Teen Suicide: A Preventable Tragedy

1. Teen Suicide: A Preventable Tragedy Ms. Patrice Davis, Intervention Supervisor Baldwin County Public School System

2. Did You Know? • Every year there are approximately 10 teen suicides for every 100,000 teenagers. • Every day there are approximately 11.5 teen suicides. • Every 2 hours and 5 minutes, a person under the age of 25 completes suicide. American Association of Suicidology (ASA), Youth Suicide Fact Sheet, 2006

3. Teen Suicide Awareness: Statistics • Suicide is the third leading cause of death for young people between the ages of 15-24. • Suicide is the fourth leading cause of death for young people between the ages of 10-14. • Suicide is the second leading cause of death in colleges. • For every one suicide completion, there are between 50 and 200 attempts. • The suicide attempt rate is increasing for young people between the ages of 10-14.

4. Teen Suicide Awareness: Statistics • Suicide has the same risk and protective factors as other problem behaviors, such as drugs, violence, and risky sexual activities. • A recent survey of high school students found that almost 1 in 5 had seriously considered suicide; more than 1 in 6 had made plans to attempt suicide; and more than 1 in 12 had made a suicide attempt in the last year. • The ratio of male to female suicides is 4:1; however, young women attempt suicide four times more frequently.

5. Teen Suicide Awareness: Statistics • Reports of suicide clusters, in which one suicide triggers several others within a school or community, have increased. • Girls who attempt suicide are more likely to try killing themselves by overdosing on pills or by cutting themselves. • Boys who attempt suicide are more likely to choose a method that is more lethal—and quick. Boys more often use guns, jump from great heights, or hang themselves.

6. Teen Suicide: Do You Know the Answers? • Pre Post Test

7. Preparing for and Responding to a Death by Suicide • Inform all staff members about the suicide and provide a debriefing session where staff may voice their concerns, apprehensions, and any questions they may have. • Talk with all students at the beginning of the school day to announce the death of the student. (This is best achieved via small groups.) • Provide counseling sites throughout the school for students. • Avoid any glorification of the suicide such as holding a memorial for the student or in some way honoring the student.

8. Preparing for and Responding to a Death by Suicide • Refer all media inquiries to the Communications Director. • Continually monitor the school’s emotional climate. (Has there been an increase in fights or school delinquency following a death by suicide?) • Evaluate all activities done following a death by suicide. (How did the school respond? What worked and what did not work?)

9. Preparing for and Responding to a Death by Suicide • Utilize an established linkage system or community network in order to make referrals to the appropriate services as well as to exchange information concerning the appropriate steps for treating those affected by the suicide. • Utilize an established school response crisis team, which should include a diverse group of school professionals, such as the principal, counselor, teacher, and possibly the school nurse.

10. Preparing for and Responding to a Death by Suicide • Announcements to Students, Faculty, and Staff • Day One • Day Two • Written Communications • Notification Letter to Parents Following a Suicide • Sample Letter to Send Home • Parent Communications • Sample Response to Incoming Calls from the Media

11. Guidelines for Announcements for Students or Faculty • Share only confirmed facts: who, what, when, where, and how. • Use age-appropriate language. • Refer to the family’s wishes regarding privacy when possible. • When making the announcement, model appropriate leadership and grief response. • Do not sensationalize or make judgments. • Avoid euphemisms and clichés.

12. Suicide Prevention Guidelines • This checklist can be used to quickly evaluate what services and policies your school already has in place (indicated by a “yes”) or what services and policies your school may be lacking that may need to be implemented or revised (indicated by a “no”). Suicide Prevention Guidelines Checklist

13. Checklist for Administrators Responding to a Suicide • This checklist can be used to quickly evaluate what services and policies your school already has in place (indicated by a “yes”) or what services and policies your school may be lacking that may need to be implemented or revised (indicated by a “no”). Administrative Issues Checklist

14. Suicide Prevention Referral Process The following steps outline the suicide prevention referral process for the Baldwin County Public School System: • Talk/conference with the student who is at suicide risk. • Have the student to complete a “No Harm Contract.” This contract should be signed by both the student and the counselor. • Encourage the student to make contact with either the Baldwin County Mental Health Center Crisis Line (1-800-738-2871) or the Mobile Helpline (1-800-239-1117) if he/she feels as though he will change his mind and harm himself.

