Transcript Document

Baseline Survey
Before the training begins, please fill
out the baseline survey and put your
completed survey in the box provided.
Thank you!
Ending A Deadly Silence
Florida Suicide Prevention
Gatekeeper Training
Insert your name and agency
What to Look For
What to Do
How to Help
Prevention is often a matter of a caring person
with the right knowledge being available in the
right place at the right time.
Adapted with permission from the Washington State Youth Suicide
Prevention Program and the Maine Youth Suicide Prevention Program
Silent Epidemic
Serious public health problem
Preventable
Neither random nor inevitable
Research shows that during our lifetime:
20% of us will have a suicide within our
immediate family
60% of us will personally know someone who
dies by suicide
Attitudes and Beliefs:
Taboo Nature of Suicide
Taboo subjects: suicide, rape, child
abuse, mental illness, drug and alcohol
abuse, incest
Myths of Taboo Subjects
History of suicide – sin, crime, mental
illness
Truth or Myth Handout
What Do You Know
About Suicide?
Truth Or Myth
Survivors at lower risk
MH professionals only ones who can help
More common with the rich
No correlation between drugs, alcohol and
suicide
As many as 2 youth attempts to every
death
Most suffer from depression
More Floridians die by suicide than
homicide
Most have made up their minds
More suicides during Christmas holidays
People who are suicidal tend to hide it
Need to take all talk seriously
Suicide rates for 15-24 year olds have
more than doubled since the 1950s
while other rates stayed about the
same
Asking may encourage the idea
Elderly have the highest rate
Important not to break the trust of
confidentiality
2005 National Statistics
32,637 suicides (89.4 per day)
3rd leading cause of death for young
Americans 15-24 years old
3.8 male deaths by suicide for each
female death
3 female attempts for each male
attempt
Suicide claims a life every 16.1 minutes
Source: AAS, USA Suicide: 2005 Official Final Data
Florida Statistics
3rd leading cause for 15-24 year olds (2007)
2007 YRBS: 25.7% felt sad or hopeless,
11.2% seriously considered, 8.1% made plan,
5.7% attempted, 2.1% made attempt requiring
medical attention
Over 2,000 Floridians die by suicide each year
An average of 4 Florida youth take their
own life each week
Not Just Statistics
Statistics alone don’t
paint the whole picture
Suicide is devastating to
family, friends, and
communities
Opportunities to help
Understanding People in Crisis
Why Everyone Is Vulnerable
Stressors are infinite
Assets are finite
Pressures
Assets
A Young Person May Feel They
Can’t
Can’t
Can’t
Can’t
Can’t
Can’t
Can’t
Can’t
stop the pain
think clearly
make decisions
sleep, eat or work
make the sadness go away
see the future without pain
see themselves as worthwhile
get someone’s attention
Source: AAS @ www.suicidology .org
Cup Full of Problems
Each cup represents a problem
that a young person may
be having.
Only rule is that the cups
cannot be stacked inside
one another.
A Basic Model of Living
Pain Tolerance
Adaptive
Factors
Pain
Threshold
Maladaptive
Factors
When the pain tolerance
threshold is broken
(when the pain is intolerable),
dangerous behaviors may follow.
