Frank J. Zenere , Ed.S . School Psychologist, Crisis Management Specialist Miami-Dade County Public Schools Miami, Flo

1. RVTS Conference 2014 “Creating a School Culture of Prevention” June 3, 2014 Kristiansand, Norway Frank J. Zenere, Ed.S. School Psychologist, Crisis Management Specialist Miami-Dade County Public Schools Miami, Florida U.S.A.

2. Greetings from Miami

3. Miami-Dade County Public Schools Fourth largest school district in the U.S.A. (350,000 students)

4. 73% of students eligible for free and reduced price lunch 91% of all Miami-Dade students are minority children 50% of all families are foreign born More than 12% of households are headed by a family member with less than a 9thgrade education 75% of families speak a language other than English at home Miami-Dade entered the 21st century with graduation rates barely 55%

5. A Changing World … changing needs M-DCPS meets these changing needs.

6. Student Safety & Health Priority Areas

7. School Safety

8. DID YOU KNOW? Tragic incidents and large scale acts of violence in schools anywhere in the United States are EXTREMELY RARE.

9. Homicides on school grounds during the school day are VERY RARE U.S. Department of Justice, 2012

10. What does research say about the most serious incidences of school violence?

11. Safe School Initiative Findings • Incidents of targeted violence at school rarely were sudden, impulsive acts. • Prior to most incidents, other people knew about the attacker’s idea and/or plan to attack. • There is no accurate or useful “profile” of students who engaged in targeted school violence. • Most attackers engaged in some behavior prior to the incident that caused others concern or indicated a need for help. United States Secret Service and the United States Department of Education, 2002

12. Safe School Initiative Findings • Most attackers had difficulty coping with losses or personal failures. • Many had considered or attempted suicide. • Many attackers felt bullied, persecuted or injured by others prior to the attack. • Most attackers had access to and had used weapons prior to the attack. • In many cases, other students were involved in some capacity. United States Secret Service and the United States Department of Education, 2002

14. Bullying Statistics, 2010, U.S.A. • Approximately, 70-80% of school age students have been involved in bullying during their school years, as a bully, victim or bystander (Graham, 2011). • Children identified as bullies often experience significant mental health problems such as depression (Swearer, Song, Cary. Eagler & Mickelson, 2001). • Victims of chronic bullying suffer severe and profound consequences including; depression, anxiety and are at incresed risk of dropping out of school. • Cyberbulling victims are twice as likely to attempt suicide as others who are bullied (Hinduja & Patchin, 2010). • 90% of bullying takes place between 4th and 8th grades (makebeatsnotbeatdowns.org ). • .

15. DID YOU KNOW? There were 6,477 homeless students identified in Miami-Dade County Public Schools in 2012-2013.

16. Did You Know? • Florida reported 117,612 AIDS cases to CDC, cumulatively, from the beginning of the epidemic through December 2008. • Florida ranked 3rd highest among the 50 states in cumulative reported AIDS cases. • Miami ranks as the top city in the nation with the most reported cases.

17. DID YOU KNOW? • Drug use by 12th grade students in the U.S.A. over the last year. • Alcohol: 70.6% • Marijuana: 34.3% • Stimulants: 10% • Other Opiates: 9.5% • Tranquilizers: 7.3% • Sedatives: 6.5% • Hallucinogens: 6.2% • Cocaine: 5.3% • Inhalants: 4.2% • Steroids:2.5% • Heroin: 0.9% United States Department of Justice, 2012

18. Did You Know? • Currently there are approximately 27 million people enslaved throughout the world with 2.5 million located in the USA. • Florida, with one of the highest incidences of human trafficking in the country, has been identified as a hub for human trafficking. • Trafficking can involve school-age children—particularly those not living with their parents—who are most vulnerable.

19. Mental Health in the U.S.A. At least 1 in 5 children and adolescents has a mental health disorder 1 in 10 has a serious disorder 90% of people who develop a mental disorder show warning signs during their teen years

20. Youth Suicide Data, U.S.A., 2010 • Suicide was the third leading cause of death for 15-24 year olds. • For youth aged 15-19, the suicide rate was 13.62 per 100,000; for children 10-14, the rate was 1.29 per 100,000. • Male youth die by suicide four times more frequently than female youth. • The majority of youth who died by suicide used firearms (44.5% of deaths). Suffocation was the second most common method (39.7% of deaths). American Association of Suicidology

21. Youth Suicide Data in NorwayAge 15-24, Male and Female Year

22. Youth Suicide Data in NorwayAge 15-24, Male

23. Youth Suicide Data in NorwayAge 15-24, Female

24. Youth Suicide Data in NorwayAge 15-24, Male and Female

25. Why Schools Should Address Suicide Maintaining a safe school environment is part of a school’s overall mission. • Other prevention activities (e.g., violence, bullying, substance abuse, etc.) can also reduce suicide risk (Epstein & Spirito, 2009). • Programs that improve school climate and promote connectedness help reduce suicide risk (Blum, McNeely & Rinehart, 2002). • Activities designed to prevent suicide and promote student mental health reinforce the benefits of other student wellness programs. Preventing Suicide: A Toolkit for High Schools, 2012

26. Why Schools Should Address Suicide • 26.1% of high school students, grade 9-12, felt sad or hopeless for two or more weeks • 16 % of high school students, grade 9-12, seriously considered suicide in the previous 12 months • 8% of students, grade 9-12, reported making at least one suicide attempt in the previous 12 months • 30%-40% of teens who die by suicide have made a prior attempt USA, Youth Risk Behavior Survey, 2011, CDC, 2012

