Transcript Crisis Response Training - Clermont County Educational

2014
Suicide prevention, intervention, and
postvention
 Young people who talk about suicide never
attempt or complete suicide.
Fact: Talking about suicide can be a
plea for help and a late sign in the
progression toward a suicide attempt.
 Attempted or completed suicides happen without
warning.
Fact: The survivors of a suicide often say
that the intention was hidden, however it
is more likely that the intention was not
recognized.
 A survivor of a suicide attempt is likely to make
future attempts.
Fact: Adolescents typically make 8-10
attempts before they actually die by
suicide
 People who really want to die will find a way, it
won’t help to try to stop them.
Fact: Most of the time suicidal people are
ambivalent about the decision. They are
torn between wanting to die and wanting
to live. Most suicidal individuals don't want
death, they just want the pain of living to
stop.
 Suicidal youth cannot help themselves.
Fact: While contemplating suicide, young
people may have distorted perception of
their actual life situation and what
solutions are appropriate for them to take.
With support, young people can gain full
self-direction and self-management of
their lives.
 Most suicidal youth seek or ask for help with their
problems.
Fact: Evidence shows that they often tell
their school peers of their thoughts and
plans. Adolescents are more likely to
“ask” for help through non-verbal gestures
than to express their situation verbally to
others.
 People who threaten suicide are just seeking
attention.
Fact: All suicide attempts must be treated as
though the person has the intent to die. It
is likely that the person has tried to gain
attention and, therefore, this attention is
needed.
 Not every death is preventable.
Fact: No matter how well intentioned, alert
and diligent people’s efforts may be, there
is no way of preventing all suicides from
occurring.
 One should not try to discuss suicide with
depressed people, it might give them the idea or
upset them enough to put them over the edge.
Fact: Many severely depressed individuals have
already considered the option of ending their
lives. Discussing suicide openly helps the suicidal
person sort through problems, and provides a
sense of relief and understanding.
 Prevalence
 Every 4 hours in America a child commits suicide
 3rd leading cause of death 15-24 year-olds (2nd for 11-19
year olds)
 25% of high school students at risk at any given time
 U.S. has highest suicide rate among 26 industrialized
nations (double the rate)
 Prevalence
 300% increase since 1950 (youth suicide)
 Approximately 5,000 annually
 Approximately 100-120 attempts per completed suicide
 Suicide rates are gross underestimates (many reported as
accidents)
 Doing something places school in less jeopardy than
doing nothing
 Legal Issues
 District did not:
 Warn Parents Immediately
 Provide Adequate Student Supervision
 Provide Training to Staff
 Issues:
 Foreseeability
 Negligence
 Court Cases:
 Wyke v. Polk County School Board (11th Cir., 1997)
 “Are School Psychologists Liable,” 1994
 Montgomery County, Maryland, 1988
 Comprehensive Processes for Suicide and/or
Violence Prevention Include:
 PREVENTION
 INTERVENTION
 POSTVENTION
 Comprehensive programs are built over years!
It is the policy of the Governing Board that all staff
members learn how to recognize students at risk, to
identify warning signs of suicide, to take preventive
precautions, and to report suicide threats to the
appropriate parental and professional authorities.
Administration shall ensure that all staff members
have been issued a copy of the District's suicide
prevention policy and procedures. All staff members
are responsible for knowing and acting upon them.
 Part of the strategic plan for Clermont County’s
Suicide Coalition
 Established in October 2003
 Funded by the Clermont County Mental Health
and Recovery Board through levy dollars
 513-528-SAVE (7283)
 Provides supportive services to individuals
experiencing mental health crisis
 Primary purpose is to provide suicide prevention
services to callers
 Dedicated to reducing suicide attempts, saving
lives, and restoring hope through education,
advocacy and collaboration in suicide prevention
 Residents of Clermont County of all ages
 24 hours a day, 7 days per week
 Unique feature – Mobile phone Hotline
 3 responders – highly qualified
 Gatekeeper
 Individuals who by the nature of their job, their special
interest in people, or in their personal relationships and
friendships are in a position to observe high-risk
behaviors and warning signs and take action when
necessary
 Gatekeeping describes the protective functions in the
process of using his or her critical skills in recognizing,
responding to, and helping suicidal persons get the help
they need
 The process by which individuals acquire basic
suicide prevention and intervention skills
 Participants are not intended to be an “expert” at
the conclusion
 Not intended in any way to replace counseling or
mental health services
 Intended to offer hope through positive action
 Talk about suicide
 Ask about suicide
 Listen
 Keep youth safe.
 Get help.
 Recognize risk factors/warning signs
 When following-up with the youth
 Encourage expression of feelings
 Listen without passing judgment
 Make empathic statements
 Do not offer reassurances that may not be true
 Do not offer simplistic solutions (e.g., “all you need is a
good night’s sleep”)
 Explore options for support in the environment
 Get parents involved with the youth’s knowledge
 Assess lethality
 Is the individual making threats? Don’t be afraid to ask.
 Does the individual have a plan?
 How specific is the plan? (e.g., time frame, details,
chance of intervention)
 Does the individual have access to means that would
assist in carrying out the plan?
 Has the individual made any previous suicide attempts?
 Collaborate with others
 Student
 Family – it is imperative to involve the
PARENT/GUARDIAN!!!!
 School Personnel (e.g., principal, counselors,
psychologists, mental health workers, and other school
professionals)
 Community Agencies
 Referral for professional help
 When risk is present (e.g., specific plan, available
means)
 Know your community resources
 Maintain collaboration with treating agency to conduct
on-going assessment
 Risk Factors
 Variables that signal the need to look for warning
signs of suicidal thinking.
 Warning Signs
 Variables that signal the possible presence of suicidal
thinking.
 Suicide notes
 Direct & indirect suicide threats
 Making final arrangements
 Giving away prized possessions
 Talking about death
 Reading, writing, and/or art about death
 Hopelessness or helplessness
 Social Withdrawal and isolation
 Lost involvement in interests & activities
 Increased risk-taking
 Heavy use of alcohol or drugs
 Abrupt changes in appearance
 Sudden weight or appetite change
 Sudden changes in personality or attitude
 Inability to concentrate/think rationally
 Sudden unexpected happiness
 Sleeplessness or sleepiness
 Increased irritability or crying easily
 Low self esteem
 Dwindling academic performance
 Abrupt changes in attendance
 Failure to complete assignments
 Lack of interest and withdrawal
 Changed relationships
 Despairing attitude
 Postvention= the provision of crisis intervention,
support and assistance for those affected by a
completed suicide
 Primary Goal= Prevent further suicides
 Create a Crisis Fact Sheet
 Include Risk Factors and Warning Signs
 Include local sources of assistance
 When Suicide is Confirmed:
 Educate staff about suicide “contagion”
 Provide suicide postvention recommendations
 Encourage the use of the Clermont County Crisis
Response Team
 20 years of experience assisting schools and
communities in the aftermath of tragedies
 70-80 active members comprised of mental health
professionals working throughout Clermont
County
 This could be the most important role for any
educator
 While remediation of reading and math skills is a
worthwhile endeavor, and improving behavioral
concerns is certainly helpful, they are not a matter
of Life and Death!
 Information presented today was the tip of the
iceberg; your challenge is to seek out further
information, training, and experience!