15. Suicide Prevention Referral Process (cont.) • Notify the school principal of the student who is at suicide risk. • After talking with the student, complete the “Suicide Intervention Form,” which should be forwarded to the Intervention Supervisor via courier. (DO NOT FAX THE SUICIDEINTERVENTION FORM.) The counselor should make a copy for herself, which should be retained for her personal files. The principal’s signature should also be included on this Suicide Intervention Form.

16. Suicide Prevention Referral Process (cont.) • Inform the student’s parent that the child is at suicide risk. (Make contact with the student’s parent via telephone.) • Decide if the student needs to be referred to Baldwin County Mental Health. If he is referred, make sure that the Parent Release of Information is signed, and that the Baldwin County Mental Health Referral Form is also completed. Fax the referral form to 928-0126. (DO NOT FAX THE REFERRAL FORM TO THEINTERVENTION SUPERVISOR.) Direct the parent/guardian to contact Access to Care at 1-800-738-2871.

17. A Suicide In-Service Training Model • Pre-Training Planning • Gaining administrative support • When and where to offer the training • In-service participants • Presentation Components • Pre/Post test • Verbal and behavioral warning signs, as well as general statistics about suicide • School referral procedures • Generate an awareness of personal feelings and attitudes regarding suicide

18. A Suicide In-Service Training Model (cont.) • Explore role plays or case examples • Evaluate for two reasons: (1) to gauge the effectiveness of the in-service format and materials and (2) to assess the amount of knowledge gained

19. Additional Training Activities for Consideration • Asking staff to write down phrases or sentences they have heard that may be verbal warning signs of suicide. • Counselors reading a short story about adolescent suicide to faculty and staff members so they can become more familiar with feelings experienced by suicidal students. • Performing more extensive role plays to help demonstrate how to recognize and refer suicidal students.

20. School Suicide Postvention: Response Protocol • Review risk factors and warning signs with school faculty and support staff • Do not release information in a large assembly or over the intercom • Conduct small group student notifications • Visit the victim’s classes • Provide psychoeducation and/or psychological first aid services for impacted students and staff, as indicated

21. School Suicide Postvention: Response Protocol • Notify parents of highly affected students • Provide recommendations for community-based mental health services • Conduct faculty planning session • Hold evening meeting for parents • Provide information on community-based funeral services/memorials • Collaborate with media, law enforcement, and community agencies • Prepare for secondary adversities/anniversaries

22. School Suicide Postvention: Key Messages • Points to emphasize to students, parents, media: • Prevention (warning signs, risk factors) • Survivors are not responsible for death • Mental illness etiology • Normalize anger • Stress alternatives • Help is available

23. Suicide Postvention: Cautions • Avoid romanticizing or glorifying the event • Avoid vilifying the victim • Do not provide excessive details • Do not describe the event as courageous or rational • Address the loss, but avoid school disruption as best as possible

24. School Suicide Postvention: Intervention Goals • Help students separate facts from rumors • Redirect guilt responses • Ensure understanding that suicide is permanent • Ensure acceptance of reactions as normal • Express that coping will occur with support • Ensure understanding that fleeting thoughts of suicide are not unusual • Ensure student recognition of warning signs and help resources • Ensure understanding of funeral expectations

25. Memorial Activities Following a Suicide • Don’t conduct on campus memorial services • Don’t glorify act • Avoid mass assemblies focusing on the victim • Don’t establish permanent memorials to the victim such as plaques • Don’t dedicate yearbooks, songs, or sporting events to the suicide victim • Don’t fly the flag at half staff • Don’t have assemblies focusing on the suicide victim, or have a moment of silence during an all-school assembly

26. Memorial Activities Following a Suicide • Treat all deaths in the same way • Do something to prevent other suicides (e.g., encourage crisis hotline volunteerism) • Develop living memorials, such as student assistance programs, that will help students cope with feelings and problems • Encourage affected students, with parental permission, to attend the funeral • Encourage parents and clergy to avoid glorifying the suicidal act

