Act 219 Barzanna White, S.S.P., Ph.D. District School Psychologist, - - PowerPoint PPT Presentation

Suicide Prevention and Intervention Act 219

Barzanna White, S.S.P., Ph.D. – District School Psychologist, Prevention Coordinator, and SCTG Director

What does it mean to be suicidal?

• Suicide is the act of

intentionally taking

• ne’s own life

voluntarily or intentionally.

Myths About Depression

• T or F

When someone is depressed, that person has no trouble going about their daily life.

• T or F

Depression effects everyone the same way.

• T or F

You can just snap out of depression.

• T or F

Depression looks the same in females and males

The Facts About Depression

• False

Depression is more common than AIDS, cancer, and diabetes combined and impacts people in different

• ways. Many find it hard to do routine tasks and they

may not recognize they are depressed.

• False

Although there are common signs and symptoms, everyone experiences Depression differently.

• False

Depression is a real and it typically requires treatment… medication, and counseling to help an individual effectively.

• False

Some depression symptoms like anger and irritability may be more common in males. Although depression runs in families, there are other factors at play…death and loss, certain medication, personal problems, etc.

Test Your Knowledge About Suicide

• T or F

There is a time of the year when suicides are most common.

Fact

• True

Most people think suicides are most common during the holidays, but the Spring is the peak for suicides. Suicides are lowest in December.

Test Your Knowledge About Suicide

• T or F

The greater the elevation of a person’s home, the higher the risk for suicide according to a 2011 study.

Fact

• True

Suicide rates are about 70% higher in homes with elevations 2000 meters in elevation compared to sea level and the study controlled for gun ownership and population density.

Test Your Knowledge About Suicide

• T or F

Suicides of teenagers make more headlines but adults are more likely to take their own lives.

Fact

• True

This is a tricky statement. Adults who die by suicide (ages 45-54, 19.72 per 100,000; ages 85 and over, 19 per 100,000; ages 15 – 24, 13.15 per 100,000). It’s the second leading cause of death for ages 15-24!

Check Your Knowledge About Suicide

• T or F

Whites are more likely to commit suicide.

Facts About Suicide

• True

Whites, 15.17 per 100,000; Native Americans, 13.37 per 100,000; and all other groups, 6 per 100,000.

Check Your Knowledge About Suicide

• T or F

Writing style may be linked to suicide.

Fact

• True

Writing style may be one possible indicator of

• depression. Creativity, depression, and suicide

have long been linked, so it may come as no surprise that some of history’s most creative individuals suffered from a mental illness. Depression affected great minds such as Charles Dickens, Keats, and Tennessee Williams.

• Several favorite writers committed suicide including Ernest

Hemingway, Sylvia Plath, and David Forest Wallace. These individual’s also wrote in first person.

Check Your Knowledge About Suicide

• T or F

Depression is always the cause of suicide.

Fact

• False

Two out of every three people who commit suicide are depressed by the time they take their

• life. However, alcoholism plays a role in 1 in 3

completed suicides.

• Major depression is the psychiatric diagnosis most

commonly associated with suicide and has about 20 times the risk found in the general population.

Test Your Knowledge About Suicide

• T or F

Your family affects your risk.

Fact

• True

A family history of depression increases the risk a child will suffer the same by a factor of 11.

• Protective factors such as family

connectedness, great friends and a strong social support network are known to lower suicide risk.

Test Your Knowledge About Suicide

• T or F

Poor countries have higher suicide rates.

Fact

• False

Many rich countries have higher suicide rates than developing nations.

Test Your Knowledge About Suicide

• T or F

Most suicide attempts fail.

Fact

• True

Only 1 in every 10 to 25 attempts results in

• death. The rate is reduced more when the

means (guns, pills, etc.) are taken away.

Test Your Knowledge About Suicide

• T or F

Suicides are more common than in the past.

Fact

• It depends! Suicides in the U.S. have remained relatively

constant over the past several decades. However, youth between the ages of 15-24 are more than twice as likely to commit suicide today compared to 50 years ago. That’s a 60% increase in the last 45 years according to the World Health Organization.

