in 6 had deliberately cut or burned himself and 1 in 10 had considered suicide. • Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others, and daily functioning.

3. An Emotional Crisis can Lead to  • SUICIDE • Suicide is the SECONDleading cause of death for college students. • Someone dies by suicide every 16-18 minutes in the United States. An attempt is estimated to be made once every minute. • Every day, approximately 80 Americans take their own life, and 1,500 more attempt to do so. • There are approximately 24,000 suicide attempts annually among US college students between 18 and 24 years old • 1,100 are completed

4. Suicide Intervention Purpose • Suicidal behavior is the most frequent mental health emergency. The goal of crisis intervention in this case is to keep the individual alive so that a stable state can be reached and alternatives to suicide can be explored. Lower distress & chances of living Read more: http://www.minddisorders.com/Br-Del/Crisis-intervention.html#ixzz0Okw4vVS0

5. How??

6. College Student Population • There is an increase of college students with psychiatric disorders • Highest rate in seniors (undergraduate) • Higher rate among graduate students • 90% of suicides are associated with mental illness • Males die by suicide more than females, but females attempt more often • Why??

7. Suicide & Race/Ethnicity • American Indian/Alaskan Native male adolescents have the highest suicide rate. • Highest rates (per 100,000 people): • American Indian and Alaska Natives — 15.1 • Non-Hispanic Whites — 13.9 • Lowest rates (per 100,000 people): • Hispanics — 4.9 • Non-Hispanic Blacks — 5.0 • Asian and Pacific Islanders — 5.7 (CDC, 2006). Web-based Injury Statistics Query and Reporting System (WISQARS) : www.cdc.gov/ncipc/wisqars

8. The Jed Foundation • The Jed Foundation • College Student Suicide Mental Health Topics

9. How do you ??? Half of Us • Talk to that person • Persuade them that they could use some help • Help them get that help • Follow-up • Notify your supervisor

10. Counseling Is…. When I am around someone who is emotional, I….

11. Counseling Is…. A process of self-exploration and discovery that usually happens by way of a dialogue between two people. Counseling can help people … Identify negative or illogical thinking patterns & other factors that contribute to difficulties Explore learned thoughts and behaviors that create or maintain problems Regain a sense of control and pleasure in life Find solutions to life’s problems Discover personal strengths to overcome problems Counseling takes courage to address problem areas and painful feelings. Entering counseling is the first step in resolving difficulties and initiating the healing process…

12. When I am around someone who is emotional, I…. Find out what is wrong and how I can help Get my supervisor if the situation requires this Work within my own comfort zone while doing what I need to as my job as an RA dictates Check in with myself and get support, if needed

13. Counseling Services • Tom McDermott, LMHC, NCC-Director • Bernadette Peters, Ph.D.- Assistant Director/Licensed Psychologist • Monica Romeo, LMHC - Licensed Mental Health Counselor • Morgan Brooks, Ph.D.- Licensed Mental Health Counselor • Maria DiNardo, M.S. – Graduate student intern • Emily Bennett, B.A. – Graduate student intern • Isabel Molina, PMHNP-BC – Psychiatric Nurse Practitioner • Kathy Palazzo- Office Coordinator

14. Counseling Services Monday – Friday 9am-5pm 716.286.8536 NU Counseling Services LL- Seton Hall 24/7 on call consultation service

15. Counseling Services • On Campus Emergencies After Hours and On Weekends: • For on-campus emergencies that occur after hours and on weekends, Counseling Services’ staff is available for consultation by contacting Campus Safety at 286-8111 or GRD/RD/RC. • Students may also directly contact Niagara County Crisis Services at (716) 285-3515.

16. Counseling Services • Depression • Anxiety • Relationship Concerns • Eating Disorders • Substance abuse and Dependence • Childhood Abuse • Rape/Sexual Assault • Anger Management • Stress Management • Support for a friend • Family Problems • Death of a loved one • Health Problems • Sexual Orientation concerns

17. Behavioral Signs • serious grade changes • very emotional • special attention • new or regularly occurring behavior that pushes the limits of decorum • dramatic weight loss • agitated • highly disruptive behavior • inability to communicate clearly • loss of contact with reality • overtly suicidal thoughts • homicidal threats

18. Other Signs • he/she looks upset • isolates • sleep problems • you notice drastic behavior changes • he/she tells you something is wrong • friends are concerned • Facebook, etc- status is alarming (e.g., soon it will be over)

19. Help Yourself • Talk with someone • Recognize that it can be very difficult to see someone in distress and have to intervene • Seek your own support • Do your best to consult appropriately, but realize you are not responsible for student’s actions • Remember- do not burden yourself by taking on inappropriate responsibility

20. Scenario You get a knock on your door at 1am from Tasha, a female student on your floor who is concerned about her roommate. She tells you the roommate, Carly, is acting highly emotional, crying a lot, and not making a lot of sense. Tasha attempted to ask Carly what is wrong but did not get a good answer from her and came to you because she does not know what else to do. As the RA, what do you do?

21. Scenario- Part II Carly appears extremely sad and depressed and has cried most of the 30 minutes you have been talking to her. She tells you that her boyfriend of 3 years just broke up with her unexpectedly and that she called her sister who she usually confides in who told her simply to “suck it up.” Carly states that she does not see “the point” if she no longer is in a relationship with her boyfriend, who she had planned to marry after graduation.

22. What you should do • Always go and talk to the student of concern • Be prepared to ask questions & listen • Ask about his or her intentions regarding living- if you can’t, get someone who can • Are you thinking about killing yourself? • Do you want to die? • Are you considering suicide? • If you have ANY doubt about the person’s safety, get the senior staff member on call • Please talk with Counseling that day or next morning to let us know about the situation

23. The Truth About Suicide Video- The Truth about Suicide: Real stories of Depression in College (27 min) Film includes people who have been personally touched by student depression and suicide May evoke strong personal reactions

24. Reactions to Video?

25. Key points to Remember & Utilize: • Know what services are available • Recognize signsand take them seriously • Know how to approach and manage students in distress – and know when you need to get help • Know your role and work within your limits • Please remember you are not alone and help is available (for you too). Always consult! • Put critical numbers in your cell phone

26. Numbers to have on hand (aka, in your cell phone!) Niagara County Crisis Services: 716.285.3515 Niagara County RAPE Crisis Services: 716.285.3518 Niagara University Campus Safety: 716.286.8111 Niagara University Counseling Services: 716.286.8536 Suicide Prevention Lifeline: 1.800.273.TALK (8255) National Hopeline Network: 1.800.784.2433 The On-Call Phone: 716.799.4896

27. Questions? Concerns?