Family wellness conference, oct. 8, 2016

Suicide causes, signs, prevention
and resources from a suicide
survivor

Richard Gardner
rtgardner3@yahoo.com

These slides are posted online at:
http://www.slideshare.net/rtgardner3

National Suicide Prevention Lifeline
1-800-273-TALK (8255)
Berks County Crisis Hotline
1-877-236-4600

FAST FACTS
Accessed from CDC Fast Facts, Sept. 30, 2016 for the calendar year 2013
http://www.cdc.gov/nchs/fastats/suicide.htm
All suicides
•Number of deaths: 41,149
•Deaths per 100,000 population: 13.0
•Cause of death rank: 10
Firearm suicides
Suffocation suicides
Poisoning suicides

selected 2014 suicide stats
42,773 total suicides
38,675 white*
33,113 males**
29,971 white males***
9,660 females
3 males complete suicide to every female
* 90% of all completed suicides in the U.S.
** 77% of all completed suicides in the U.S.
*** 70% of all completed suicides in the U.S.
http://www.cdc.gov/nchs/data/hus/2015/019.pdf

Suicide is often triggered by an intense
life crisis which will pass if given
enough time.

Crises may be
• the breakup of an important interpersonal relationship,
• loss of a job,
• bankruptcy,
• arrest,
• death of a spouse or other close person,
• retirement,
• a chronic progressively debilitating disease and
• other crisis events that are as diverse as humans are.

Helping a person get through the
immediate crisis usually prevents their
suicide.

This is the point in time at which a person
makes the decision to attempt suicide
and decides the method to complete the
suicide.

A common myth is that someone
attempting suicide is determined to
complete it and nothing can be done
to stop it.

The truth is that very few people are
determined enough to take their life.

Instead they use an attempted suicide
as a catalyst to make positive changes
in their lives.

Guns are the most common method of
suicide, accounting for about half of all
completed suicides.

In 2013 there were 21,175 gun
suicides out of a total 41,149 suicides.

In other words, 51% of completed
suicides were by firearm.

Almost all of these firearm suicides
were white men.

Guns give no second chance as they
are almost always fatal.

The largest suicide cohort is
young men.

The second largest is men of
retirement age.

Men, especially older men, with no
spouse or significant other in their
lives are the most vulnerable.

Another myth is that if one method of
suicide is blocked, another will be used.

In reality, there is little substitution
between suicide methods.
Stopping the preferred method usually
prevents the suicide from being
completed.

The more barriers which can be put in
a person’s life to prevent suicide, even
small annoying ones, the less apt a
person is to complete a suicide
because it gives the person time to
think, recover emotionally and move
away from the suicidal impulse.

This may mean:
• dumping bottles of medication into a toilet,
especially acetaminophen (Tylenol),
• removing sharp objects from immediate
access,
• pouring alcohol down the drain,
• removing ropes from a home, etc.

Mostly, it means removing guns from
a home and making sure the suicidal
person has no access to firearms,
including the ability to purchase one.

Some suicide is pathological, such as I deal
with due to being bipolar 2.

I have been given a tremendous gift of
intelligence, creativity and drive.

There is nothing I can do to eliminate
the suicide drive from my life that
does not destroy my creativity.

However, I can learn to live with it!

If the mind can be trained to increasingly
negative cycles, the mind can be trained to
increasingly positive cycles. We need to learn
to train the brains of the mentally ill to these
positive cycles.

Teaching coping, relationship and life
skills with self-knowledge of when a
suicidal episode is beginning to
manifest itself are essential in
preventing suicide in people like me.

Among the most important life skills I have
learned is to live a healthy life style.
This means eating a whole foods based diet,
while avoiding additives, sugars and stimulants
(including coffee).

Additionally, this means daily exercise.

For people gifted with bipolar like myself
the signs of impending suicide include
1.) purchase of a gun,
2.) overstocking either over the counter
medications or prescription medications,
3.) being in a mixed state - a combination
of manic and depressed and
4.) loss of a significant relationship
through death or a break-up.

Of these, purchase of a gun and
overstocking medications give the
person the tools to commit suicide.