Test Your Knowledge About Suicide

• T or F

Getting appropriate help/treatment reduces risk.

Fact

• True

If you successfully treat depression, suicidal ideation declines. Note: Anti-depressants can raise the risk of suicide among patients under the age of 25 during the first few weeks of therapy so monitoring is critical!

Test Your Knowledge About Suicide

• T or F

Suicides are more common on weekends.

Fact

• False

The Center for Disease Control found the highest number of suicides occurred on Mondays and Tuesdays.

Test Your Knowledge About Suicide

• T or F

Males are at greater risk.

Fact

• True

While females are three times more likely than males to attempt suicide, males are four times more likely to actually kill themselves.

Additional Myths About Suicide

• People who talk about suicide are just trying to get attention.
• People who talk about wanting to die by suicide do not try to kill

themselves.

• Suicide always occurs without any warning signs.
• Suicide only strikes people of a certain gender, race, financial

status, age, etc.

• People who attempt suicide and survive will not attempt suicide

again.

Additional Facts about Suicide

 People who die by suicide usually talk about it first. They are in pain and oftentimes reach out for help because they do not know what to do and have lost hope. Any time someone talks about suicide, it should be taken seriously.  People who talk about wanting to die by suicide often kill themselves, especially without intervention.  There are almost always warning signs.  Suicide can strike anyone.  People who attempt suicide and survive will

• ften

make additional attempts.

Why is Suicide a Public Health Problem?

• After

cancer and heart disease, suicide accounts for more years of life lost than any other cause of death.

Statistics

• In 2017 (the most recent year for

which full data are available), 41,173 suicides were reported, making suicide the 10th leading cause of death for Americans.

• In

that year, someone in the country died by suicide every 12.8 minutes.

• There were an estimated 1,400,000

suicide attempts in 2017.

Facts about Suicide in the U.S.

• 14.0 per 100,000
• Rate of suicide is highest in middle-age white men.

They accounted for 69.67% of suicide deaths in 2017.

• In 2017, men died by suicide 3.54 times more often

than women.

• On average, there are 129 suicides every day.

(American Foundation for Suicide Prevention, 2019)

Most Common Suicide Methods

 In 2017, firearms were the most common method of death by suicide, accounting for a little more than half (50.57%) of all suicide deaths. Currently, firearms are involved in 56% of male suicides and 30% of female suicides.  The next most common method was suffocation (including hangings) at 24.5% Hanging or other means of suffocation are used in about 25% of both male and female suicides.  Among U.S. women, the most common suicide method involves poisonous substances. Poisoning accounts for 37% of female suicides, especially

• verdoses
• f

medications, compared to only 12% of male suicides.

Methods of Suicide

• Falls
• Cutting/Stabbing
• Drowning
• Inhaling Carbon Monoxide
• Electrocution
• Vehicular Impact
• Freezing
• Exsanguination

Behavioral Risk Factors

Changes in eating or sleeping patterns Withdrawal from friends, family Increase in drug or alcohol use Difficulty concentrating/school problems Unusual neglect of personal appearance Increased opposition to authority and rules Risk taking behaviors Giving away prized possessions Themes of death, dying, or violence in talk, music, drawings, writings, etc. Perfectionism Teens: violent actions, rebellious behavior, or running away

Need More Information…

• A comprehensive document can be found on the

Caddo Parish Schools website for staff (Suicide Prevention Manual – Developed by Dr. White for the Louisiana State Department of Education and modeled after the SAMHSA Toolkit).

• This document includes additional information on

bullying, teen trends, suicide, non-suicidal self injury, and more.

Louisiana Statistics

• On average, one person dies by suicide every 12

hours in Louisiana.

• More than three times as many people died by

suicide in Louisiana in 2017 than in alcohol related motor vehicle accidents.

• It’s the 11th leading cause of death in Louisiana

(AFSP, 2019)

Louisiana Statistics

• 3rd leading cause of death (ages 15-34)
• 4th leading cause of death (ages 35-44)
• 5th leading cause of death (ages 45-54)
• 10th leading cause of death (ages 55-64)
• 17th leading cause of death (ages 65 and older)

Louisiana v. National Statistics

• Number of deaths by suicide: 720 v. 47,173
• Rate per 100,000population: 15.18 v. 14.00
• State rank: 28

(AFSP, 2019)

Suicidal Ideation & Social Media

• Vast information on the topic of suicide is

available on the Internet and via social media.