Drug Abuse
Violence
Suicide
Psychotic Break
Depression and Suicide
Depression often goes undiagnosed until a
crisis occurs
Be concerned if: significant changes are
noted, symptoms last 2 weeks or longer
Change in eating/sleeping, isolating,
concentration problems, feelings of
hopelessness, irritability, guilt, anger, vague
physical complaints and suicidal thoughts
Source: NAMI, What Families Should Know about Adolescent
Depression and Treatment Options, May 2005
The Reality Of It
12 million (1 in 10) suffer
from mental illness
80% go without services
90% youth suicides had
a diagnosable,
treatable mental disorder
65% of boys and 75% of girls in juvenile
detention have at least one psychiatric
diagnosis
Source: Surgeon General, 1999. IOM Report, 2002, Teplin L. Archives of
General Psychiatry, Vol. 59, December 2002
Risk Factors Include
Previous suicide attempt – exposure to
suicidal behavior/ family history of suicide
Psychiatric disorders: depression, conduct,
anxiety, impulse disorders
Alcohol/substance abuse
Stressful life event or loss
Source: National Youth Violence Prevention Resource Center, 2000
Physical, emotional, or sexual abuse
Rejection, harassment by peers (bullying)
Loss of an important relationship
Sexual orientation
Easy access to lethal means
Change in family structure
Problems at school
Disciplinary action or incarceration
Warning Signs and Clues
What To Look For
The red flags that something
is wrong
Changes in a person’s
behavior, feelings, and beliefs
about oneself that are
maladaptive or out-of-character
I – Ideation
S – Substance Abuse
P – Purposelessness
A – Anxiety
T – Trapped
H – Hopelessness
W–
A–
R–
M–
Withdrawal
Anger
Recklessness
Mood Change
Source: American Association of Suicidology, November 2003
Some Signs Demand
Immediate Action
Talking or writing about suicide or death
Verbal clues – open talk about suicide
Isolating from friends and family
Putting affairs in order – giving away
cherished possessions
Exhibiting a sudden and unexplained
improvement after being depressed
Source: The Suicide Prevention Resource Center
In Summary
There is no typical suicide victim
There are no absolute reasons for suicide
There are no all-inclusive predictive lists
of warning signs or a definitive method
for determining if a young person is or is
not suicidal
Suicide is always multi-dimensional
Most don’t want to die – they want to end
their pain
Protective Factors
Positive conditions and personal and
social resources
Promote resiliency and reduce the
potential for suicide
Ability to manage or cope with
adversity or stress
Youth Protective Factors
•Positive connections to school
•Coping and problem solving skills
•Academic achievement
•Family cohesion/stability
•Help-seeking behaviors
•Good relationships with other youth
•Positive self worth - confidence
•Impulse control – conflict resolution abilities
•Social integration/opportunities to participate
•Access to care for mental/physical/substance
disorders
Being engaged in family, school and
community is a key to preventing youth
suicide.
Youths need to feel
comfortable,
connected,
respected
and supported
by peers and adults.
Personalizing Crisis
Exercise
•What helps?
•What hurts?
Intervention Steps and Goals
Get through crisis
without harm
Listen – establish rapport
Identify and clarify problem
Pinpoint feelings – evaluate hopelessness
Talk about suicide
Evaluate lethality
Identify and utilize resources
What To Do
Intervention - 3 Basic Steps
SHOW YOU CARE
ASK THE QUESTION
GET HELP
Adapted with permission from the Washington Youth Suicide Prevention Program
http://www.yspp.org
SHOW YOU CARE
Trust your judgment
Be Genuine - show them you truly care
Share observations and concerns
Concern can counter their sense of
hopelessness
Reflect what you hear
LISTEN!
Bad News: No script for these situations
Good News: “They may forget what you
said, but they will never forget how you
made them feel.” Carl W. Buechner
Don’t worry about doing or saying the
right thing. Your genuine concern is
what is most important
Ask The Question
Don’t assume they aren’t the “suicidal type”
Be direct. “What I hear you saying is you’re
in a lot of pain and you’re thinking of killing
yourself … Are you thinking about
suicide?”
Do they have a plan, the means to carry
out the plan – more detailed the plan the
greater the risk
Don’t have to solve all their problems
but you must get help
Suicide Paraphrase
Activity
Get Help - How To Help
Your support in building hope and finding
help truly can make the difference
between life and death.
If you have any reason to suspect a
person may attempt suicide or engage
in self-harm,
DO NOT LEAVE THE PERSON ALONE
Resources
Supportive friends
Family members
Clergy/youth minister
Mental Health Agency
Counselor or therapist
Family physician
Local hospital emergency room
Crisis Center – 9-1-1
1-800-SUICIDE or 1-800-273-TALK
Additional Resources
• Substance Abuse
programs
• Community health
department
• Parent HelpLine at
800-352-5683
• YOUTHLINE at 1877-968-8454
• Wide range of local
support groupsmental health,
survivors, abuse
• Addiction Help Line
1-800-758-5877
• FL Abuse Hotline 1800-96ABUSE
• Children’s
Protective Services
Group Role Play
Conclusion
It doesn’t take a
professional to save a life
We are all gatekeepers
Preventing suicide is
everyone’s business –yours
and mine
Together we can end this
deadly silence
Thoughts or Questions
Closing Comments
Post-training Survey
Please fill out the post-training survey
and the training evaluation form. Put
completed forms in the box provided.