Child Life Support through

Suicidal Situations

“Keeping More Than Dreams Alive”

Staff TrainingSeminar

Douglas T. Chan, M.S., LPC-Supervisor,

C.A.R.T.

Youth Suicide

“The Silent Epidemic”

The Purpose

To confront the “Silent Epidemic” of youth suicide by equipping Child Life Specialists, young people, and their parents with information, tools, and resources to help identify and assist at-risk individuals.

Attorneys General Attorneys General

in many states have committed to taking a stand against the “Silent Epidemic.”

March 2004 – NAAG Passed Resolution urging AG’s to become involved in youth suicide prevention.

Texas Attorney GeneralGreg Abbott

What Can You Expect Today?

Not meant to make you an expert on youth suicide or a crisis counselor.

We will… help bring an awareness of the problem of youth suicide and suggest ways of identifying and helping “at-risk” youth.

First Step

Awareness

Dr. David Satcher, US Surgeon General, declared

Suicide a “A National Health Problem” ..especially within

the youth and elderly.

In 1999…

How Many young people do

we lose Each Year to Suicide?

In the United States

We will lose in Excess of 5,000 Young People.

It is estimated that…

Each Week in our Nation….

We lose approximately 100+ young people to this “Silent Epidemic” of youth Suicide!

Reported that in the year 2010 over THREE million youth, ages 12-17, were at-risk of suicide.

And, of that THREE million, over ONE million actually attempted suicide.

In July 2012, NHSDA Report / SAMHSA and U.S. Dept. Of Health

In a typical week, there are more than 19,000 suicide attempts nationally!

Almost two attempts each minute - 2700+ per day

That Means…

Girls attempt suicide

over three times more

than boys. Why?

Fact

Fact

However, boys complete suicide over three times more than girls.The reason for the difference…

Choice of means:

Girls usually choose drugs, which can provide a “window

of opportunity” for intervention.

Boys usually choose firearms, which are more lethal.

Girls are turning to more lethal means at an alarming rate. If this continues, the number of completed suicides will rise at an even higher pace.

A recent trend…

Firearms are used in almost 70% of completed suicides…. Since 1980, 90% of the increase in suicide attempts has been through the use of firearms.

Fact

Suicide is the THIRD leading cause of

death for youth ages 15-24

Fact

Suicide is now the SECOND leading cause of death for college-age youth.

Fact

In Ages 10-14, We have seen an alarming 128% increase in Suicides since 1980- making it the 4th leading cause of death

for that age group.

Fact

In the last 40 years…

youth suicide rates have more

than tripled.

More teenagers and young adults die from suicide than from

cancer, heart disease, AIDS, birth defects, stroke, pneumonia and

influenza, and chronic lung disease, COMBINED

Did you know?

Youth Risk Behavioral Survey2012 - CDC

This survey covers a broad range of questions concerning behavioral actions and thoughts from our youth. It is presented in public schools to grades 9-12 – some districts choose to include grades 7-8.

Question #1

“Have you felt sad or hopeless almost every day in a row for two weeks or greater so that it affected your usual activities in the past twelve months?”

Nationally 28.5% Over 1 out of every 4 Students

Question #2

“Have you seriously considered suicide in the past twelve months?”

Nationally 16.9% 1 out of every 6 students

Question #3

“Have you made a plan on how to commit suicide in the past twelve months?”

Nationally 13% 1 out of every 8 students

Question #4

“Have you attempted suicide one or more times in the past twelve months?”

Nationally 8.4%

Almost 1 out of every 12 students

What About Our State?

Texas

Question #1

“Have you felt sad or hopeless almost every day in a row for two weeks or greater so that it affected your usual activities in the past twelve months?”

Texas – 31.4%

Almost 1 out of 3 battled the start of depression

Question #2

“ Have you seriously considered suicide in the past twelve months?”

Texas – 15.9%

Almost 1 out of 6 seriously considered suicide.

Question #3

“Have you made a plan on how to commit suicide in the past twelve months?”

Texas – 12.2 %

1 out of 8 made a plan to commit suicide

Question #4

“ Have you attempted suicide one or more times in the past twelve months?”

Texas – 9.4 %

1 out of 11 attempted suicide

• Beginning Depression – 605,256

• Seriously Consider Suicide – 306,483

• Will Make a Plan – 235,163

• Will Make an Attempt – 181,914 or an average of 496 young people each day!

What does that mean in real lives for Texas ??

Utilizing 2005 Student Population

Key to Prevention:

Education

Four out of five completed suicides gave “clear warning” signs

before the attempt!

According to the National Mental Health Association

That means…

In 80% of suicide attempts…..we have an “opportunity” to recognize the warning signs and intervene!

Do not normalize

It is important to remember and share that not everyone is attempting suicide. (1 out of 12 did, 11 did not attempt etc.)

However, we must not understate suicide’s impact on our youth, families and communities.

One is too many!

Youth

Educators Parents

Triangle of Prevention Programs and Seminars

An effective program of prevention

must include the three main

areas of influence in a

young person’s life.

What Can Be Done:

Increase awarenessDispel Myths Educate Learn warning signs and

elevated risk factors

Increasing Your Awareness

Increasing Awareness through; Listening to the patient’s words and meanings. Paying attention the patient’s actions and lack of

actions Listen to the family and friends. Pay attention to what the patient desires to do and

what he/she is not wanting to do. Don’t Be afraid to ask questions.

Dispelling Myths

Talking to a person about his/her suicidal feelings may cause him/her to attempt suicide.

Someone who talks about suicide often is not a risk.

Suicide is impulsive and there is nothing we can do to prevent it.

