Suicide Prevention Workshop Evergreen Valley College October 14, 2009

1. Suicide Prevention WorkshopEvergreen Valley College October 14, 2009 1 Mary & Victor Ojakian October 14, 2009

2. Suicide Prevention Workshop Evergreen Valley College Agenda • Topics • Basic Information • Suicide Risks, Warning Signs, and Protective Factors • Myths About Suicide Prevention • Helping Someone With Suicide Ideation • Suicide “Survivors” • Available Help / Resources • Some Websites • Ending Remark • Contact 2 Mary & Victor Ojakian October 14, 2009

3. Suicide Prevention Workshop Evergreen Valley College Suicide Prevention Basic Information • Suicide: a significant national, public health crisis (US Surgeon General, 1999) • Limited public awareness, understanding, or conversation: Stigma on Steroids (SoS) • An underlying mental health need, especially mood disorders, schizophrenia, anxiety disorders, and borderline personality disorders. • No gene identified, though generic cause • No medication treatment, though lithium and clozapine are effective • Some best practice treatments: therapy, including Cognitive and Dialectic Behavior Therapy 3 Mary & Victor Ojakian October 14, 2009

4. Suicide Prevention Workshop Evergreen Valley College Basic Information • Some statistics on death by suicide: • Every sixteen (16) minutes an American dies • 32,000 Americans die annually • 4,000 deceased below the age of 24 • 10 to 20 times more Americans attempt suicide – 520,000 to 720,000 attempts • 3,300 Californians die annually • Increase rate of suicide by young people since 2004 • For more information see: http://www.sprc.org/stateinformation/PDF/statedatasheets/sprc_national_data.pdf 4 Mary & Victor Ojakian October 14, 2009

5. Suicide Prevention Workshop Evergreen Valley College Basic Information, continued • Suicide data in Santa Clara County: • Between 100 to 160 deaths annually • Rate: 6.7 per 100,000 (low rate for California counties) • Attempts range from 600 to 900 annually • Suicidal ideation: about 3,000 people annually (Santa Clara County Suicide and Crisis Hotline data) 5 Mary & Victor Ojakian October 14, 2009

6. West Valley College: National College Health Assessment (NCHA) – Spring 2007 • Factors Impacting Academic Performance: • Stress 32.2% • Sleep Difficulties 26.1 • Cold/Flu/Sore Throat 23.6 • Concern for Troubled Friend or Family Member 21.3 • Depression/Anxiety Disorder/Seasonal Affective Disorder 15.6 • Relationship Difficulty 14.1 • Internet Use/ Computer Games 13.3 • Death of friend or Family Member 12.0 • Attention Deficit Disorder 11.4 • Sinus Infection/Ear Infection /Bronchitis/Strep Throat 9.6 • Learning Disability 8.2 • Alcohol Use 6.0 • Injury 5.2 • Allergies 5.0 • Drug Use 4.1 • Chronic Illness 3.9 • Eating Disorder/Problem 3.0 • Chronic Pain 2.4 Mary & Victor Ojakian October 14, 2009

7. Suicide Prevention Workshop Evergreen Valley College Quote • “It was simply the end of what I could bear, the last afternoon of having to imagine waking up the next morning only to start over again with a thick mind and black imaginings. It was the final outcome of a bad disease, a disease it seemed to me I would never get the better of. No amount of love from or for other people – and there was a lot – could help. No advantage of a caring family and fabulous job was enough to overcome the pain and hopelessness I felt; no passionate or romantic love, however strong, could make a difference. Nothing alive and warm could make its way in through my carapace. I knew my life to be a shambles, and I believed – incontestably – that my family, friends, and patients would be better off without me. There wasn’t much of me left anymore anyway, and I thought my death would free up the wasted energies and well-meant efforts that were being wasted in my behalf.” • Kay Redfield Jamison, Night Falls Fast (p 290 – 291), about her suicide attempt at age 28 Mary & Victor Ojakian October 14, 2009

8. Suicide Prevention Workshop Evergreen Valley College Suicide Risk Factors • Be aware of factors (risks) that make a person more vulnerable: • Hopelessness • Major mental health disorders (mostly major depression) • Alcohol and other substance abuse disorders • Previous suicide attempt(s) • Easy access to lethal means • Local clusters of suicides (contagion) • Lack of social support and sense of isolation • Stigma associated with help-seeking behavior • Trauma and childhood abuse • Media exposure to suicide and the influence of high profile death(s) by suicide • Additional information at: http://www.sprc.org/library/srisk.pdf • Source: Suicide Prevention Resource Center 8 Mary & Victor Ojakian October 14, 2009

9. Suicide Prevention Workshop Evergreen Valley College Suicide Warning Signs • There are behaviors (warning signs) that cause concern: • Threatening to hurt or kill themselves • Seeking a method (means) • Talking or writing about death, dying, or suicide • Feelings of hopelessness • Showing rage or anger • Acting reckless or doing risky activities • Trapped feeling • Excess alcohol or drugs use • Withdrawn behavior and sleeping problems • Dramatic mood changes • Expressing no reason for living • Source: National Alliance on Mental Illness (NAMI) 9 Mary & Victor Ojakian October 14, 2009