Being in a mixed state and the loss of a
significant relationship often set the
stage for a potential suicide and give
the impetus to make the attempt.

The best answers are:
• self-knowledge of the disease
• supportive environment of family and friends
• stable emotional environment, (even though we
try hard to destabilize it)
• stable physical environment
• stable routines
• healthy eating
• regular exercise
• physical contact with other people – hug us a
lot!

An almost invisible group at high risk for
suicide which we need to be aware of are
people who have experienced childhood
sex abuse,
especially males.

In Pennsylvania we have two large
groups of people who were abused as
children on a continual basis over the
last 30 years because the institutions
protected the abusers.

These institutions were Penn
State/Sandusky/Second Mile and various
dioceses of the Roman Catholic Church,
such as Scranton/Wilkes-Barre.

If you have males in your family that
may have been sexually abused by
members of these organizations, talk
with them and find out.

Then get them help before a suicidal
crisis develops!

One of the largest risk factors I have seen is
having had a family member commit suicide.

If a parent, grandparent, aunt or uncle
commits suicide, it gives permission to other
family members to do the same by creating a
family culture where suicide is acceptable.

This is the most dreadful
consequence of suicide – being the
role model family members use to
take their lives!!!

KNOW YOUR MEDICATIONS
or have someone close to you act as your champion and
know what medications you are taking so they can ask the
questions about what you are taking because you often
will be incapable of doing so.

The medications which are an especial risk factor are Tricyclic
antiepileptics/antidepressants such as Trileptal and Tegretol.
Apparently, for people like myself with bipolar they can
increase the risk for suicide.
http://www.rxlist.com/trileptal-drug/consumer-side-effects-precautions.htm
http://www.rxlist.com/tegretol-drug/warnings-precautions.htm

Combat veterans suicide at a rate of
over 21 people each day.

The Veteran’s Administration and
other organizations have programs to
help active and inactive soldiers.

Call 1 (800) 273-8255 and pressing 1, texting
to 838255 or going online and clicking on the
confidential Veterans Chat link at
www.veteranscrisisline.net.
Anyone can receive fast, compassionate and
confidential care.

Suicide warning signs based on Suicide Prevention Resource
Center Best Practice Registry (SPRC & AFSP):
• Threatening to hurt or kill self.
• Looking for ways to kill self (e.g., seeking access to pills,
guns, etc.).
• Talking or writing about death or suicide.
• Experiencing rage/uncontrolled anger or seeking revenge.
• Acting reckless or engaging in risky activities.
• Feeling hopeless or trapped.
• Increasing drug or alcohol use.
• Withdrawing from friends or family.
• Having dramatic changes in mood.
• Feeling like there is no purpose in life or reason for living.
• Sleeping too much or too little.

Additional signs may include:
• An unexpected change in normal routines and habits.
• Rehearsals of a method or possible methods.*
• Concerns about wills and inheritances when there is no
apparent reason to do so.
• Giving away valued possessions to family and friends.
• Extended and/or frequent episodes of depression.
• An unexplainable period of calm following a period of
agitation.
• Prior attempts.

* Risky behaviors such as reckless gun play, putting toes
over a ledge, strangulation games and similar may be
suicide rehearsals which need to be talked about as soon
as possible.

Suicide Warning Signs
Kevin Caruso, Suicide.org
Appearing depressed or sad most of the time.
(Untreated depression is the number one cause for suicide.)
Talking or writing about death or suicide.
Withdrawing from family and friends.
Feeling hopeless.
Feeling helpless.
Feeling strong anger or rage.
Feeling trapped -- like there is no way out of a situation.
Experiencing dramatic mood changes.
Abusing drugs or alcohol.
Exhibiting a change in personality.
Acting impulsively.
Losing interest in most activities.
Experiencing a change in sleeping habits.
Experiencing a change in eating habits.
Losing interest in most activities.
Performing poorly at work or in school.
Giving away prized possessions.
Writing a will.
Feeling excessive guilt or shame.
Acting recklessly.
http://www.suicide.org/suicide-warning-signs.html

Anyone who feels their life has no purpose needs
to give it purpose.
Find a cause you value and give it more value by
volunteering.