• There are several specific ways that social media

can increase risk for pro-suicide behavior. Cyber- bullying and cyber harassment, for example, are serious and prevalent problems

• Unfortunately, the Internet has also provided a

way for people to obtain detailed descriptions of how to commit suicide including the use of lethal means.

Social Media and Suicide

Movies with Suicide Themes

• The Perks of Being a Wallflower
• Suicide Room
• It’s Kind of a Funny Story
• Dead Poets Society
• It’s Kind of a Funny Story
• Girl, Interrupted
• The Virgin Suicides
• A Girl Like Her

Continued

• Wrist cutters: A Love Story
• Seven Pounds
• Heathers
• Chatroom
• Ordinary People
• Romeo and Juliet
• It’s a Wonderful Life
• Leaving Las Vegas
• …and many more

Songs and Suicide

Songs with Suicide Themes

• Jamestown Story – Goodbye (I’m

Sorry)

• Green Day – Boulevard of Broken

Dreams

• James Taylor – Fire and Rain
• Billy Joel – You’re Only Human
• Brandi Carlisle – That Year
• Brad Paisley and Alison Krauss –

Whiskey Lullaby

Suicide Prevention /Help Songs

• The Fray – How to Save a Life
• Nickelback – Lullaby
• Rascal Flatts – Why
• R.E.M. – Everybody Hurts
• Smile Empty Soul – Stay Alive
• Creed – One Last Breath
• Third Eye Blind - Jumper

Who is at risk for Suicide?

• EVERYONE

Self Injury doesn’t mean suicidal

Self-Injury is also termed self-mutilation, self-harm or self-abuse. The behavior is defined as the deliberate, repetitive, impulsive, non-lethal harming of

• neself.

 Cutting  Scratching  Picking scabs or interfering with wound healing  Burning  Punching self or objects  Infecting oneself  Inserting objects in body opening  Bruising or breaking bones  Some forms of hair pulling  Other various forms of bodily harm  For more information about non-suicidal self-injury, a comprehensive document can be found on the Caddo Parish Schools website for staff (Suicide Prevention Manual – Developed by Dr. White for the Louisiana State Department of Education and modeled after the SAMHSA Toolkit).

Bullycide

• Bullycide is a term used to identify those children/teens who were

victims of bullying and became so emotionally distressed that they committed suicide.

• Several

environmental risk factors and risk behaviors were associated with suicidal thinking and behavior among youth involved in bullying.

• Approximately 22% of frequent perpetrators, 29% of frequent

victims, and 38% of frequent bully-victims reported suicidal thinking or a suicide attempt during the past year.

Things to Consider…

• Besides the risk of suicide, long-term exposure to

bullying also can increase the chance of homicide.

• So what’s your role in making sure students are

protected?

• Are you doing enough?
• Should you do more?
• What if it was your child? How would you want staff to

intervene?

Prevention is Key!

• Listen carefully
• Don’t be judgmental
• Provide comfort
• Call for help

Steps towards Intervention

• Genuinely begin by telling the suicidal person you are concerned about

them.

• Tell them specifically what they have said or done that makes you feel

concerned about suicide .

• Don't be afraid to ask whether the person is considering suicide and

whether they have a particular plan or method in mind. These questions will not push them toward suicide.

• Stay with the child and immediately seek assistance from your school

counselor. They will address concerns, assess the situation, contact the parent, and contact Dr. Barzanna White.

• Do not try to argue someone out of suicide. Instead, let them know that you
• care. Tell them that they are not alone and that they can get help. Focus on

the fact that “This is treatable!” Avoid pleading and preaching to them with statements such as, “You have so much to live for,” or “Your suicide will hurt your family.”

Ask the Tough Question…It Might Save Their Life!

• Are you thinking about killing

yourself?

• Do you have a plan? If so, ask

about when, where, how, etc.?

