Fairhope Middle School

1. Fairhope Middle School Teen Suicide Prevention Training

2. Teen Suicide Prevention Training Outline I. Why Suicide Prevention is Important II. Staff Responsibility III. Your Role Simplified IV. Seriousness of All Suicide Threats V. First Step-Assess Attitudes About Suicide VI. Suicide Myths and Facts VII. Risk Factors and Warning Signs VIII. Teen Depression IX. Protective Factors X. FMS Suicide Prevention Referral Process XI. Self-Harm and Reporting

3. EVERY… • 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 completes suicide

4. Why Suicide Preventionis Important • Third leading cause of death for teens • Second leading cause of death in colleges • For every completion, there are between 50-200 attempts • CDC Youth Risk Survey: 8.5% grades 9-12 reported attempt in past year • 25% high school students report suicide ideation • Attempt rate increasing for 10-14 year olds • Same risk and protective factors for suicide as other problem behaviors such as drugs, violence, risky sexual activities

5. Staff Responsibility • Understand the importance of your critical but limited role in the identification of students at-risk for suicide • Familiarize yourself with school policies and procedures that address this issue • Learn information that facilitates identification of at-risk students • Listen to students, verbally and nonverbally, for warning signs • Identify those students who may be at elevated risk based on that identification • Refer those students to appropriate resources

6. Your Role Simplified: • Learningsigns of risk in students • Identifyingat-risk students • Referringto appropriate resources

7. Consider “Zero Tolerance”for Suicide • Demonstrates school’s commitment to the welfare of all its students • Sends message that personal violence is as much a concern as other-directed violence • Reinforces fact that suicide is taken seriously-Any suicidal threat even said in a joking manner is taken seriously • Reminds school community that resources are available for at-risk students

8. Assessing Attitudes About Suicide Your First Step:

9. Talking About Suicide On a 1 to 10 scale, rank how comfortable you are talking about suicide. ----------------------+----------------------- 1 5 10 Very Uncomfortable Very Comfortable

10. True False True False Suicide Myths & Facts 1. If questioned, youth will admit suicidal thoughts or behaviors to parents.

11. True False True False Suicide Myths & Facts 2. It is inaccurate and sexist to suggest that there is a difference in suicidal behavior between boys and girls.

12. True False True False Suicide Myths & Facts 3. People who talk about suicide don’t complete suicide - they are just seeking attention.

13. True False True False Suicide Myths & Facts 4. Talking about suicide can plant the idea in the minds of at-risk youth.

14. True False True False Suicide Myths & Facts 5. The only one who can really help a suicidal student is a counselor or mental health professional.

15. True False True False Suicide Myths & Facts 6. Once a youth is suicidal, he / she is suicidal forever.

16. Risk Factors / Warning Signs Red -Warning Signs Yellow -Risk Factors Green -Protective Factors

17. SuicideWarning Signs • Suicide risk factors endure over some period of time, while warning signs signal imminent suicide risk • Clearest warning signs for suicide are behaviors that indicate the person is thinking about or planning for suicide, or is preoccupied or obsessed with death Looking for ways to kill oneself (e.g., searching the internet for methods, seeking access to firearms or other means for suicide) Talking or writing about suicide Talking or writing about death in a way that suggests preoccupation

18. Risk Factors for Teen Suicide • Key suicide risk factorfor all age groups is an undiagnosed, untreated or ineffectively treated mental disorder • 90% of people who die by suicide have a mental disorder • In teens, suicide risk is most clearly linked to 7 mental disorders, often with overlapping symptoms: Major Depressive Disorder Conduct Disorder Bipolar Disorder Eating Disorders Generalized Anxiety Disorder Schizophrenia Substance Use Disorders