Signs of Concern

A general listing by The U. S. Surgeon General’s Office, these

are sometimes referred to as

Warning Signs

It is important to note that these represent a few general signs of

concern and are not to be considered a comprehensive list that always

indicates suicidal intentions.When in doubt, always seek

professional help!

Important

Remember that many times signs of concern can be considered part of normal growth unless…

They persist over a long period of time,

There are several signs evident at once or

The behavior is “out-of-character” for the individual as you know him/her.

Five Signs of Concern:

Suicide Threats Previous Suicide Attempts Depression Out of Character Behavior Final Arrangements

Suicide Threats

“I would be better off dead!”“You won’t have me around much longer

to bother you!”“I wish I was dead”“I am going to kill myself”…(this is

straight forward, but it happens)

Can you think of other examples….

Previous Suicide Attempts

Four out of five completed suicides are not the first attempt by the victim.

Take even so-called “half-hearted” attempts seriously…these are serious calls for help!

Never keep an attempt secret from parents / school officials (counselors).

Depression

In a study conducted by the U.S. Surgeon General’s office in 2010, it was reported that one out of seven teenagers in our nation could be considered “clinically depressed”.

Depression in young people often times exhibits itself through “out-of-character behavior”.

Out-of-Character Behavior may include:

Abrupt changes in attendance…

Dwindling academic performance

Sudden failure to complete assignments

Lack of interest and withdrawal

Sudden changes in appearance

Changed relationships with classmates

Increased irritability or aggressiveness

Preoccupation with death and suicide

Despairing attitude Abrupt changes in

eating and sleeping habits

Final Arrangements

Giving away “prized possessions” Examples: favorite piece of jewelry or clothing, driver’s license, collection, etc.

“Making rounds” (visiting friends to set things right and say good-bye)

Sharing of funeral plans (primarily by girls to a best friend).

Can you think of any other “Signs of Concern” that

could signal that a student might be having problems?

Additional Signals

If you have any doubt of a young person’s intentions or

any concern about their behavior, get professional

help for them immediately!

Basic Rule to Remember

Although there is really no suicidal type of young person, the

statistics on youth suicide do suggest that there are certain

behaviors or characteristics that can alert you to an elevated risk

of possible suicidal ideation.

Elevated Risks

Elevated Risk Factors:

PerfectionistsLow self esteemDepressed TeensStudents first

real troubleAbused,

molested or neglected youth

LonersGay/ Lesbian

youthLearning-DisabledChanges in school

statusAbusers of Drugs /

Alcohol

The Don’ts• Don’t Panic.• Don’t ignore the situation and hopes that it goes away.• Don’t blame the patient for the choices that he/she has made.• Don’t look for quick fix solutions to make the patient feel

better.• Don’t criticize or blame the patient for the way that they are

and have been feeling.• Don’t trivialize, normalize or dismiss the issues that the

patient may be going through. • Don’t be patronizing, assuming, or judgmental.• Don’t take it personally. (Q-TIP)

The Don’ts (con’t)

• Don’t leave the patient alone if they are claiming a suicidal risk.

• Don’t make promises that you can not keep (i.e.. Keeping their suicidal feelings a secret).

• Don’t Argue with the suicidal person. Avoid saying things like: "You have so much to live for," "Your suicide will hurt your family," or “Look on the bright side.”

• Don’t lecture on the value of life, or say that suicide is wrong

The Don’ts (con’t)

• Don’t offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one

• Don’t blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility.

The Do’s• Do be there for the patient.• Do ask if the patient is thinking about suicide.• Do check out their safety. (Think safety with the

items that you may use with the patients.)• Do ask if the patient has a plan and the means to

complete the plan. • Do ask for a promise.• Do Stay involved and hand off any

communication.• Do take care of yourself.

The Do’s (con’t)

• Do look, listen and learn from what the patient is doing and saying.

• Do ask the patient to consider talking with their family about the situation.

• Do consider talking with the family and friends about the ongoing situation.

• Do consider working with the MD about a psych consult.

• Do work with your team for the best outcome.

References• American Academy of Pediatrics - http://www.aap.org/• American Foundation for Suicide Prevention - http://www.afsp.org/• American Psychiatric Association - http://www.psych.org/• American Psychological Association - http://apa.org/• Center for Disease Control and Prevention - http://www.cdc.gov/• Jason Foundation - http://jasonfoundation.com/• National Survey on Drug Use and Health - http://www.whitehouse.gov/ondcp/national-survey-on-drug-use-and-health• Office of the Attorney General Texas - https://www.oag.state.tx.us/• Office of the Surgeon General - http://www.surgeongeneral.gov/• SAMHSA - http://www.samhsa.gov/• Suicide Awareness Voices of Education - http://www.save.org/• Suicide Prevention Resource Center - http://www.sprc.org/states/texas• Texas Counseling Association - http://www.txca.org/• Texas Department of State Health Services - http://www.dshs.state.tx.us/mhsa/suicide/Suicide-Prevention.aspx• Texas Suicide and Crisis Hotline - http://www.suicidehotlines.com/texas.html• Texas Suicide Prevention - http://www.texassuicideprevention.org/• U.S. Department of Health and Human Services - http://www.hhs.gov/• Youth Risk Behavior Surveillance System (YRBSS) - http://www.cdc.gov/HealthyYouth/yrbs/index.htm

Thank YouDouglas T. Chan, M.S., LPC-Supervisor, C.A.R.T.

(281) 826 – 1699douglas.chan.lpc-s@comcast.net

KBCC2323 Timber Shadows Drive, Suite B

Kingwood, Texas 77339

KPH2001 Ladbrook Drive

Kingwood, Texas 77339