Youth Suicide: The Silent Epidemic Dianne McKissack, MA, LMFT - - PowerPoint PPT Presentation

Youth Suicide: The Silent Epidemic

Dianne McKissack, MA, LMFT September 2013

O bjectives

• Participants will be able to identify the difference

between the realities and myths associated with teen suicide.

• Participants will be able to identify risk factors and

warning signs associated with youth suicide and will be able to implement appropriate interventions.

• Participants will learn ways to make a difference in their

communities in order to end the silent epidemic of teen suicide.

• Participants will identify resources to educate the

community and healthcare field about youth suicide prevention.

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The faces of suicide….

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W hy Talk About Suicide?

Suicide doesn’t discriminate by

gender, age, race, ethnicity, education, or socioeconomic status. There is no typical suicide victim!

Suicide is the most preventable

form of death in the U.S. today.

Arkansas ranks 13th in the nation in

suicide deaths.

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W hy Talk About Youth Suicide?

1 in 5 high school students reported seriously

considering suicide (N IMH).

Every 2 hours and 15 minutes a person under

the age of 25 completes suicide (N IMH).

IF our children were dying from

an illness at this rate, we would be screaming for a vaccine!!!

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Prevalence of Suicide

According to the NIMH…

• 11th leading cause of death
• 3rd leading cause of death among youths ages 15-24
• 4th leading cause of death among children ages 10-14
• Every week 100 teenagers commit suicide in the US
• More teenagers and young adults died from

suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, flu, and chronic lung disease COMBINED.

• Each year as many as 5 to 8 percent of U.S. children and

young adults attempt suicide, according to the U.S. Centers for Disease Control and Prevention. In 2010, 4,867 youths between the ages of 10 and 24 died by suicide, making it the second leading cause of death for people in this age group.

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Prevalence of Suicide

Research has shown that young females are

more likely to attempt suicide; whereas, young males are more likely to commit suicide (NASW ).

The National Institute on Mental Health

(2010) reports that more than 90%

• f people

who die by suicide have depression, other mental disorders, or a substance-abuse disorder.

According to a 2012 report from the Centers

for Disease Control and Prevention, 13.5 percent of Hispanic female students in grades 9-12 admitted attempting suicide - significantly higher than their black and non-Hispanic peers.

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Myths versus facts…

MYTH:

People who talk about suicide don't complete suicide.

FACT:

Many people who die by suicide have given definite warnings to family and friends of their

• intentions. Always take any comment about

suicide seriously .

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Myths versus facts…

MYTH:

Suicide happens without warning.

FACT:

Most suicidal people give many clues and warning signs regarding their suicidal intention.

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Myths versus facts…

MYTH:

Asking a depressed person about suicide will push him/her to complete suicide.

FACT:

Studies have shown that patients with depression have these ideas and talking about them does not increase the risk of them taking their own life.

Myths versus facts…

MYTH:

“People who attempt suicide and do not complete suicide are just trying to get attention and are not really serious.”

FACT:

N ot true: To a certain degree, they are trying to get attention and help for the pain they are

• experiencing. A suicide attempt is an attempt to

seek help! All attempts should be taken seriously regardless of severity…..

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Risk Factors

Suicide may occur with one or a combination

• f risk factors. The greater the risk factors

the greater the risk.

Suicide ideation, thoughts, or suicide are not

normal responses to stressful events

Depression, mental illness, and substance

abuse

• O f the suicide completions in youth, 60% suffer

from depression.

• Alcohol – 50-67% associated with suicide attempts.

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Elevated Risk in Youth

• Perfectionists – rigid perfectionism
• Learning disabled – twice the emotional distress and

females twice as likely to attempt suicide

• Loners – usually show signs of being troubled
• Low self-esteem – “everyone would be better off without

me”

• Depressed youth – 60% of those who commit suicide are

clinically depressed

• Students in trouble
• Gay and lesbians – don’t feel safe in schools
• Abused children
• Alcohol and drug users
• Bullied students

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Teen Suicide Risk Factors

Anger and aggression – strong connection

between interpersonal violence and suicide…

Self-mutilation – cutters Situational crises – 40% are associated with an

identifiable event, i.e. boyfriend breakup

Lack of cohesion in the home Strong feelings of stress Struggling with classes – perceive teachers as not

understanding them or caring about them

Poor relationships with peers

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O ther Contributors to Teen Suicide

• Social networks – Facebook, twitter
• Bullying – According to recent studies,

between 20-40% of U.S. teenagers report being bullied three or more times during the past year.

• The Internet danger – YouTube

Suicide chat rooms Instructions on methods Solicitations for suicide pacts

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Support for Teens

Teens who turn to school (21%) or

community (24%) sources of support and advice are twice as likely to have attempted suicide than teens who turn to family members.

