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Ending A Deadly Silence

Suicide PreventionGatekeeper Training

Insert your name and agency

What to Look For

What to Do

How to Help

Adapted with permission from the Washington State Youth Suicide Prevention Program and the Maine Youth Suicide Prevention Program

Prevention is often a matter of a caring person with the right knowledge being available in the right place at the right time.

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 someonewho 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

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 Statistics32,637 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

2007 Florida Statistics

Over 2,000 deaths (2,570 = 7 per day)

3rd leading cause of death for 25-34 y.o.

3rd leading cause for 15-24 y.o.

Suicide rate consistently is about double the homicide rate

69% of all suicides were among ages 25-64

Source: DOH, Florida 2007 Vital Statistics Report

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

PressuresPressures AssetsAssets

Stressors are Stressors are infiniteinfinite

Assets are finiteAssets are finite

A Person May Feel TheyCan’t stop the painCan’t think clearlyCan’t make decisionsCan’t sleep, eat or workCan’t make the sadness go awayCan’t see the future without painCan’t see themselves as worthwhileCan’t get someone’s attention

Source: AAS @ www.suicidology .org

Cup Full of Problems

Each cup represents a problemthat a person may be having.Only rule is that the cupscannot be stacked inside one another.

Depression and Suicide

Depression often goes undiagnosed Depression often goes undiagnosed until a crisis occursuntil a crisis occurs

Be concerned if significant Be concerned if significant changes are noted, symptoms last 2 changes are noted, symptoms last 2 weeks or longerweeks or longer

Change in eating/sleeping, Change in eating/sleeping, isolating, difficulty making isolating, difficulty making decisions, feelings of decisions, feelings of hopelessness, irritability, anger, hopelessness, irritability, anger, vague physical complaints vague physical complaints

Risk Factors Include

Previous suicide attempt – family history of suicide

Mental disorders, particularly mood disorders (depression)

Alcohol and other substance abuse

Easy access to lethal means

Impulsive and/or aggressive tendencies

History of trauma or abuse

Loss – job, financial, relationship

Lack of social support and sense of isolation

Stressful life events

Certain cultural and religious beliefs

Exposure to and influence of others who died by suicide

Psychological pain:HopelessnessHelplessnessPerceived burden on others

Warning Signs and CluesWhat 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

P – PurposelessnessA – AnxietyT – TrappedH – Hopelessness

W – WithdrawalA – AngerR – RecklessnessM – Mood ChangeSource: American Association of Suicidology, November 2003

I – IdeationS – Substance Abuse

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 someone is or is not suicidal

Suicide is always multi-dimensional

Most people don’t want to die – they want to end their pain

Protective FactorsPositive conditions – personal and social resources – feeling connected

Promote resiliency and reduce the

potential for suicide

Ability to manage or cope with adversity or stress

Youth Elderly 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 and impulse control

Supportive family relationships

Sense of purpose and identity

Involvement in community activities

Ability to live independently

Better preparation for retirement, interests and support networks outside of workplace

What To DoIntervention- 3 Basic Steps

SHOW YOU CARE

ASK THE QUESTION

GET HELP

Adapted with permission from the Washington Youth Suicide Prevention Programhttp://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!

Ask The Question

Don’t assume they aren’t the “suicidal type”

Be direct. “It sounds like 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

ResourcesSupportive friends Family membersClergyMental Health AgencyCounselor or therapistFamily physicianLocal hospital emergency roomCrisis Center – 9-1-1

1-800-SUICIDE1-800-273-TALK

Additional Resources

Florida Suicide Prevention Coalition

Youth Suicide Prevention School-Based Guide, FMHI

Community Health Department

Addiction Help Line 1-800-758-5877

FL Abuse Hotline 1-800-96ABUSE

Elder Abuse 1-800-962-2873

Domestic Violence Hotline 1-800-500-1199

Suicide Prevention Resource Center

1-877-YOUTHLINE 2-1-1 Elder Helpline 1-800-955-8770

Parent HelpLine at 800-352-5683

Group Role Play

Conclusion

It doesn’t take aprofessional to save a life

We are all gatekeepers

Preventing suicide is everyone’s business –yoursand mine

Together we can end this deadly silence

Post-training Survey

Please fill out the post-training survey and the training evaluation form. Put completed forms in the box provided.