Suicide is the third leading cause of death among children, teens, and young adults ages 10-24. About 4,000 young people die by suicide each year. But this is only the tip of the iceberg. Every year, about 125,000 young people in this age group are brought to the emergency room to receive treatment for injuries that were self-inflicted in the course of attempting suicide.
Tyler Clementi: gay Rutger student.
Situational: recent loss of a loved one, survivor of a previous suicide attempt, loss of prestige, serious illness, family history of suicide, a close friend commits suicideBehavioral: Talks or writes about death/suicide, giving away personal possessions, change in behavior, freefalling grades, ending close relationships, crying a lot, buying weapons, pills, etc, reading a lot about suicideEmotional: sense of personal failure, overwhelming sadness, general lack of interest, feelings of hopelessness, guild, withdrawl/isolation, feelings of being a burden to othersVerbal: Its too late now, I can’t go on, I have nothing to live for, No one cares what happens to me, I just want the pain to stop, They’d be better off without me
Connect: Mach contact with the person. Actively show that you hear what is being said and you understand that the pain is realListen: Listen actively and let them know that you careUnderstand: Don’t tell them how they should feel or what they should do. Express desire to support and help understand how they are feeling. Reflect what is said back to the person. Ask the hard questionsExpress Concern: Let the person know you are worried and want to helpSeek Help: The person’s safety is the number one priority.
When death occurs, particularly of an unexpected nature, there is no pattern of behavior to draw upon, and confusion results. Survivors face the loss of many roles the deceased person filled in their life: classmate, friend, teammate, etc. Students need special treatment when dealing with the loss of a friend. (go through list)Young people continue to communicate their need for help in understanding their feelings of confusion, loss, alienation, loneliness, depression, anger, sadness, and guilt. Counselors, administrators, and parents need to provide a curative environment that fosters prevention and intervention with at-risk students.
EXAMPLE#1: Four teenagers from a suburban New Jersey community committed suicide by locking themselves inside a 13-car garage and sitting in a car with a running engine. Two of the young people were males aged 18 and 19, and two were females aged 16 and 17. The young women were sisters. The two men died of a synergism of carbon monoxide poisoning, cocaine, and alcohol; the two young women, of a synergism of carbon monoxide and cocaine. All four teenagers had had trouble in school: three had dropped out of high school, and one had recently been suspended. Both males had been friends of an 18-year-old youth who had died after falling from a cliff 6 months earlier . One had witnessed this fall.Within days after these suicides, the community responded with a number of efforts, coordinated mainly by the municipal government, to prevent other suicides. School officials identified students they thought might be at high risk, such as close friends of the victims or students with a history of suicide attempts, and provided counselors for these students and any others who wanted help.Despite these measures, a 20-year-old female and a 17-year-old male attempted suicide together in the same garage by the same means 6 days after the simultaneous suicides. A policeman found them unconscious in a car after noticing that the lock on the garage had been broken. Both were successfully resuscitated. The garage door was removed. EXAMPLE#2: Over the past six months, four students at Henry M. Gunn High School in Palo Alto, Calif., have committed suicide in the same location, using the same method: stepping in front of an oncoming commuter train. A fifth student was pulled from the tracks by his mother and a bystander moments before a train passed.
Detection/awareness. All school personnel (including teachers, paraprofessionals, administrators, support staff, bus drivers, and cafeteria workers) who interact with students on a regular basis should know the warning signs of suicide and the importance of sharing their concerns about a student with an appropriate adult, such as the school counselor. • Parent notification. School personnel who are aware that a student is considering suicide must contact the student’s parents or guardians. Ideally, this contact should be made face to face and should include recommendations to parents about how to decrease the risk of suicide by increasing supervision, removing lethal means, and finding appropriate mental health services for the young person. A confidential record of parent notifications should be kept. • Support for students at risk of suicide. School personnel, including psychologists and counselors, should support students who are at risk of suicide with counseling, monitoring, and follow-up services.
