Not One More! Stopping the Suicide Epidemic

1. Not One More!Stopping the Suicide Epidemic

2. Suicide is…..

3. The Enemy Within • Play video clip “The Enemy Within” • Available from the California Highway Patrol

4. Definition of Suicide • “Suicide is a conscious act of self-induced annihilation, best understood …as a needful individual who defines an issue for which the suicide is perceived as the best solution.” • Dr. Ed Shneidman, Suicide as Psychache, 1993

5. Suicide Survivors • Spouse • Significant Others • Parents • Children • Extended family • Grandparents • Lovers • Friends • Co-Workers • Classmates 6:1 • Family members and others who survive following the death of their loved one by suicide:

6. Nationwide Statistics2004 data • One suicide every 16 minutes • 11th ranking cause of death in the US • 811,000 suicide attempts every year • 5 million living Americans have attempted suicide • Firearms used in 52% of suicides

7. Suicide in Specific Populations

8. LE Suicide Rate LE LODD Rate LE Homicide Rate Law Enforcement Suicide Compared

9. Retired Comparison Group Retired LE Retired LE - Medical Disability Law Enforcement and Retirement

10. Write a Name Exercise

11. “It takes only the smallest of changes to shatter an epidemic’s equilibrium.” Malcolm Gladwell in the “Tipping Point”

12. The Tipping Point:Agents of Change • The Law of the Few • The Stickiness Factor • The Power of Context

13. The Law of the Few • Connectors • Mavens • Persuaders

14. The Stickiness Factor Courage is taking the first step Let us help each other live Just do something! • Advice that is practical and personal also becomes memorable…

15. The Power of Context • Epidemics strongly influenced by their situation • Circumstances and conditions • Particulars of environments Kitty Genovese Graffiti

16. Courage Communication Awareness One Voice

17. “Suicide is completed in inches not in leaps” Attempt Gesture Ideation Completion

18. Exercise Write down the 3 most important things in your life.

19. Myths? Don’t mention suicide • Happens without warning • Low risk after mood improvement • Once suicidal, always suicidal • Only experts can prevent it • Runs in the family • No note = no suicide

20. More Myths.. • Suicide is not preventable • Only certain “types” of people become suicidal • Don’t talk about suicide or they will “do it.” • Antidepressants cause people to be suicidal

21. Phil’s Letter to Mom

22. Life’s Most Valuable ________ My mind ________ My family ________ My work

23. Loss change important perceived intolerable • Loss or changein animportantrelationship • To avoid or endperceivedpain • Escapeintolerablesituation • Gain attention • Manipulate • Punish others/Punish self • Become a martyr

24. Social Support SystemWarning signs • Separation from family or friends • - Geographic, legal, temporary • Loss of significant others • A loner or newcomer • Rejected by peers • Feels like people don’t care

25. Loss due to death or divorce Marital problems or a bad relationship Terminal illness Guilt over partner’s death Legal Problems Feeling alone Sexual Accusations Disability/Retirement Internal Affairs Investigation Financial Problems Arrest Loss of Employment PTSD Why Police Officers Commit Suicide L O S S .

26. Loss of Rational Thinking • Lack of sleep • Stress or anxiety • Substance Abuse • Immaturity • Psychosis: Command hallucinations Alien control Religious preoccupation

27. Change in sleep Change in appetite Loss of energy, motivation Loss of interest in pleasurable activity Apathy Deterioration of personal appearance Deterioration of job performance Frequent physical complaints Preoccupation with death Symptoms of Depression Hopelessness and Helplessness

28. It is from PTSD that the unseen wounds of an officer begin to manifest. Since we do not see these battle scars, we sometimes try to pretend they do not exist. Trying to pretend doesn’t make the pain go away. PTSD • Intense arousal after a traumatic event • Overwhelms coping mechanisms • Leaves the responder feeling helpless and out of control • Posttraumatic stress is not prejudiced • PTSD invades the mind with almost constant thoughts about the event

29. It’s Everybody’s Business Do Something! • The student will be able to list the signs & signals of a person who is at risk of suicide.

30. Suicide and Alcohol • Risk is 2-3x higher among alcoholics • 15-25% of suicides are completed by alcoholics • 50% of those who completed suicide were intoxicated • Among suicides of alcoholics, 89% were actively drinking at time of death

31. Indirect Verbal Clues • I can’t go on any longer • Nobody needs me anymore • I’m tired of life • You won’t be seeing me any more • I can’t take it any more • You’d be better off without me • I can’t take the pain

32. Indirect Suicide IndicatorsClues.... Clues.... Clues.... • The “practice run” • Sudden religious interest/ disinterest • Substance abuse relapse • More confrontational with subject • Buying a weapon • Giving away possessions • Changes in social behavior • Reckless officer safety/behavior • Changes in personality

33. Direct Verbal Clues • I wish I were dead • You’d be better off without me • I might as well be dead • If ___doesn’t happen, I’m going to end it • I’m going to commit suicide • I’m going to kill myself

34. How Bad Is It? Lethality lets you know how much help you need and how fast you need it How: • Is the plan specific? • Do they have the means? • Are the means lethal? History: • Prior attempts? • Any family history? Help: • Are they alone? • Are they drinking?

35. Intervention is Action Do Something! Respond! A Silent Code 3 Request for Help

36. Barricades to Seeking Help • Denial • Avoidance • Anger Fear: Will impact job Command will be contacted Hospitalization Being labeled

37. Do’s of Intervention • Remain calm • Accept their feelings • Focus on central issue • Stay close • Emphasize temporary nature of problem • Explore resources Hear what is being said ** Listen ** Listen ** Listen **

38. Don’ts of Intervention Don't overlook signs! Don't remain the only one helping! • Don’t sound shocked • Don’t offer empty promises • Don’t try to joke them out of it • Don’t debate morality • Don’t assume things will improve • Don’t leave person alone • Don’t keep it a secret

39. A Good Listener: • Copes with strong emotion • Is prepared to listen – time • Provides for comfort • Tolerates repetition • Listens carefully • Respect others perspective • Avoids interrupting WAIT THINK RESPOND

40. The Question • Have you been thinking of • killing yourself?

41. Important Questions How would you kill yourself? When did you last think about suicide? What is the closest you’ve come? Have you ever attempted suicide? Has anyone in your family attempted/completed suicide? What are the odds that you will kill yourself? What has been keeping you alive so far? What do you think the future holds in store for you?

42. Referrals • Employee Assistance Program (EAP) • Health Care Plan

43. Suicidal Thoughts Boxed In! Relationship Difficulties Do Something! Depression/Trauma Adverse Job Action Alcohol Abuse

44. Do Something! Do Something! • Continue C.P.R.: • Caring • Preserving Life • Referrals and Resources

45. Suicide Postvention

46. “Stigma spillover” Survivor ReactionsHigh risk groups Children/Siblings Friends/Coworkers Those who find the body Those who witness the suicide • Parents • Spouses/Significant Others

47. Survivor Reactions“Survivor Syndrome” • Shock • Numbness • Denial of death as a Suicide • Religious concerns • Prolonged search for “Why??” • Fear of personal susceptibility

48. Survivor ReactionsEmotional Guilt ! • Shame • Anger • Responsibility • Blaming • Scapegoating • Abandonment

49. Survivor Reactions • Loneliness • Social Isolation* • Social stigma • Diminished social supports • Difficulty trusting others • Negative family relations • Over protectiveness

50. Play video clip “Suicide Interviews Take 2” stored on Disk #2