BUILDING COMPETENT COMMUNITIES FOR YOUTH SUICIDE PREVENTION

Maureen M. Underwood, LCSWmaureenunderwoodlcsw@gmail.com

Society for the Prevention of Teen Suicide1

Workshop Leader

• Maureen M Underwood LCSW

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Lead author, Lifelines Suicide Prevention Trilogy

Previous coordinator, NJ Youth Suicide Prevention Program

Clinical director, Society for the Prevention of Teen Suicide

•Review information about youth suicide , including bullying as a risk factor

•Relate youth suicide prevention to bullying initiatives

•Describe the role of the “competent community” in youth suicide prevention

•Outline how community members can participate in the prevention effort

•Help you better recognize youth who may be at risk

Workshop Objectives

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Is Bullying a Suicide Risk Factor

• Frequent exposure to bullying or victimizing others related to high risks for:– Depression– Suicidal ideation– Suicide attempts

Klomek etal. (2007). Bullying, depression and suicidality in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry ; 46(1);40-49.

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Students Involved In Bullying: Increased Risk for Suicide (12mos) Compared to Youth Not Involved in Bullying

Middle School • Ideation:

– Targeted students: 3x more likely

– Students who bullied: 4.1x more likely

– Bully/Targets: 6.6 x more likely

• Attempts– Targeted students: 2.1x more

likely– Students who bullied: 4.4x– Bully/Targeted students: 7.5x

Data from Massachusetts, 2009

High School• Ideation:

– Targeted students: 3.9x– Students who bullied: 2.9x

more likely– Bully/Targeted students:

4.9x more likely

• Attempts– Targeted students: 4.3x

more likely– Students who bullied: 3.1x– Bully/Targeted students:

5.7x

Victimization-Suicidality Pathway

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What School Strategies Help Reduce Bullying?

Research clearly shows that the key to reducing bullying (and creating lasting, positive change in school climate) is to get everyone in the school community involved in building a competent, caring community.

• Third-leading cause of death in adolescents

• Second-leading cause of death among college students

• There are 50 to 200 attempts for every completion

• Almost 7% of high school students report making a suicide attempt

• Over 14% of high school students report suicidal thoughts

Why Talk about Youth Suicide?

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• Every year, there are approximately 10 youth suicides for every 100,000 youth

• Every day, there are approximately 11 youth suicides

• Every 2 hours and 11 minutes,

a person under the age of 25 dies by suicide

In Simpler Numbers …

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WHY HAVE A “COMMUNITY PLAN”?

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A ‘Competent’ Youth Suicide Prevention Community

• Community leaders/key stakeholders are committed to welfare of all members of the community

• Everyone in community is committed to preventing youth suicide

• Everyone knows where to get help when a community member is in need

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Includes:

• Community leaders

• All segments of the community:– Government– Law enforcement– Education– Recreation– Clergy– Business– Community service agencies

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Focuses on:

• Developing community awareness of dimensions of the problem

• Engaging community & school leaders

• Assessing needs & existing services

• Developing action plans that target identified needs & anticipate emerging ones

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…AND WHAT DO YOU WANT TO KNOW?

Starting at the beginning:What Do You Already Know About Youth Suicide…

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AnsweringCommon Questions

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Aren’t mental health

professionals the only ones who can

really help suicidal kids?

Answering Common Questions

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Can Suicide Really be Prevented?

Can Suicide Really be Prevented?

Answering Common Questions

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Answering Common Questions

Is Talking about Suicide Just a Way for Someone to Get Attention?

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Answering Common Questions

Can Talking about Suicide Plant the Idea in the Minds of Vulnerable Teens?

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Are School Programs That Address Suicide Safe?

Answering Common Questions

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Understanding Suicide

“A problem well-defined is a problem half- solved”

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Suicide

An attempt to solve a problem of intense psychic pain with impaired problem-solving skills

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Characteristics of Suicide

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Overlap Theory of Suicide Risk

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Red: Warning Signs

Yellow: Risk Factors

Green: Protective Factors

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F = Feelings

A = Actions

C = Changes

T = Threats

S = Situations

Warning Signs

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Feelings• Hopelessness

• Anger

• Worthlessness

• Emptiness

• Excessive worry

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Actions• Trying to get access to guns or pills

• Risky or dangerous behaviors

• Increasing drug/alcohol use

• Getting into fights

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Changes• Changes in moods, actions or behaviors

• Recent prescription of medication with depression as potential side effects

• Adjustment/changes in antidepressant medications

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Threats• Specific verbal statements: I want to die, I

want to kill myself

• Worrisome innuendos

• Themes of death /destruction in school assignments

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Situations• Situations that may serve as a trigger-

when a student’s coping skills are really challenged, especially:– Loss– Change– Getting into trouble

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How a Suicide Crisis Develops

1. Series of problems

2. Attempts to deal with them perceived as unsuccessful

3. Suicide seen as consistent with self-image

4. Suicide perceived as viable option

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Tunnel ThinkingMaking the shift in thinking that can lead to the perception of suicide as an alternative

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THE PERFECT STORM

Suicide RSuicide Risk Factors v. isk Factors v. Protective FactorsProtective Factors

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Protective Factors

• Contact with a caring adult• Sense of connection• Positive self-esteem and good coping

skills• Access to care for emotional/physical

problems, substance abuse• Cultural/religious beliefs that

discourage suicide and promote self-preservation

Fostering Protective Factors

• Teach children it is okay to ask for help

• Give children permission to talk about traumatic events like suicide

• Help children identify trusted adults

• Encourage participation in school & community activities

• Be a resource to parents

•Provides an effective initial response to potentially suicidal students

•Knows where to refer students for additional assistance

The Competent School Community in Suicide Prevention

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•Identification

•Support and Response

•Education

Suicide Prevention Strategies

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Program Goal:•To develop the school-

based expertise and supports needed for responding to the problem of adolescent suicidal behavior

The Lifelines Program

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1. To increase the probability that persons who come into contact with potentially suicidal adolescents:

a. can more readily identify them b. know how to respond to them c. know how to rapidly obtain help

for them d. will be consistently inclined to

take such action2. To make sure troubled youth are

aware of and have access to helping resources so that they are inclined to seek help as an alternative to suicide

Lifelines Objectives

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•Administrative Readiness Consultation

•Faculty and Staff Training

•Parent Workshop

•Student Curriculum

Lifelines Components

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• To present relevant facts about suicide

• To alert students to signs of suicide risk in peers and encourage serious responses

• To outline ways to respond to troubled peers

• To demonstrate positive attitudes about intervention and help-seeking behavior

• To identify resources

Curriculum Learning Objectives

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Identifying risk factors & warning signsKnowing and protective factors

Your Role as Community Members

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• The competent school community engages all members in suicide prevention activities

• The competent school community can increase the effectiveness of responses to at-risk teens, their families, and friends

Putting It All Together

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www.sptsusa.orgSociety for the Prevention of Teen SuicideFocuses on resources for the competent school community

www.sprc.orgSuicide Prevention Resource CenterNational resource

www.afsp.orgAmerican Foundation for Suicide PreventionPrinted materials & resources

www.suicidology.orgAmerican Association of SuicidologyData, resources, links

Additional Resources

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