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You are muted and will not hear anything until the moderator begins - - PowerPoint PPT Presentation
You are muted and will not hear anything until the moderator begins - - PowerPoint PPT Presentation
Welcome to SPRCs Research to Practice Webinar Expanding Suicide Prevention to Include Upstream Approaches You are muted and will not hear anything until the moderator begins the session. If you are experiencing technical difficulties,
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Call-in for audio Enter question during Q&A
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SPRC Research to Practice Webinar
If you are experiencing technical difficulties, please call 307-GET-WEB1 (307-438-9321)
Expanding Suicide Prevention to Include Upstream Approaches
September 25, 2012
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Opening Remarks
Gail F. Ritchie
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SAMHSA’S MISSION
To reduce the impact of substance abuse and mental illness on America’s communities
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National Research Council and Institute of Medicine, 2009
SAMHSA and the Institute of Medicine
Preventing Mental, Emotional, and Behavioral Disorders, Among Young People, Progress and Possibilities
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Contact Information
Gail F. Ritchie, M.S.W., LCSW-C Coordinator, Prevention Practices in Schools Grant Program Mental Health Promotion Branch Substance Abuse and Mental Health Services Administration gail.ritchie@samhsa.hhs.gov
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Today’s Presenter
Philip Rodgers, PhD
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Organizing Committee
- Scott Fritz, SPTS
- Effie Malley, formerly of AAS
- Maureen Underwood, SPTS
- Peter Wyman, U. of Rochester Medical Center
- Phil Rodgers, AFSP
Expanding the Youth Suicide Prevention Paradigm: Establishing and Promoting the Importance of Upstream Suicide Prevention Approaches
Expert meeting held at the 45th Annual Conference of the American Association of Suicidology, April 18, 2012, Baltimore, MD.
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2 4 6 8 10 12 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
U.S. Suicide Rate for 1999-2009 by Age
Rate per 100,000
Can a suicide that occurs here Have been prevented here? Age
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Rate per 100,000
U.S. Suicide Rate for Years 1999-2009 by Age Group
2 4 6 8 10 12 14 16 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Age 5-9 Age 10-14 Age 15-19 Age 20-24
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The IOM report supports a Mental Health Intervention Spectrum
O’Connell, Boat, & Warner (2009). Preventing Mental, Emotional, and Behavioral Disorders Among Young People. Washington, D.C.: The National Academies Press.
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2 4 6 8 10 12 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
U.S. Suicide Rate for 1999-2009 by Age
Rate per 100,000
Can a suicide that could occur here Be prevented here? Age
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Today’s Presenter
Dennis D. Embry, PhD
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Acting for Early, Upstream Suicide Prevention
Dennis D. Embry, Ph.D.
President/Senior Scientist
PAXIS Institute
Research to Practice Webinar
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A recent webinar experience
- n the topic
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Is this early prevention?
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Is this early prevention?
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Is this early prevention?
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Is this early prevention?
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Thinking way upstream
Really?
What if we started here with early suicide prevention?
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Thinking way upstream
What might be the early malleable predictors? Could we actually change those predictors easily and reliably? And what else might change as a consequence of the prevention or protection strategies.
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risk factors during development from early childhood to adolescence
Psychiatric problems in childhood and/or adolescence, including depression Child and/or adolescent externalizing disorders Childhood adversity (especially with the above) Low self-esteem (self-efficacy) Aggressive or delinquent behavior
Prax Kinderpsychol Kinderpsychiatr. 2012;61(1):32-49.
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First Grade
When are these risk factors most universally detectable?
Psychiatric problems in childhood and/or adolescence, including depression Child and/or adolescent externalizing disorders Childhood adversity (especially with the above) Low self-esteem (self-efficacy) Aggressive or delinquent behavior
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Thinking midstream
What might be the midstream malleable predictors?
- Early and current smoking
- Dose response, MORE smoking =
MORE suicide risk, controlling for
- ther variables
- Smoking affects monoamine
- xidase (MAO), which increases
suicide risk
Breslau et al. Arch Gen Psychiatry 2012;():1-8
Adolescence
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Hypothesis #1
If we can reduce early aggressive or ADHD-like behavior and victimization by peers in First Grade, that might be the first step toward the long-term prevention of suicide.
Golly, almost every teacher would like it if there was more time to teach and for kids to learn.
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Hypothesis #1
If we can reduce early aggressive or ADHD-like behavior and victimization by peers in First Grade, that might be the first step toward the long-term prevention of suicide.
Let’s see if we can reduce disturbing, distracting, and inattentive behaviors in classrooms — as
- ur first test.
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Montrose Wolf Harriet Barrish Muriel Saunders invented the Game in 1967 as a first-year, 4th grade teacher. Published as a study in 1969.
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www.pubmed.gov
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Longitudinal Johns Hopkins Studies of GBG
Every child rated by teachers
Kindergarden First Grade
GBG NO GBG
Tested in 41 first- and second-grade classrooms within 19 elementary schools with two consecutive groups of first graders.
Young Adulthood Follow Up
Age 19-21 Age 26 Age 30 Age 19-21 Age 26 Age 30
Purpose: To find
- ut if GBG
affected their adult lives.
No More GBG
No GBG
Grades 2 thru 12 Follow Up
Purpose: To find out if GBG affected their adolescent lives.
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By the early 1990s, multiple studies including this randomized one proved that GBG reduced the early predictive behaviors.
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Wow! In 1998, Drs. Kellam and Anthony showed that GBG reduced tobacco initiation—one of the middle predictors.
Tobacco Initiation (Age of First Use)
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So now, let’s see if GBG affects suicide indicators among youth and young adults.
Wilcox, H. C., Kellam, S., Brown, C. H., Poduska, J., Ialongo, N., Wang, W., & Anthony, J. (2008). The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts. Drug & Alcohol Dependence, 95(Suppl 1), 60-73.
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So now, let’s see if GBG affects suicide indicators among youth and young adults.
Wilcox, H. C., Kellam, S., Brown, C. H., Poduska, J., Ialongo, N., Wang, W., & Anthony, J. (2008). The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts. Drug & Alcohol Dependence, 95(Suppl 1), 60-73.
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Timeline of Benefits…
More time for teaching and learning
First Month
Less stress for Staff & Students
Better Attendance Better Academics Less Illness
Fewer Service Needs
Fewer Referrals
First Year
Happier Families Less Vandalism
2nd & 3rd Years
ADHD Averted
Oppositional Defiance Averted Special Education Averted
5-15 Years
No Tobacco
Less Alcohol Less Conduct Disorders Less Depression Less Crime, Violence, Suicide High School Grad & University
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How is this accomplished?
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By teams with group based reward— during any regular teaching & learning activity
The Blue Team The Red Team The Yellow Team
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The Team Aim: to Win
- Ms. Dion
Jan 23
Blue Red Yellow
20 40 20 60 Spleems are counted and marked with neutral tone for the team, not the individual child. Teams who have 3 or fewer Spleems win. Winning teams earn a “Granny’s Wacky Prize”. Team having 4 or more Spleems lose that game. PAX Minutes = winning teams x minutes played.
e.g., disturbing behaviors
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Thank you,
Dennis D. Embry, Ph.D dde@paxis.org 1-520-299-6770
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Today’s Discussants
Morton M. Silverman, MD Sheppard G. Kellam, MD
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Today’s Discussants
Morton M. Silverman, MD Sheppard G. Kellam, MD
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Thank you!
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