10. Suicide Prevention Workshop Evergreen Valley College Suicide Prevention Actions and Protective Factors • There are actions (protective factors) that can help prevent a suicide: • Effective clinical care • Easy access to clinical interventions and support • Restrict access to lethal methods (means) • Strong family and community support • Ongoing medical and mental health care • Developing skills to avoid risky behaviors • Supportive cultural and religious beliefs • Additional information at: http://www.sprc.org/library/srisk.pdf • Source: Suicide Prevention Resource Center 10 Mary & Victor Ojakian October 14, 2009

11. Suicide Prevention Workshop Evergreen Valley College Myths About Suicide Prevention • Myth: People who talk about suicide do not commit suicide. • Fact: Most people who commit suicide have talked about or given definite warning signs of their suicidal intentions. • Myth: Suicide happens without warning. • Fact: There are almost always warning signs, but others are often unaware of the significance of the warnings or unsure about what to do. • Myth: Suicidal people are fully intent on dying. Nothing others do or say can help. • Fact: Suicide is preventable. Most suicidal people desperately want to live; they are just unable to see alternatives to their problems. • Reference: American Association of Suicidology 11 Mary & Victor Ojakian October 14, 2009

12. Suicide Prevention Workshop Evergreen Valley College Myths About Suicide Prevention • Myth: Once someone is suicidal, they are suicidal forever. • Fact: Most suicidal people are suicidal for only limited periods of time. However, someone who has made an attempt is at increased risk for future attempts. • Myth: Suicide strikes most often among the rich, or conversely, among the poor. • Fact: Suicide cuts across social and economic boundaries. • The San Francisco Suicide Prevention Crisis Line quiz: http://www.sfsuicide.org/html/quiz.html • Reference: American Association of Suicidology 12 Mary & Victor Ojakian October 14, 2009

13. Suicide Prevention Workshop Evergreen Valley College Helping Someone With Suicide Ideation • What training and knowledge would help to prevent a suicide: • Gatekeeper training: QPR – Question, Persuade, Refer • Mental Health First Aid • Crisis Intervention Team (CIT) – for first responders • See SPRC for best practices: http://www.sprc.org/featured_resources/bpr/index.asp • Source: CrisisLink: http://www.crisislink.org/ 13 Mary & Victor Ojakian October 14, 2009

14. Suicide Prevention Workshop Evergreen Valley College Helping A Suicidal Person • Listen attentively to everything that the person has to say • Comfort the person with words of encouragement • Let the person know that you are deeply concerned • If the person is at a high risk of suicide, do not leave him or her alone • Talk openly about suicide • When in doubt about what to do, call 911 immediately. Be safe • Don't promise confidentiality • Source: Suicide.org 14 Mary & Victor Ojakian October 14, 2009

15. Suicide Prevention Workshop Evergreen Valley College Suicide Survivors • Survivor definition: people who have lost a loved one to suicide • Survivors’ reactions: (Night Falls Fast by Kay Redfield Jamison) • Denial, disbelief and depression • Anger and rage • Intense loneliness and a pervasive sense of loss • Blame and guilt • Survivor support and grief groups: • American Foundation For Suicide Prevention • County Mental Health support group • Local grief support groups (e.g., KARA) 15 Mary & Victor Ojakian October 14, 2009

16. Suicide Prevention Workshop Evergreen Valley College Available Help / Resources • Suicide and Crisis Hotline numbers: • National: 1-800-273-TALK • San Francisco: (415) 781-0500 San Mateo: (650) 579-0353 • Santa Clara: (408) 683-2482 (south) and (650) 494-8420 (north) • Santa Clara County Urgent Care and Emergency Psychiatric Services (EPS) • Your school psychology center • County and community mental health providers and agencies • Palo Alto Veterans Hospital and County Office of Veterans Services • Golden Gateways, Catholic Charities of Santa Clara County (elderly) 16 Mary & Victor Ojakian October 14, 2009

17. Suicide Prevention Workshop Evergreen Valley College Some Websites • American Foundation for Suicide Prevention (AFSP) http://www.afsp.org/ • American Association of Suicidology (AAS) http://www.suicidology.org/web/guest/home • Suicide Prevention Resource Center (SPRC) http://www.sprc.org/ • California Office of Suicide Prevention (OSP) http://www.dmh.ca.gov/PEIStatewideProjects/SuicidePrevention.asp • National Alliance on Mental Illness (NAMI) http://www.nami.org/ • Jed Foundation: http://www.jedfoundation.org/ 17 Mary & Victor Ojakian October 14, 2009

18. Suicide Prevention Workshop Evergreen Valley College Ending Remark • "For some, talking about suicide is awkward. Our goal is to stop suicides, and to do that we need everyone's willingness to talk about it.“ • Dr. Ileana Arias, director of CDC's National Center for Injury Prevention and Control (News release September 6, 2007) 18 Mary & Victor Ojakian October 14, 2009

19. Suicide Prevention Workshop Evergreen Valley College The End • Questions & Answers 19 Mary & Victor Ojakian October 14, 2009