This high rate may be a result of a

breakdown in the family networks of troubled teens, who then turn to or are referred to outside sources.

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Becoming Aware: WARNING SIGNS

Talking about suicide (at any level) or making a

plan… “I’d be better off dead!” - “You won’t have me around to pick on!”

Making suicidal gestures… i.e. putting a “finger

gun” to their head

Statements about hopelessness, helplessness, or

worthlessness

Strong wish to die or preoccupation about

death; Hinting at “not being around” in the future… saying goodbye, visiting, calling, or contacting significant people.

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Becoming Aware: WARNING SIGNS

Displaying symptoms of depression/behavioral

changes: moodiness, hopelessness, lack of participation in social interactions/withdrawal, anger, changes in appetite, appearance, dwindling academic performance, not turning in assignments, and relationship problems

Sudden mood swings including moving from a

depressed mood to suddenly feeling calmer, happier, and more energetic

Increased alcohol and/or other drug use Previous suicide attempt Giving things away

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Warning Signs of Suicide Mnemonic IS PATH WARM

I Ideation Threatening to hurt or kill him/herself or talking of wanting to hurt or kill him/herself Looking for ways to kill him/herself by seeking access to firearms, pills, or other means Talking or writing about death, dying, suicide when these actions are out of the ordinary S Substance Abuse Increase or excessive substance use P Purposelessness No reason for living; no sense of purpose in life A Anxiety Anxiety, agitation, unable to sleep, or sleeping all the time T Trapped Feeing trapped – like there is no way out; resistance to help H Hopelessness Hopelessness about the future W Withdrawal Withdrawing from friends, family ,and society A Anger Rage, uncontrolled anger, seeking revenge R Recklessness Acting reckless, engaging in risky activities, seemingly without thinking M Mood Change Dramatic mood change

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Mental Healthcare Facts

• Adolescents with psychopathology who also experience

psychotic symptoms have a nearly 70-fold increased odds

• f acute suicide attempts, according to new research.

This information, the authors noted, may help develop clinical markers for suicide risk and should improve suicide assessment success. The results of the prospective cohort study was published in J

AM A Psychiatry (Psychiatric Times, 2013).

• State governments spend about $900 million dollars per

year on medical costs associated with completed suicides and suicide attempts by individuals up to 20 years old. (N ASW, 2009)

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Mental Healthcare Facts

Most adolescents considering suicide or who have

attempted suicide do not receive specialized mental health services, according to NIMH.

According to NIMH researchers…. Although between

50% and 75%

• f those teens who reported having suicidal

ideation had recent contact with a service provider, most had only three or fewer visits, suggesting that treatment tends to be terminated prematurely.

The study results suggest that risk assessment for

suicide should be integrated into routine physical and mental health care for teens and that even if adolescents are in treatment they should continue to be monitored for suicidal ideation and behaviors.

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Prevention…

A set of four questions that takes

emergency department nurses or physicians less than 2 minutes to administer can successfully identify youth at risk for attempting suicide, reported a study by N IMH researchers that was published in the December 2012 issue of the Archives of Pediatrics and Adolescent

M edicine.

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Youth Suicide: Dos and Don’ts

Remain calm

Though you may be shocked and overwhelmed, it is important to try to stay relaxed.

Be prepared to talk about suicide

1.

Four out of five completed suicides gave clear warning signs before the attempt.

2.

W hile death is an uncomfortable subject for many people, it is important to be able to talk about it openly and honestly . Do not hesitate to ask the questions!! BE DIRECT.

3.

Your first question should be whether or not he or she is having suicidal

• thoughts. If the answer is yes, then ask the individual if he or she has a

plan of how to do it. If the youth answers yes again, ask if he or she has

• btained whatever is needed to do it, and if so, if a time has been
• determined. Getting the answers to these questions can help you

evaluate the mindset of the youth and get him or her the necessary help.

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Youth Suicide: Dos and Don’ts

Be prepared to ACT

If someone is suicidal, he or she must not be left

• alone. Try to get the person to seek help

immediately from his or her doctor or the nearest hospital emergency room, or call 911. It is also important to limit the person's access to firearms, medications, or other lethal methods for suicide.

Do not try to play the hero

Though it is important to act immediately , it is better not to act alone.

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Youth Suicide: Dos and Don’ts

Do not promise confidentiality

Though an individual may ask you to guarantee confidentiality , try to avoid making this promise, and be prepared to break it if you do. Keeping a child's promise is not as important as saving a child's life.

Don't fall into the "Not My Child

Syndrome"

It is all too easy to think of suicide as a terrible tragedy that happens to other people's families.