19. Let’s Talk About Teen Signs and Symptoms of Teen Depression:A teen may be depressed if He/She experiences at least 5 of these symptoms for at least 2 weeks:✔Feeling more irritable or angry than usual✔Losing or gaining a significant amount of weight (not due to diet) or dramatic change in appetite✔Having trouble sleeping or sleeping too much✔Physical feelings of restlessness or being slow, sluggish✔Not having any energy✔Feeling worthless or guilty (no clear cause)✔Not being able to concentrate or make decisions ✔Thinking about wanting to end His/Her life

20. Risk Factors FAMILY • History of suicide EXPOSURE • To suicide (personally or in media) • Death of peer under any circumstance RECENT, SEVERE STRESSORS • Loss • Trouble • Change – transition

21. Students at Higher Risk • Threatening suicide • Looking for access to means • Talking or writing about death, dying, suicide • Previous attempt seriousenough to requirehospitalization

22. Risk Factors vs.Protective Factors

23. Protective Factors • Contact with a caring adult • Sense of connection orparticipation in school • Positive self-esteem andcoping skills • Access to and care formental / physical / substancedisorders

24. Fostering Protective Factors • Teach students it is okay to ask for help • Give students permission to talk abouttraumatic events like suicide • Help students identify trusted adults • Encourage participation inschool & community activities • Acknowledge student efforts • Be a good listener, as often as you can

25. So Here’s Your Homework: Remember your role: - Identify - Listen - Refer

26. Fairhope Middle School’s Suicide Prevention Referral Process • What do you do if a student tells you, or you hear that he/she is threatening to harm him/her self? Take it seriously even if said in a “joking” manner. • Notify Kathryn Doyle, or Chesley Bowling, School Counselors, immediatelyor an Administrator if the Counselors are off campus. Do not wait until the end of the school day. You may email us, however, if we do not respond within 15 minutes, it is your responsibility to communicate this information to us face to face. If it is after 2:30 pm, it is imperative that you do not email us, but find us to convey this information.

27. Fairhope Middle School’s Suicide Prevention Referral Process Continued • Please do not send a student to the Counselor’s office unescorted who is a suicide risk.Students must be escorted by an adult. There is school system protocol that has to be followed by the School Counselor, which includes a conference with the student and telephone contact with the guardian. This must occur prior to the student leaving campus for the day. Be prepared to communicate to the School Counselor specific information regarding the self harm statement, the context in which it was said, and identify any students who were privy to the information. After notifying the School Counselor or Administrator, keep confidentiality, and do not talk to others about it.

28. Self-Harm Behavior Self-harm refers to hurting oneself to relieve emotional pain or distress. The most common forms of this behavior are cutting and burning. One major reason why some teens self-harm is the endorphin effect. When they cut or burn themselves, endorphins are quickly secreted into their bloodstreams and they experience a numbing or pleasurable sensation. For some of these youth, cutting or burning themselves numbs away unpleasant thoughts and feelings or they feel "high" from the experience. Like addiction to a particular drug, the endorphin "high" provides fast-acting relief for these teens from their emotional distress and other stressors in their lives. Cutting can become habit forming. Teens may also self- harm because they want to "fit in" within a particular peer group that encourages and rewards self-harming behavior. Most teens who cut aren't attempting suicide. Cutting is usually a person's attempt at feeling better, not ending it all. Although a student may not be suicidal who is cutting, it is dangerous behavior and needs to be reported to an adult. It's possible to misjudge the depth of a cut, making it so deep that it requires stitches (or, in extreme cases, hospitalization). Cuts can become infected if a person uses non sterile or dirty cutting instruments — razors, scissors, pins, or even the sharp edge of the tab on a can of soda.Mental health counselors can help students who self-harm learn healthier ways to cope with life stressors. REPORT CUTTING AND OTHER SELF-HARM BEHAVIOR TO THE SCHOOL COUNSELORS

29. Revisit This Question: On a 1 to 10 scale, rank how comfortable you are talking about suicide, now? ----------------------+----------------------- 1 5 10 Very Uncomfortable Very Comfortable