Baseline Survey

1. Baseline Survey Before the training begins, please fill out the baseline survey and put your completed survey in the box provided. Thank you!

2. Ending A Deadly Silence Florida Suicide PreventionGatekeeper Training Insert your name and agency

3. What to Look For What to Do How to Help Prevention is often a matter of a caring person with the right knowledge being available in the right place at the right time. Adapted with permission from the Washington State Youth Suicide Prevention Program and the Maine Youth Suicide Prevention Program

4. Silent Epidemic Serious public health problem Preventable Neither random nor inevitable Research shows that during our lifetime: 20% of us will have a suicide within our immediate family 60% of us will personally know someone who dies by suicide

5. Attitudes and Beliefs: Taboo Nature of Suicide Taboo subjects: suicide, rape, child abuse, mental illness, drug and alcohol abuse, incest Myths of Taboo Subjects History of suicide – sin, crime, mental illness

6. Truth or Myth Handout What Do You Know About Suicide?

7. Truth Or Myth Survivors at lower risk MH professionals only ones who can help More common with the rich No correlation between drugs, alcohol and suicide As many as 2 youth attempts to every death

8. Most suffer from depression More Floridians die by suicide than homicide Most have made up their minds More suicides during Christmas holidays People who are suicidal tend to hide it

9. Need to take all talk seriously Suicide rates for 15-24 year olds have more than doubled since the 1950s while other rates stayed about the same Asking may encourage the idea Elderly have the highest rate Important not to break the trust of confidentiality

10. 2005 National Statistics 32,637 suicides (89.4 per day) 3rd leading cause of death for young Americans 15-24 years old 3.8 male deaths by suicide for each female death 3 female attempts for each male attempt Suicide claims a life every 16.1 minutes Source: AAS, USA Suicide: 2005 Official Final Data

11. Florida Statistics 3rd leading cause for 15-24 year olds (2007) 2007 YRBS: 25.7% felt sad or hopeless, 11.2% seriously considered, 8.1% made plan, 5.7% attempted, 2.1% made attempt requiring medical attention Over 2,000 Floridians die by suicide each year An average of 4 Florida youth take their own life each week

12. Not Just Statistics Statistics alone don’t paint the whole picture Suicide is devastating to family, friends, and communities Opportunities to help

13. Understanding People in Crisis Why Everyone Is Vulnerable Stressors are infinite Assets are finite Pressures Assets

14. A Young Person May Feel They Can’t stop the pain Can’t think clearly Can’t make decisions Can’t sleep, eat or work Can’t make the sadness go away Can’t see the future without pain Can’t see themselves as worthwhile Can’t get someone’s attention Source: AAS @ www.suicidology .org

15. Cup Full of Problems Each cup represents a problem that a young person may be having. Only rule is that the cups cannot be stacked inside one another.

16. A Basic Model of Living Pain Tolerance Adaptive Factors Maladaptive Factors Pain Threshold

17. When the pain tolerance threshold is broken (when the pain is intolerable), dangerous behaviors may follow. Suicide Drug Abuse Psychotic Break Violence

18. Depression and Suicide Depression often goes undiagnosed until a crisis occurs Be concerned if: significant changes are noted, symptoms last 2 weeks or longer Change in eating/sleeping, isolating, concentration problems, feelings of hopelessness, irritability, guilt, anger, vague physical complaints and suicidal thoughts Source: NAMI, What Families Should Know about Adolescent Depression and Treatment Options, May 2005

19. The Reality Of It 12 million (1 in 10) suffer from mental illness 80% go without services 90% youth suicides had a diagnosable, treatable mental disorder 65% of boys and 75% of girls in juvenile detention have at least one psychiatric diagnosis Source: Surgeon General, 1999. IOM Report, 2002, Teplin L. Archives of General Psychiatry, Vol. 59, December 2002

20. Risk Factors Include Previous suicide attempt – exposure to suicidal behavior/ family history of suicide Psychiatric disorders: depression, conduct, anxiety, impulse disorders Alcohol/substance abuse Stressful life event or loss Source: National Youth Violence Prevention Resource Center, 2000