27. Memorial Activities Following a Suicide • Provide a day of community service • Sponsor a mental health awareness day • Purchase books on mental health for the school media center • Raise funds for a local crisis center • Create a memory book for the family of the deceased that includes condolences and memories

28. Memorial Activities Following a Suicide • Make a contribution to support a suicide prevention program • Donate blood to the American Red Cross • Establish a scholarship fund

29. Suggestions for Helping Children Grieve After a Suicide • Be honest with your children. Give the correct information in a loving, compassionate way. • Provide a clear and direct explanation. Be careful not to over explain. • Listen carefully. Answer children’s questions truthfully and be consistent in telling the truth about the suicide. • Talk about the deceased family member. • Discuss better ways than suicide to handle problems.

30. Suggestions for Helping Children Grieve After a Suicide • Tell all your children—even the younger ones. • Encourage children to share their grief with those at home and with trusted persons outside the family. • Help children grieve by letting them see your tears, by crying with them, and by letting them know that it’s okay to be upset. • Have a positive attitude toward your children. • Be aware of your children’s possible feelings of guilt. Assure them that it wasn’t their fault.

31. Suggestions for Helping Children Grieve After a Suicide • Let children know that suicide is an individual matter. Even if family members do it, they can still choose not to. • Be aware that children may experience all the many emotions and phases of grief. • Teach your children to be selective about who they tell the story of suicide.

32. Suggested Activities for Raising Awareness of Teen Suicide • Provide an in-service for staff about suicide issues • Provide presentations to schools, churches, parents, etc. in your local community, to local legislators and politicians • Ask local community leaders to declare the first week in September as Suicide Prevention Week • Utilize the visual arts to emphasize suicide prevention, i.e., art/poster contests, etc.

33. Suggested Activities for Raising Awareness of Teen Suicide (cont.) • Send a letter home to parents about suicide, means of prevention, and resource information including the Info line number: 2-1-1 • Check with area youth service bureaus, libraries, schools, etc. for information on local initiatives regarding Youth Suicide Prevention Week • Include information about suicide prevention in your agency communiqué

34. Suggested Activities for Raising Awareness of Teen Suicide (cont.) • Encourage and support student involvement • Hold a fundraiser/awareness raiser for a suicide prevention foundation • Ask the local paper to write on some aspect of teen suicide prevention. Other possibilities include: a school or college newspaper, radio, television, public access networks, pod-cast(s), blogs, etc.

35. Community Resources • Alabama Chapter of the American Foundation for Suicide Prevention 3918 Montclair Road, Suite 210 Birmingham, Alabama 35213 205-323-4433 or www.afsp.org A leading not-for-profit organization exclusively dedicated to understanding and preventing suicide through research, education, and advocacy, and to reaching out to people with mental disorders and those impacted by suicide.

36. Community Resources • Baldwin County Mental Health Center 372 South Greeno Road Fairhope, Alabama 36532 928-9500 Maintains a 24-hour crisis line with professional staff available to respond to persons in crisis because of serious emotional, mental, and substance abuse problems.

37. Community Resources • Bay Area Grief Coalition 432-6200 or contactus@dauphinwayumc.org Provides grief support for children and teens, ages 4-19, who are grieving the loss of a close family member Meetings are held the 3rd Saturday of each month at Dauphin Way United Methodist Church from 10:00 a.m.-11:30 a.m. in McGowin Hall Support is also available for adults who are dealing with their child’s grief.