Notes:
For me the toughest days are heavily overcast ones.
Several days of constant overcast are very hard for me.
Snowstorms are the hardest of all in that they dampen the noise and sight lines, making me feel
isolated from people and the world around me.
Getting outside helps change how I feel. Lava lamps inside are a big help. Artificial sunlight lamps also
help. Brightly colored rooms (yellow! yellow! yellow!) help keep my moods up.
Self-medication is not an issue I worry about. As long as the self-medicating is not destructive or
harmful I see no problem with it. Even better is when it is an activity which involves creativity, physical
movement and other people.
Social dance is a great outlet that involves people contact, touch, creativity, music and physical
movement.
Participatory (not spectator) sports are also a good mood modifier for the same reasons dance is.
Dogs, cats and other interactive pets, even gerbils, are a big help in balancing emotions.
One of the biggest challenges we have is to recognize the incredible gifts mentally ill people have given
us. Many great inventors, scientists, scholars, writers, … , were mentally ill.
The United States ranks 41 out of 171 countries listed by WHO for suicide prevalence rate or in the top
25% for suicide world wide. This most probably is because of the preferred method, guns.

The National Suicide Prevention Lifeline
If you or someone you know is considering suicide, call 1-800-273-8255 now! The National Suicide Prevention
Lifeline has trained counselors available 24 hours a day, 7 days a week. The Lifeline is free and confidential. You
can call about an issue you’re facing or if you’re concerned about a friend or family member. If you’re struggling
or concerned, please call. No call is too small or unimportant.
Suicide Prevention Resource Center http://www.sprc.org/
SPRC is the nation’s only federally supported resource center devoted to advancing the National Strategy for
Suicide Prevention. They provide technical assistance, training, and materials to increase the knowledge and
expertise of suicide prevention practitioners and other professionals serving people at risk for suicide. They also
promote collaboration among a variety of organizations that play a role in developing the field of suicide
prevention.
American Foundation for Suicide Prevention http://www.afsp.org/
The American Foundation for Suicide Prevention has been at the forefront of a wide range of suicide prevention
initiatives – each designed to reduce loss of life from suicide. They are investing in groundbreaking research,
new educational campaigns, innovative demonstration projects and critical policy work. And they are expanding
their assistance to people, whose lives have been affected by suicide, reaching out to offer support and offering
opportunities to become involved in prevention.
American Association of Suicidology http://www.suicidology.org/home
AAS is a membership organization for all those involved in suicide prevention and intervention, or touched by
suicide. AAS is a leader in the advancement of scientific and programmatic efforts in suicide prevention through
research, education and training, the development of standards and resources, and survivor support services.
Services for Teens At Risk (STAR Center) http://www.starcenter.pitt.edu/
Services for Teens At Risk (STAR-Center) is a comprehensive research, treatment, and training center. Funded
by the State of Pennsylvania's General Assembly in 1986 to address adolescent suicide and depression, the
program provides individual assessment and treatment to teens that are experiencing depression and
suicidality. They also provide community education services about depression and suicidality to schools, social
service agencies, churches and other organizations that request them.
Resources

Substance Abuse and Mental Health Services Administration (SAMHSA)
www.samhsa.gov
SAMHSA provides leadership and devotes it’s resources – programs, policies, information and data, contracts
and grants – toward helping the nation act on the knowledge that: behavioral health is essential for health;
prevention works; treatment is effective; and people recover from mental health and substance use disorders.
Suicide Prevention Resources For Schools
*** Please note that the resources listed here are free of charge. There are many more excellent resources for
minimal cost.
General Information (many with webinar sessions)
PA Youth Suicide Prevention Initiative http://payspi.org/
Mission -The Pennsylvania Youth Suicide Prevention Initiative is a multi-system collaboration to reduce youth
suicide.
Vision -Youth suicide prevention will be embraced and incorporated into the fabric of every community in
Pennsylvania to address the social and emotional needs of youth at risk and survivors of suicide.
Toolkit for High Schools http://store.samhsa.gov/product/SMA12-4669
Assists high schools and school districts in designing and implementing strategies to prevent suicide and
promote behavioral health. Includes tools to implement a multi-faceted suicide prevention program that
responds to the needs and cultures of students. Released in June 2012.
American Foundation for Suicide Prevention http://www.afsp.org/
The American Foundation for Suicide Prevention has been at the forefront of a wide range of suicide prevention
initiatives – each designed to reduce loss of life from suicide. They are investing in groundbreaking research,
new educational campaigns, innovative demonstration projects and critical policy work. And they are expanding
their assistance to people, whose lives have been affected by suicide, reaching out to offer support and offering
opportunities to become involved in prevention.
American Association of Suicidology http://www.suicidology.org/home
AAS is a membership organization for all those involved in suicide prevention and intervention, or touched by
suicide. AAS is a leader in the advancement of scientific and programmatic efforts in suicide prevention through
research, education and training, the development of standards and resources, and survivor support services.