27. Why Schools Should Address Suicide Approximately 90% of youth suicide victims suffer from some form of mental illness, the majority of which have a mood disorder. Mental illness can impact student performance in the following ways: • Difficulty concentrating • Academic difficulties • Disruptive behavior • Problems with peers • Increased irritability and aggression • Poor judgment • Excessive sleeping

28. Why Schools Should Address Suicide A student suicide can significantly impact other students and the entire school community. • Taking appropriate and timely actions following a suicide is critical in helping students cope with the loss and preventing additional tragedies. Preventing Suicide: A Toolkit for High Schools, 2012

29. Why Schools Should Address Suicide Schools have been sued for negligence for the following reasons: • Failure to notify parents if their child appears to be suicidal • Failure to get assistance for a student at risk of suicide • Failure to adequately supervise a student at risk Preventing Suicide: A Toolkit for High Schools, 2012

30. Components of Comprehensive School Suicide Prevention Plans • Policy and procedures • Universal, targeted and indicated prevention • Gatekeeper training • Screening • Risk assessment protocol • Resource identification • Case management • Postvention plan Miller, D., SUNY

31. Suicide Prevention Components Tier 3: Intensive, Individual Interventions 1-5% individual students Tier 2: Targeted, classroom, group Interventions 5-10% students Tier 1: Universal, Prevention and Interventions 80-90%% individual students

32. Suicide Prevention: Universal Program Perspectives • Focus upon reduction of risk factors – intrapersonal and interpersonal. • Enhance protective factors - intrapersonal and interpersonal (family, school, community)

33. Risk Factors and Protective Factors • Suicide prevention efforts seek to reduce risk factors and increase protective factors. • Risk Factors are characteristics that make it more likely that a person will think about suicide or engage in suicidal behaviors - could create the impetus for a suicidal act. • Protective Factors are not just the opposite or lack of risk factors. They are conditions that promote strength and resilience and ensure that vulnerable individuals are supported and connected with others during difficult times, thereby making suicidal behaviors less likely.

34. Risk Factors

35. Protective Factors

36. Universal Prevention Components

37. Universal Prevention Components • Skill building lessons for students • Suicide awareness education, including knowledge of warning signs (Middle and Senior High Schools) • Promote help-seeking • Screening of all students • Gatekeeper training for caregivers

38. Suicide Prevention Curricula Purpose • Provide information about suicide prevention • Promote positive attitudes • Increase students’ ability to recognize if they or their peers are at risk of suicide • Encourage students to seek help for themselves and their peers. Preventing Suicide: A Toolkit for High Schools, 2012

39. Suicide Prevention Curricula Content • Basic information about depression and suicide • Warning signs that indicate a student may be in imminent danger of suicide • Underlying factors that place a student at higher risk of suicide • Appropriate responses when someone is depressed or suicidal • Help-seeking skills and resources Preventing Suicide: A Toolkit for High Schools, 2012

40. WHAT WE DO KNOW… • Presenting information to students can increase knowledge, positively affect referral practices and change their negative attitudes toward suicidal youth • Talking about suicide with youth, including warning signs, does NOT result in negative, unintended side effects • Reliable and valid screening and assessment measures and methods are available Miller, D., SUNY

41. WHAT WE DO KNOW The following have lead to reductions in self- reported suicidal behavior • Providing information to students regarding suicide awareness and intervention • Teaching students problem solving and coping skills • Reinforcing protective factors, while addressing risk factors Miller, D., SUNY

42. MIAMI-DADE COUNTY PUBLIC SCHOOLS SUICIDE PREVENTION COMPONENTS Universal Level • Comprehensive Student Services Program PK-12: Meets the academic, personal/social, career/community awareness and health needs of all students. This program provides students with non-academic skills that promote and support student achievement and individual growth.

43. COMPREHENSIVE STUDENT SERVICES PROGRAM • Philosophical Basis • Program Content • Program Modes of Delivery • Resources

44. Philosophical Basis Our Vision- The Division of Student Services provides the necessary resources and services for students to be successful in school, work, and in life.

45. Promoting Healthy Relationships Youth Empowerment Individual Counseling Group Counseling Family Counseling Crisis Prevention Crisis Intervention Community Resources College Assistance Career/Goal Exploration Evaluation Consultation Academic Advisement Support Student

46. Program Content Student Development Framework (standards and benchmarks) Four (4) Areas of skill development • Academic • Personal/Social • Career/Community Awareness • Health and Wellness

47. Program Modes of Delivery • The program modes of delivery organize the work of student services personnel into direct and indirect activities and services. They include the direct services to students, parents, teachers, and administrators through curriculum, planning, responsive services, and indirect services of system support.

48. Resources • The Comprehensive Student Services Program PK-Adult is supported by resources in the form of personnel, funding, policies and procedures, and the community.

49. Goals • Eliminate or reduce barriers to student achievement • Maximize student personal, emotional and social growth • Promote and enhance a healthy and safe learning environment • Provide support to teachers, administrators and staff

50. Miami-Dade County Public Schools Suicide Prevention Components Universal Level • Curricula to Promote Healthy Relationships/Youth Empowerment: provides developmental and transitional strategies to promote physical and psychological health, and the social-emotional well-being of all students (e.g., teen dating violence, sexting).