38. Community Resources • Fairhope United Methodist Church 155 South Section Street Fairhope, Alabama 36532 928-1148 or www.fairhopeumc.org Offers a support group for students who are coping with suicide loss • Family Counseling Center of Mobile, Inc. 431-5111 Monday-Friday or 1-800-273-TALK A suicide hotline that is available 24 hours a day/7 days a week This anonymous, confidential community resource serves Mobile, Baldwin, Clarke, and Washington Counties

39. Community Resources • National Hopeline Network 1-800-784-2433 This national crisis hotline network automatically connects people who are depressed or suicidal, or those who are concerned about someone they love, to a CONTACT USA or AAS certified crisis center. • Suicide Prevention Hotline 1-800-273-8255 A free, 24-hour hotline available to anyone in suicidal crisis or emotional distress

40. Community Resources • Survivors of Suicide 979-5705 Contact Mr. Bill Specht for information This is a resource for anyone whose life has been affected by another’s suicide. This resource is not for individuals who are suicidal.

41. Community Resources • Youth Suicide Prevention Program c/o Catholic Social Services 400 Government Street, Mobile, AL 36602 434-1550 ext. 27 Contact: Mrs. Buffy Marston Jason Foundation Program—counsels students ages 4-18; strives to provide students with accurate information and tools to identify the warning signs of suicide, how to provide peer support, and learn where to get help. Provide educational classes to school groups and youth programs in Mobile and Baldwin counties. Also provides one on one counseling to individuals of all ages who are experiencing suicidal thoughts or whose life has been affected by another’s suicide.

42. National Resources • American Association of Suicidology (AAS): The goal of the AAS is to understand and prevent suicide. AAS promotes research, public awareness programs, education, and training for professionals, survivors, and all interested persons. AAS serves as a national clearinghouse for information on suicide. AAS has many resources and publications, which are available to its membership and the general public. • www.suicidology.org • 5221 Wisconsin Avenue, NW • Washington, DC 20015 • 202-237-2280

43. National Resources • NAMI (National Alliance on Mental Illness) is the nation’s largest grassroots mental health organization dedicated to improving the lives of persons living with serious mental illness and their families. Founded in 1979, NAMI has become the nation’s voice on mental illness, a national organization including NAMI organizations in every state and in over 1,100 local communities across the country who join together to meet the NAMI mission through advocacy, research, support, and education • www.nami.org

44. National Resources • Suicide Prevention Resource Center (SPRC) promotes the implementation of the National Strategy for Suicide Prevention and enhances the nation’s mental health infrastructure by providing states, government agencies, private organizations, colleges and universities, and suicide survivor and mental health consumer groups with access to the science and experience that can support their efforts to develop programs, implement interventions, and promote policies to prevent suicide. • www.sprc.org

45. National Resources • The American Foundation for SuicidePrevention (AFSP) is the only national not-for-profit organization exclusively dedicated to funding research, developing prevention initiatives, and offering educational programs and conferences for survivors, mental health professionals, physicians, and the public. • www.afsp.org • 120 Wall Street, 22nd Floor • New York, New York 10005 • 888-333-2377

46. National Resources • Suicide Awareness Voices of Education(SAVE): SAVE’s mission is to prevent suicide through public awareness and education, eliminate stigma, and serve as a resource to those touched by suicide. • www.save.org • 8120 Penn Avenue South, Suite 470 • Bloomington, MN 55431 • 952-946-7998

47. Educational Resource • The Youth Suicide Prevention School-BasedGuideis designed to provide accurate, user-friendly information. The Guide is not a program, but is 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.

48. Resource Books • After a Parent’s Suicide: Helping ChildrenHeal by Margo Requarth • After a Suicide: An Activity Book for GrievingKids by The Dougy Center • An Empty Chair: Living in the Wake of aSibling’s Suicide by Sara Swan Miller • Do They Have Bad Days in Heaven?Surviving the Suicide Loss of a Sibling by Michelle Linn-Gust

49. Resource Books (cont.) • My Son…My Son: A Guide to Healing AfterDeath, Loss, or Suicide by Iris Bolton • Someone I Love Died by Suicide: A Story forChild Survivors and Those Who Care ForThem by Doreen T. Cammarata • Why Did You Die? Activities to Help ChildrenCope With Griefand Loss by Erika Leeuwenburgh and Ellen Goldring • Why Would Someone Want to Die? by Rebecca C. Schmidt

50. Unexpected death is always painful, but perhaps none more so than the self-destruction of a young person and a life, with all its potential and promise, cut short by one desperate and all too final act.