Services for Teens At Risk (STAR-Center) is a comprehensive research, treatment, and training center. Funded
by the State of Pennsylvania's General Assembly in 1986 to address adolescent suicide and depression, the
program provides individual assessment and treatment to teens that are experiencing depression and
suicidality. They also provide community education services about depression and suicidality to schools, social
service agencies, churches and other organizations that request them.
The Trevor Project http://www.thetrevorproject.org/
The Trevor Project is the leading national organization providing crisis intervention and suicide prevention
services to lesbian, gay, bisexual, transgender, and questioning youth.
Comprehensive School Guide Youth Suicide Prevention School Based Guide http://theguide.fmhi.usf.edu/
The Youth Suicide Prevention School-Based Guide is designed to provide accurate, user-friendly information.
The Guide is not a program but a tool that provides a framework for schools to assess their existing or proposed
suicide prevention efforts (through a series of checklists) and provides resources and information that school
administrators can use to enhance or add to their existing program. First, checklists can be completed to help
evaluate the adequacy of the schools' suicide prevention programs. Second, information is offered in a series of
issue briefs corresponding to a specific checklist. Each brief offers a rationale for the importance of the specific
topic together with a brief overview of the key points. The briefs also offer specific strategies that have proven
to work in reducing the incidence of suicide, with references that schools may then explore in greater detail. A
resource section with helpful links is also included. The Guide provides information to schools to assist them in
the development of a framework to work in partnership with community resources and families.
School Policy Model School Policy on Suicide Prevention –
https://afsp.org/wp-content/uploads/2016/01/Model-Policy_FINAL.pdf
Written by American Foundation for Suicide Prevention, National Association of School Psychologists, American
School Counselor Association, and The Trevor Project. This modular, adaptable document will help educators
and school administrators implement comprehensive suicide prevention policies in communities nationwide.
STAR Center Sample School Suicide Prevention Policy and Procedure -
http://www.starcenter.pitt.edu/Files/PDF/Sample%20Suicide%20Policy%20-
%20Suicide%20Prevention%20and%20Postvention%20-%20REVISED%209%2015%2014%20-%20FINAL.pdf

Training for School Staff Society for Prevention of Teen Suicide http://www.sptsusa.org/
The mission of the Society for the Prevention of Teen Suicide is to reduce the number of youth suicides and
attempted suicides by encouraging overall public awareness through the development and promotion of
educational training programs for teens, parents and educators.
The free, interactive series Making Educators Partners in Suicide Prevention is designed to be completed at the
viewer's own pace. Pennsylvania school staff requiring Act 48 hours may submit the certificate of completion to
c-paschool@pa.gov or fax it to 717-783-4790, along with your Dept. of Education Professional ID number, to
have these hours submitted.
17 minute video for parents – schools / taskforce http://www.sptsusa.org/
More Than Sad Program http://www.afsp.org/preventing-suicide/our-education-and-prevention-
programs/programs-for-professionals/more-than-sad
The More Than Sad Program of the American Foundation for Suicide prevention provides education about
factors that put youth at risk for suicide, in particular depression and other mental disorders. The program
includes two sets of materials-one for teens and one for teachers and school personnel. Instructional materials
accompany the More Than Sad Program, including a power point presentation -
http://www.morethansad.org/materialspts.html
American Foundation for Suicide Prevention(http://www.afsp.org/ ) - PA AFSP chapters will make the “More
Than Sad” DVD available free to all high and middle schools in PA that request one.
Contact Pat Gainey to receive your copy.
Patricia Gainey, Regional Director, American Foundation for Suicide Prevention, Greater Philadelphia Regional
Office3535 Market Street, Suite 4047Philadelphia, PA 19104; Office: (215)-746-7256
Suicide Prevention Resource Center - Best Practice Registry http://www.sprc.org/bpr
The purpose of the Best Practices Registry (BPR) is to identify, review, and disseminate information about best
practices that address specific objectives of the National Strategy for Suicide Prevention. The BPR is a
collaborative project of the Suicide Prevention Resource Center (SPRC) and the American Foundation for Suicide
Prevention (AFSP). It is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Many of the best practice resources listed have to be purchased.

