Not One More!Stopping the Suicide Epidemic

Suicide is…..

The Enemy Within

Play video clip “The Enemy Within”Available from the California Highway Patrol

Definition of Suicide

“Suicide is a conscious act of self-induced annihilation, best understood …as a

needful individual who defines an issue for which the suicide is perceived as the

best solution.”

Dr. Ed Shneidman, Suicide as Psychache, 1993

Suicide Survivors

Family members and others who survive following the death of their loved one by

suicide:

•Spouse•Significant Others•Parents•Children•Extended family

•Grandparents•Lovers•Friends•Co-Workers•Classmates

6:1

Nationwide Statistics2004 data

One suicide every 16 minutes11th ranking cause of death in the US811,000 suicide attempts every year5 million living Americans have attempted suicideFirearms used in 52% of suicides

Suicide in Specific Populations

10.7

18

13

18.5

0

5

10

15

20

Suicides per 100,000

General Population White Males 21-55

Military Law Enforcement

Law Enforcement Suicide Compared

LE Suicide Rate LE LODD Rate LE Homicide Rate

18.5

9.1

4.5

0

5

10

15

20

Suicides per 100,000

Law Enforcement and Retirement

Retired Comparison Group Retired LE

Retired LE - Medical Disability

33.5

335

2616

0

500

1000

1500

2000

2500

3000

Suicides per 100,000

Write a Name Exercise

“It takes only the smallest of changes to shatter an epidemic’s equilibrium.”

Malcolm Gladwell in the “Tipping Point”

The Tipping Point:Agents of Change

The Law of the Few

The Stickiness Factor

The Power of Context

The Law of the Few

Connectors

Mavens

Persuaders

The Stickiness Factor

Advice that is practical and personal also becomes memorable…

Courage is taking the first stepLet us help each other liveJust do something!

The Power of Context

Epidemics strongly influenced by their situation

Circumstances and conditions

Particulars of environments

Kitty GenoveseGraffiti

One Voice

AwarenessCommunication

Courage

“Suicide is completed in inches not in leaps”

Ideation

Gesture

Attempt

Completion

Exercise

Write down the 3most important things in your life.

Myths?

•Happens without warning•Low risk after mood improvement•Once suicidal, always suicidal

Don’t mention suicide

•Only experts can prevent it•Runs in the family•No note = no suicide

• Suicide is not preventable

• Only certain “types” of people become suicidal

• Don’t talk about suicide or they will “do it.”

• Antidepressants cause people to be suicidal

More Myths..

Phil’s Letter to Mom

Life’s Most Valuable

My mind

My family

My work________

________

________

Loss or change in an important relationship

To avoid or end perceived pain

Escape intolerable situation

Gain attention

Manipulate

Punish others/Punish self

Become a martyr

Loss change important

perceivedintolerable

Social Support SystemWarning signs

Separation from family or friends- Geographic, legal, temporary

Loss of significant others A loner or newcomer

Rejected by peersFeels like people don’t care

Why Police Officers Commit Suicide

Loss due to death or divorceMarital problems or a bad relationshipTerminal illnessGuilt over partner’s deathLegal ProblemsFeeling alone

Sexual Accusations

Disability/Retirement

Internal Affairs Investigation

Financial Problems

Arrest

Loss of Employment

PTSD

.

LO

SS

Loss of Rational Thinking

Lack of sleepStress or anxiety

Substance Abuse

Immaturity

Psychosis:Command hallucinations

Alien control

Religious preoccupation

Symptoms of Depression

Change in sleep

Change in appetite

Loss of energy, motivation

Loss of interest in pleasurable activity

Apathy

Deterioration of personal appearance

Deterioration of job performance

Frequent physical complaints

Preoccupation with death

PTSD

Intense arousal after a traumatic event

Overwhelms coping mechanisms

Leaves the responder feeling helpless and out of control

Posttraumatic stress is not prejudiced

PTSD invades the mind with almost constant thoughts about the event

It is from PTSD that the unseen wounds of an officer begin to manifest. Since we do not see these battle scars, we sometimestry to pretend they do not exist. Trying to pretend doesn’t make the pain go away.

It’s Everybody’s Business

The student will be able to list the signs & signals of a person who

is at risk of suicide.Do Something!