Is the student…

• Obsessed with suicidal means?
• Fascinated with death and dying?
• Making suicidal statements (direct or

indirect)?

• Drafting suicidal letters, drawings or

music?

• Focusing on methods of suicide

(collecting or working to obtain knives, pills, ropes, guns, etc.)?

• Threatening to harm others?

What is a Suicide Crisis?

 If the person is talking about imminent or specific plans for suicide, this is a crisis requiring immediate attention. Do not leave the person alone.  Do not put yourself in harms way. But if it’s safe to do so…remove any firearms, medications, or sharp objects that could be used for suicide from the area.  Take the person to a walk-in clinic at a psychiatric hospital or a hospital emergency room.  If these options are not available, call 911 or the National Suicide Prevention Lifeline at 1-800-273- TALK (8255) for assistance.  NWLA Local Number: 1-877-994-2275  Text: 741741  Or ask Siri!

Help is a Phone Call Away!

Closing Thoughts

Questions?

• Contact Information:
• Dr. Barzanna White, District Sch. Psychologist,

Prevention Coordinator, and SCTG Director

• 318-603-6484
• bwhite@caddoschools.org

References

• American Foundation for Suicide Prevention (2019). Suicide facts and

figures: Louisiana 2019. www.afsp.org/StateFacts.

• Bertolote J.M. & Fleischmann A. (2002). Suicide and psychiatric

diagnosis: a worldwide perspective. World Psychiatry, 1(3): 181–5.

• Bohanna I. & Wang X. (2012). Media guidelines for the responsible

reporting of suicide: a review of effectiveness. Crisis: Journal of Crisis Intervention & Suicide, 33(4): 190–8

• Carter G.L., Child C., Page A., Clover K., Taylor R. (2007). Modifiable

risk factors for attempted suicide in Australian clinical and community

• samples. Suicide and Life-Threatening Behavior, 37: 671–80.
• Yip P.S., Caine E., Yousuf S., Chang S.S., Wu K.C., Chen Y.Y. (2012).

Means restriction for suicide prevention. Lancet, 379(9834): 2393–9

References

• Copeland W.E., Angold A., Costello E.J. Egger H. (2013). Prevalence,

comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. American Journal of Psychiatry, 170: 173–9.

• de Leo D. & Heller T. (2008). Social modeling in the transmission of
• suicidality. Crisis: Journal of Crisis Intervention & Suicide, 29(1): 11–

9.

• Jenkins G.R., Hale R., Papanastassiou M., Crawford M.J., Tyrer P.

(2002). Suicide rate 22 years after parasuicide: cohort study. BMJ, 325(7373): 1155.

• Juel-Nielsen N. & Videbech T. (1970). A twin study of suicide. Acta

Geneticae Medicae et Gemellologiae, 19(1): 307–10.

References

• Klomek A.B., et al. (2011). High school bullying as a risk for

later depression and suicidality. Suicide and Life- Threatening Behavior, 41(5): 501–16.

• Lester D. (2002). Twin studies of suicidal behavior. Archives
• f Suicide Research, 6: 338–389.
• Luoma J.B., Martin C.E., Pearson J.L. (2002). Contact with

mental health and primary care providers before suicide: a review of the evidence. American Journal of Psychiatry, 159(6): 909–16.

References

• Mann J.J. & Currier D. (2012). Neurobiology of Suicidal Behavior. In

R.I. Simon & R.E. Hales (Eds.), The American Psychiatric Publishing Textbook of Suicide Assessment and Management (481–500).

• Roy A., Segal N.L., Centerwall B.S. & Robinette C.D. (1991). Suicide in
• twins. Archives of General Psychiatry, 48(1): 29–32.
• Sisask M. & Värnik A. (2012). Media roles in suicide prevention: a

systematic review. International Journal of Environmental Research and Public Health, 9(1): 123–38.

• Tidemalm D., Langstrom N., Lichtenstein P., Runeson B. (2008). Risk
• f suicide after suicide attempt according to coexisting psychiatric

disorder: Swedish cohort study with long term follow-up. BMJ: 337, a2205.