Material for Students
More Than Sad Program http://www.afsp.org/preventing-suicide/our-education-and-prevention-
programs/programs-for-professionals/more-than-sad
The More Than Sad Program of the American Foundation for Suicide prevention provides education about
factors that put youth at risk for suicide, in particular depression and other mental disorders. The program
includes two sets of materials one for teens and one for teachers and school personnel. Instructional materials
to accompany More Than Sad Program, including a power point presentation -
http://www.morethansad.org/materialspts.html
American Foundation for Suicide Prevention (http://www.afsp.org/ ) - PA AFSP chapters will make the “More
Than Sad” DVD available free to all high and middle schools in PA that request one.
Contact Pat Gainey to receive your copy.
Patricia Gainey, Regional Director, American Foundation for Suicide Prevention, Greater Philadelphia Regional
Office3535 Market Street, Suite 4047Philadelphia, PA 19104; Office: (215)-746-7256
Suicide Prevention Resource Center Best Practice Registry http://www.sprc.org/bpr
The purpose of the Best Practices Registry (BPR) is to identify, review, and disseminate information about best
practices that address specific objectives of the National Strategy for Suicide Prevention. The BPR is a
collaborative project of the Suicide Prevention Resource Center (SPRC) and the American Foundation for Suicide
Prevention (AFSP). It is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Many of the best practice resources listed have to be purchased.
Wisconsin Department of Public Instruction
The curriculum is not SPRC listed, but does use elements of SOS and
Lifelines.http://sspw.dpi.wi.gov/sspw_suicideprev main page
Link to Student programs: http://sspw.dpi.wi.gov/sspw_spstudentprograms
Link to Curriculum: http://dpi.wi.gov/schools-educators

Postvention Assistance
This is a comprehensive research, treatment, and training center. Funded by the State of Pennsylvania's General
Assembly in 1986 to address adolescent suicide and depression, the program provides individual assessment
and treatment to teens that are experiencing depression and suicidality. They also provide community
education services about depression and suicidality to schools, social service agencies, churches and other
organizations that request them. Any PA school can contact the STAR-Center for assistance in the aftermath of a
suicide or other tragic loss. STAR-Center can also provide in-service training and resource materials on a variety
of mental health related topics.
Suicide Prevention Resource Center Postvention Toolkit
http://www.sprc.org/sites/sprc.org/files/library/AfteraSuicideToolkitforSchools.pdf
This toolkit is designed to assist schools in the aftermath of a suicide (or other death) in the school community. It
is meant to serve as a practical resource for schools facing real-time crises to help them determine what to do,
when, and how. The toolkit reflects consensus recommendations developed in consultation with a diverse group
of national experts, including school-based personnel, clinicians, researchers, and crisis response professionals.
It incorporates relevant existing material and research findings as well as references, templates, and links to
additional information and assistance.