21. Physical, emotional, or sexual abuse Rejection, harassment by peers (bullying) Loss of an important relationship Sexual orientation Easy access to lethal means Change in family structure Problems at school Disciplinary action or incarceration

22. Warning Signs and CluesWhat To Look For The red flags that something is wrong Changes in a person’s behavior, feelings, and beliefs about oneself that are maladaptive or out-of-character

23. I– Ideation S– Substance Abuse P – Purposelessness A – Anxiety T– Trapped H– Hopelessness W – Withdrawal A – Anger R– Recklessness M – Mood Change Source: American Association of Suicidology, November 2003

24. Some Signs Demand Immediate Action Talking or writing about suicide or death Verbal clues – open talk about suicide Isolating from friends and family Putting affairs in order – giving away cherished possessions Exhibiting a sudden and unexplained improvement after being depressed Source: The Suicide Prevention Resource Center

25. In Summary There is no typical suicide victim There are no absolute reasons for suicide There are no all-inclusive predictive lists of warning signs or a definitive method for determining if a young person is or is not suicidal Suicide is always multi-dimensional Most don’t want to die – they want to end their pain

26. Protective Factors Positive conditions and personal and social resources Promote resiliency and reduce the potential for suicide Ability to manage or cope with adversity or stress

27. Youth Protective Factors • Positive connections to school • Coping and problem solving skills • Academic achievement • Family cohesion/stability • Help-seeking behaviors • Good relationships with other youth • Positive self worth - confidence • Impulse control – conflict resolution abilities • Social integration/opportunities to participate • Access to care for mental/physical/substance • disorders

28. Being engaged in family, school and community is a key to preventing youth suicide. Youths need to feel comfortable, connected, respected and supported by peers and adults.

29. Personalizing Crisis Exercise • What helps? • What hurts?

30. Intervention Steps and Goals Get through crisis without harm Listen – establish rapport Identify and clarify problem Pinpoint feelings – evaluate hopelessness Talk about suicide Evaluate lethality Identify and utilize resources

31. What To DoIntervention - 3 Basic Steps SHOW YOU CARE ASK THE QUESTION GET HELP Adapted with permission from the Washington Youth Suicide Prevention Program http://www.yspp.org

32. SHOW YOU CARE Trust your judgment Be Genuine - show them you truly care Share observations and concerns Concern can counter their sense of hopelessness Reflect what you hear LISTEN!

33. Bad News:No script for these situations Good News:“They may forget what you said, but they will never forget how you made them feel.” Carl W. Buechner Don’t worry about doing or saying the right thing. Your genuine concern is what is most important

34. Ask The Question Don’t assume they aren’t the “suicidal type” Be direct. “What I hear you saying is you’re in a lot of pain and you’re thinking of killing yourself … Are you thinking about suicide?” Do they have a plan, the means to carry out the plan – more detailed the plan the greater the risk Don’t have to solve all their problems but you must get help

35. Suicide Paraphrase Activity

36. Get Help -How To Help Your support in building hope and finding help truly can make the difference between life and death. If you have any reason to suspect a person may attempt suicide or engage in self-harm, DO NOT LEAVE THE PERSON ALONE

37. Resources Supportive friends Family members Clergy/youth minister Mental Health Agency Counselor or therapist Family physician Local hospital emergency room Crisis Center – 9-1-1 1-800-SUICIDE or 1-800-273-TALK

38. Substance Abuse programs Community health department Parent HelpLine at 800-352-5683 YOUTHLINE at 1-877-968-8454 Wide range of local support groups- mental health, survivors, abuse Addiction Help Line 1-800-758-5877 FL Abuse Hotline 1-800-96ABUSE Children’s Protective Services Additional Resources

39. Group Role Play

40. Conclusion It doesn’t take a professional to save a life We are all gatekeepers Preventing suicide is everyone’s business –yours and mine Together we can end this deadly silence

41. Thoughts or Questions Closing Comments

42. Post-training Survey Please fill out the post-training survey and the training evaluation form. Put completed forms in the box provided.