Recognizing the Warning Signs -sudden deterioation in academic performance-self mutalation-fixation with death or violence-unhealthy peer relationships-volatile mood swings or a change in personality-indications that the student is in an unhealthy, destructive, or abusive relationship-risk-taking behaviors-signs of an eating disorder-difficulty in adjusting to gender identity-bullying-depressions Responding to the Warning Signs As someone whose concern and responsibilities lay with the health and welfare of students, you have the opportunity to intervene when students are in danger of suicide or other health risks. You also have a responsibility to provide support to teachers who come to you with concerns about students, and to students who come to you with concerns about themselves and their peers. There are a number of steps you can take when you have a concern that a student may be at risk of suicide. Ask the Tough Questions Research has shown that asking someone if he or she has contemplated self-harm or suicide will not increase that person’s risk. Rather, studies have shown that a person in mental distress is often relieved that someone cares enough to inquire about the person’s well-being. For example: • I’ve noticed that you are going through some rough times. Do you ever wish you could go to sleep and never wake up? • Sometimes when people feel sad, they have thoughts of harming or killing themselves. Have you had such thoughts? • Are you thinking about killing yourself Be Persistent A student may feel threatened by your concern. The student may become upset or deny that he or she is having problems. Be consistent and firm, and make sure that the student gets the help that he or she may need. Be Prepared to Act You need to know what to do if you believe that a student is in danger of harming him- or herself. Many schools have procedures for this situation. If your school has such procedures, explain them to the student. • Do Not Leave a Student at Imminent Risk of Suicide Alone • Get Help When Needed Use Your School’s Support System School districts typically have crisis policies for responding to any emergency, from a natural disaster to violence in the school community. This policy should include procedures for addressing students who try to harm themselves as well as those who are only contemplating it; students who are not in an acute state of crisis will still need support to stay in school and stay healthy. The plan should also provide some guidance for the role of individual teachers in identifying and responding to potential suicidal or violent behavior in students, as well as how to respond when actual violence takes place. If your school does not have procedures for responding to a crisis, organize a team to draft some now—don’t wait for a crisis situation! • Connect with Parents or Guardians PostventionPostvention includes grief counseling for students and staff; identification of students who may be put at risk by a traumatic incident, and support for those students; support for families; and working with the media to ensure that news coverage of such an event does not lead to additional suicides or emotional trauma. School-Based Suicide Prevention Programs As someone who will play a primary role in responding to a suicide or attempted suicide, it is in your interest (as well in the interest of your students and colleagues) to prevent suicide among your school’s students. Important steps you can take to prevent suicide and related behavior in your school include the following: • Implement a school-based suicide prevention program. These programs can be especially effective when implemented in the context of a comprehensive risk prevention or health promotion program. Such programs can reduce levels of self-harm and other risk behaviors as well as improve levels of wellness and the academic performance of the school. • Implement a gatekeeping program. Suicide prevention gatekeeping programs train those who have regular contact with young people, such as teachers, to do the following: o Recognize behavioral patterns and other warning signs that indicate that a young person may be at risk of suicide o Actively intervene, usually by talking to the young person in ways that explore the level of risk without increasing it o Ensure that young people at risk receive the necessary services • Implement school-based mental health services. The American Academy of Pediatrics Committee on School Health reported, “School-based [mental health] programs offer the promise of improving access to diagnosis of and treatment for the mental health problems of children and adolescents” (Taras & American Academy of Pediatrics Committee on School Health, 2004, p. 1839). The committee offered a set of recommendations for such programs, which may help reduce the rates of suicide and other problems among children
A comprehensive developmental school counseling program can help reduce the number of students who are at-risk. The at-risk student is disenfranchised and not connected to the school, does not view school as an important part of life and often comes from a home where school is not considered a priority. Generally, disenfranchised students have parents, and possible grandparents, who were themselves considered at-risk when they attended school. The cycle continues because interventions are not consistently in place to provide these students with the skills and behaviors to feel connected at school and/or to promote the importance of school to parents. t the elementary level, the focus is directed primarily to teaching students in the personal/social domain. Students learn the importance of respect for self and others, strategies for self-management and appropriate behaviors that lead to success. In the academic and career development domains, elementary students learn the connection between school and work as they are made aware of careers and the fact that school leads to success in the workplace. Beginning in the middle school years, the CDSCP includes a focus on planning through the implementation of Individual Learning Plans (ILP). Every student is taught the planning process. They learn how to set goals and develop action steps to reach them. They develop indicators for when they know they are successful in achieving their goals. Students are provided opportunities to review progress toward their goals, reflect on their progress, and update their plans. The planning process continues throughout high school and adds academic planning as a primary focus. High school students are involved from the beginning of ninth grade in the choice of courses and keeping track of the number of credits they need to graduate and be prepared to pursue their post-secondary goals. At the secondary level (middle and high school), students turn their attention to exploring and making informed decision about post-secondary opportunities they want to pursue. Both college and work readiness are emphasized as critical student outcomes by the time a student graduates. Contextualized learning, based on understanding and fulfilling the requirements for future educational and career success, makes school more meaningful to students. Those who have not seen the value of school often realize that they need to apply themselves to their studies if they want to attain the goals they have set for themselves. Also at the secondary level, students are provided with reinforcing activities in the personal/social domain. Learning styles, personality types, study skills and anxiety-reducing strategies are part of the school counseling curriculum. Students can build on prior knowledge from their elementary training in self-management skills, and strategize on the way to overcome barriers to academic success with which they are confronted.