10 Leading Causes of Violence-Related Injury Deaths, United States
2014, All Races, Both Sexes
Age Groups
Ran
k
<1 1-4 5-9 10-14 15-24 25-34 35-44 45-54 55-64 65+
All
Ages
1
Homicide
Unspecifie
d
119
Homicide
Unspecifie
d
149
Homicide
Firearm
58
Suicide
Suffocation
225
Homicide
Firearm
3,587
Homicide
Firearm
3,260
Suicide
Firearm
2,830
Suicide
Firearm
3,953
Suicide
Firearm
3,910
Suicide
Firearm
5,367
Suicide
Firearm
21,334
2
Homicide
Other
Spec.,
classifiable
83
Homicide
Other
Spec.,
classifiable
73
Homicide
Unspecifie
d
14
Suicide
Firearm
174
Suicide
Firearm
2,270
Suicide
Firearm
2,829
Suicide
Suffocation
2,057
Suicide
Suffocation
2,321
Suicide
Poisoning
1,529
Suicide
Poisoning
1,028
Suicide
Suffocation
11,407
3
Homicide
Suffocation
26
Homicide
Firearm
47
Homicide
Cut/pierce
12
Homicide
Firearm
115
Suicide
Suffocation
2,010
Suicide
Suffocation
2,402
Homicide
Firearm
1,835
Suicide
Poisoning
1,795
Suicide
Suffocatio
n
1,509
Suicide
Suffocation
880
Homicide
Firearm
10,945
4
Homicide
Poisoning
8
Homicide
Suffocation
24
Homicide
Suffocation
11
Homicide
Cut/pierce
19
Suicide
Poisoning
363
Suicide
Poisoning
800
Suicide
Poisoning
1,274
Homicide
Firearm
1,132
Homicide
Firearm
538
Homicide
Firearm
367
Suicide
Poisoning
6,808
5
Homicide
Firearm
5
Homicide
Other
Spec.,
NEC
N
20
Homicide
Other
Spec.,
NEC
N
7
Suicide
Poisoning
18
Homicide
Cut/pierce
314
Homicide
Cut/pierce
430
Homicide
Cut/pierce
313
Homicide
Cut/pierce
304
Homicide
Unspecifie
d
224
Homicide
Unspecifie
d
239
Homicide
Cut/pierce
1,740
6
Homicide
Cut/pierce
3
Homicide
Poisoning
14
Homicide
Poisoning
6
Homicide
Unspecifie
d
6
Suicide
Fall
168
Homicide
Unspecifie
d
208
Homicide
Unspecifie
d
226
Homicide
Unspecifie
d
278
Homicide
Cut/pierce
199
Homicide
Cut/pierce
134
Homicide
Unspecifie
d
1,585
7
Homicide
Fire/burn
2
Homicide
Cut/pierce
12
Homicide
Fire/burn
5
Homicide
Suffocation
4
Suicide
Other
Spec.,
classifiable
121
Suicide
Fall
193
Suicide
Fall
152
Suicide
Fall
197
Suicide
Cut/pierce
178
Suicide
Cut/pierce
127
Suicide
Fall
994
8
Homicide
Other
Spec.,
NEC
N
2
Homicide
Drowning
12
Homicide
Other
Spec.,
classifiable
5
Suicide
Other
Spec.,
classifiable
4
Homicide
Unspecifie
d
120
Legal Int.
Firearm
160
Suicide
Cut/pierce
134
Suicide
Cut/pierce
175
Suicide
Fall
156
Suicide
Fall
126
Suicide
Cut/pierce
740
9
Homicide
Drowning
1
Homicide
Fire/burn
11
Suicide
Suffocation
3
Three
Tied
3
Legal Int.
Firearm
79
Suicide
Other
Spec.,
classifiable
118
Legal Int.
Firearm
106
Suicide
Other
Spec.,
classifiable
90
Suicide
Drowning
70
Homicide
Suffocation
68
Homicide
Suffocation
520
10
Two
Tied
1
Two
Tied
2
Three
Tied
3
Homicide
Suffocation
54
Homicide
Suffocation
113
Suicide
Other
Spec.,
classifiable
95
Two
Tied
85
Homicide
Suffocatio
n
61
Homicide
Other
Spec.,
NEC
N
64
Suicide
Other
Spec.,
classifiable
517
N
Not elsewhere classifiable.
WISQARSTM
Produced By: Office of Statistics and Programming, National Center for Injury Prevention and Control, Centers for Disease
Control and Prevention
http://webappa.cdc.gov/cgi-bin/broker.exe

Family wellness conference, oct. 8, 2016

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