Risk is 2-3x higher among alcoholics 15-25% of suicides are completed by

alcoholics50% of those who completed suicide

were intoxicated Among suicides of alcoholics, 89% were

actively drinking at time of death

Suicide and Alcohol

Indirect Verbal Clues

•I can’t go on any longer•Nobody needs me anymore•I’m tired of life•You won’t be seeing me any more•I can’t take it any more•You’d be better off without me•I can’t take the pain

Indirect Suicide IndicatorsClues.... Clues.... Clues....

Buying a weaponGiving away possessionsChanges in social behaviorReckless officer safety/behaviorChanges in personality

•The “practice run”•Sudden religious interest/ disinterest•Substance abuse relapse•More confrontational with subject

Direct Verbal Clues

• I wish I were dead

• You’d be better off without me

• I might as well be dead

• If ___doesn’t happen, I’m going to

end it

• I’m going to commit suicide

• I’m going to kill myself

How Bad Is It?

How:Is the plan specific?Do they have the means?Are the means lethal?

History:Prior attempts?Any family history?

Help:Are they alone?Are they drinking?

Lethality lets you know how much help you need and

how fast you need it

Intervention is Action

A SilentCode 3 Request for Help

Respond!Do Something!

Barricades to Seeking Help

Denial

Avoidance

Anger

Fear:Will impact job

Command will be contactedHospitalizationBeing labeled

Do’s of Intervention

Remain calmAccept their feelingsFocus on central issue

Stay close

Emphasize temporary nature of problem

Explore resources

** Listen ** Listen ** Listen **Hear what is being said

Don’t sound shocked

Don’t offer empty promises

Don’t try to joke them out of it

Don’t debate morality

Don’t assume things will improve

Don’t leave person alone

Don’t keep it a secret

Don’ts of Intervention

A Good Listener:

Copes with strong emotion

Is prepared to listen – time

Provides for comfort

Tolerates repetition

Listens carefully

Respect others perspective

Avoids interrupting

WAIT THINK RESPOND

The Question

Have you been thinking of

killing yourself?

Important Questions

How would you kill yourself?When did you last think about suicide?What is the closest you’ve come?Have you ever attempted suicide?Has anyone in your family attempted/completed

suicide?What are the odds that you will kill yourself?What has been keeping you alive so far?What do you think the future holds in store for

you?

Referrals

•Employee Assistance Program (EAP)•Health Care Plan

Adverse Job Action

Relationship Difficulties

Depression/Trauma

Alcohol Abuse

Suicidal Thoughts

Boxed In!Do Something!

Do Something!

Continue C.P.R.:

Caring

Preserving Life

Referrals and Resources

Do Something!

Suicide Postvention

Survivor ReactionsHigh risk groups

Parents

Spouses/Significant Others

“Stigma spillover”Children/Siblings

Friends/Coworkers

Those who find the body

Those who witness the suicide

Survivor Reactions“Survivor Syndrome”

Shock

Numbness

Denial of death as a Suicide

Religious concerns

Prolonged search for “Why??”

Fear of personal susceptibility

Survivor ReactionsEmotional

Shame

Anger

Responsibility

Blaming

Scapegoating

AbandonmentGuilt !

Survivor Reactions

LonelinessSocial Isolation*

Social stigmaDiminished social supports

Difficulty trusting othersNegative family relations

Over protectiveness

Play video clip “Suicide Interviews Take 2” stored on Disk #2

Suicide Is…

The Cost of Suicide

Cut off from supportAchievements minimizedPrivate shame and guiltNo honors or recognitionSupport network collapsesDecreased benefits

“Hindering” Survivors

Denying the death as a suicide

Ignoring or not taking the problem seriously

Pressuring them to “get over it”

Self-medicating/Taking them drinking

Offering negative religious judgments

Being judgmental

Helping Survivors

Let them talk

I’m sorry for your loss…

How can I help?

Is there anyone I can call for you?

Since the suicide, what are the biggest challenges for you?

Use the loved one’s name.

Additional Help:

Help the group care about the person,

and accept the choice he or she made

Refer individuals who are struggling

excessively with anger, loss, or guilt

Don’t remain the only one helping

“Attitudes outweigh facts. Attitudes must change so that statistics can change.”

KARL MENNINGER

Do Something!

Let us all havethe courage

to take a stand

Not One More…

Not One More…