Abraham Biggs: took pills and laid on his bed in the middle of the night while on a live webcam.
B E C C A L Y N NTeen Suicide
Teen SuicideStudent Voices: Teen Suicide“I told my friends I want to kill myself and now they think im a freak and nevertalk to me. Its getting worse without friends”“You know why so many teens commit suicide? It’s because the world is dark,cold and cruel place with a few happy moments tossed here and there. Life is abitch… People say “oh it will get better” well you know what, it doesn’t. Maybefor some but not for all. Killing yourself (in my opinion) is the best way toactually be free of pain. It’s the ultimate “fuck you”.”“Problem is. No one cares. They won’t think of you being suicidally depresseduntil you say that you are going to kill yourself. No one cares.”
Statistics Ages 10-24: 3rd leading cause of death (followinghomicides & unintentional injuries) 4,000 young people die by suicide each year 125,000 are brought to ER to receive treatment forself-inflicted injuries 2 million US adolescents attempt suicide each year 2.6% of students reported making a suicide attempt
Statistics: GenderGirls-think about suicide twice as much as boys-attempt suicide by overdosing, cutting themselvesBoys-die by suicide 4 times as often as girls-use more lethal methods (firearms, hanging, jumpingfrom heights)
Suicide in SC 5 suicides/day at $7,273 per person ($13 million/year) More suicides than homicides in the last 3 years 10-14 year olds: 5th leading cause of death; 15-24 yearolds: 3rd leading cause of death; College students: 2ndleading cause of death Each completed suicide directly affects 6 other SouthCarolinians 70% have never touched a mental health system 90% of suicides are associated with an undiagnosed oruntreated mental illness
Risk Factors Prior suicide attempt Co-occurring mental andalcohol/substance abuse disorders Family history of suicide Parental psychopathology Hopelessness Impulsive/aggressive tendencies Easy access to lethal methods Exposure to suicide History of physical or sexual abuse Same-sex sexual orientation Impaired parent-child relationships Life stressors Change in eating/sleeping habits Withdrawl from family, friends, andregular activities Violent and rebellious actions Drug and alcohol use Decline in academic performance Frequent complaints about physicalsymptoms Loss of interest in pleasurable activities Not tolerating praise or rewards
Implications of SuicideStudentsParentsCounselors
Implications of Suicide:Students Hawton and Perrone (1987):Peers of adolescents who attempted suicide arevulnerable because suicide is higher:-among persons with unstable social relationships-when a population is self-contained (school)-when the element of bravado exists-when the act is sure to be noticed
Implications of Suicide:StudentsSPECIAL TREATMENT ISSUES WITH ADOLESCENTS: Allow regression and dependency Realize their lack of life experience in handling trauma Allow expression of feelings Encourage discussion Allow for fluctuations in maturity level Correct distortions Address guilt Avoid power struggles Come to terms with anger
Implication of Suicide:Students Clusters-3-5% of all suicide deathseach year-almost entirely foundamong teens and youngadults
Implications of Suicide:Parents Long-term counseling Listen intently Ask questions Talk about the LIFE of the person Allow the child to cry as often and long as they want Spend a lot of time with the child Tell them you love them and show them often
Implications of Suicide:Professional School CounselorsThe National Association of School Psychologistssummarized the school’s role as follows: Detection/Awareness Parent Notification Support for students at risk of suicide
Implications of Suicide:Professional School Counselors Recognize the warning signs Respond to the warning signs Ask the Tough Questions Be Persistant Be Prepared to Act Do not leave a student at imminent risk of suicide alone Get help when needed Use your schools support system Connect with parents or guardians Postvention School-based prevention programs Implement a gatekeeping program Implement School-based mental health services
School Counseling Program for Suicide Elementary Level: personal/social domainBeginning in the Middle School Years: Individual LearningPlans (success in achieving goals) Secondary Level:Post-secondary Opportunities;reinforcing personal/social domain
LEADS for YouthA Suicide Prevention Education ProgramUpon Completion Youth:-increased knowledge of depression,depression symptoms, and facts about suicide-increased ability to recognize risk factor and protectivefactors for suicide and suicide warning signs-increased ability to identify school and communityresources-increased knowledge and skills about how to seek help forself or a friend and how to overcome barriers to help-seeking
The Internet:The Bad Webcam suicide: Abraham Biggs Wikipedia: Suicide Methods
The Internet:The Good www.afsp.org www.nami.org www.yellowribbon.org www.guidancechannel.com www.save.org