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The Triad Approach: Students: Parents: Educators

Use the Life Model

Listen – when your friends report suicidal feelings Insist – on honesty Feelings – share Extend – a helping hand

Teach students to talk about their concerns and do not try to handle a problem such as suicide alone. Seek help. Be willing to risk a friendship to save a life!

N ational Suicide Prevention Lifeline

1-800-273-TALK (8255)

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The Triad Approach: Students: Parents: Educators

• Educate yourself about the magnitude of the problem
• Encourage schools to participate in suicide prevention

programs

• Encourage churches and youth programs to provide suicide

prevention

• W atch and listen to your children and pay attention to

sudden changes in behavior

• Be willing to seek professional help
• Talk openly and honestly with your child
• Get resources
• Use the CARL line to talk to a professional for free

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The Triad Approach: Students: Parents:

Educators

• Educate yourself about the problem
• Know the tools for prevention
• Encourage staff development training on suicide
• Become a J

ason Foundation member and become an advocate in your school – education counts for 2 hours of staff development training

• Sponsor an Annual Suicide Prevention Week
• Be aware of changes in your students and take action
• Sponsor a Poster Campaign
• Have a N O tolerance bullying policy and EN FO RCE it!
• Utilize the CARL resource line

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Preventing Suicide Resources. . .

§ American Association of Suicidology www.suicidology.org § American Foundation for Suicide Prevention (AFSP) www.afsp.org § AFSP College Film, The Truth about Suicide § Center for Disease Control www.cdc.gov § Help Starts Here www.helpstartshere.org § National Association of Social Workers www.naswdc.org/practice/adolescent_health/shift/default.asp § National Suicide Prevention Lifeline www.suicidepreventionlifeline.org § National Institute of Mental Health www.nimh.nih.gov § Suicide Prevention Resource Center www.sprc.org § The J ason Foundation http://jasonfoundation.com § YouTube – Teen Suicide and Depression, Bullied to Death…

Together we can make a difference!

SUICIDE is a PERMANENT SOLUTION to a TEMPORARY PROBLEM

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Discussion and Q uestions? ? ? ? ? ? ? ?

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Resources

• American Psychiatric Association Practice Guidelines, Suicidal Behaviors

(1999)

• American Association of Suicidology - www.suicidology.org.
• Horowitz LM, Bridge J

A, Teach SJ , Ballard E, Klima J , Rosenstein DL, W harff EA, Ginnis K, Cannon E, J

• shi P

, Pao M. Ask Suicide-Screening Q uestions (ASQ ). A Brief Instrument for the Pediatric Emergency

• Department. Archives of Pediatrics and Adolescent M edicine. December
• 2012. 166(12):1170–1176.
• Institute of Medicine. Reducing suicide:

A national imperative. W ashington, DC. The national Academies Press (2002)

• J

acobs, D. Assessment and management of suicide risk. (2004)

• J

acobs, D & Brewer M. AP A practice guidelines . Psychiatric Annals, 34 (5), 373-380. (2004)

• J
• bes, D.A. Managing suicide risk:

A collaborative approach. N ew York: Guilford Press (2006)

• Marris, R.W, Berman, A, Silverman, M. Comprehensive Textbook of
• Suicidology. N ew York:

Guilford Press (2000)

• N ational Association of Social Workers (2009). The N ASW Shift Project:

Suicide Prevention for Adolescent Girls. W ashington, DC:

N ational Association of Social Workers.

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Resources

• Practice Perspectives (J

anuary, 2011). Adolescent Depression and S uicide Risk: How S

• cial Workers Can Make a Difference.
• Psychiatric Times (2013). Evidence Points to Psychotic S

ymptoms as Clinical Marker for S uicide Attempts. - http://www.psychiatrictimes.com/suicide/evidence-points- psychotic-symptoms-clinical-marker-suicide-attempts

• S

cience Update. (2013). Emergency Department S uicide S creening Tool Accurately Predicts At Risk Youth. - http://www.nimh.nih.gov/news/science-news/2013/emergency- department-suicide-screening-tool-accurately-predicts-at-risk- youth.shtml

• S

uicide Prevention Resource N etwork. Risk and protective factors.

• http://www.sprc.org
• S

hea, S .C (2004) The delicate art of eliciting suicidal ideation. Psychiatric Annals, 34 (5), 374-400

• S

uicide Prevention. J

• int Commission Resources. -

http://store.jcrinc.com/assets/1/14/S PTK07_S ample_Pages3.pdf

• The J

ason Foundation - http://jasonfoundation.com.

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Contact Information

Dianne McKissack, MA, LMFT J

• hnson Regional Medical Center

Senior Care and Expectations 479-754-5490- office 479-774-2901-cell dianne.mckissack@ horizonhealth.com

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