Suicide Awareness & Intervention Workshop SUICIDE

1. Suicide Awareness & Intervention Workshop SUICIDE

2. OVERVIEW • Definitions and Statistics • Myths and Facts About Suicide • The Suicidal Process • Precipitating and Risk Factors • Warning Signs • Suicide Intervention (ACE Model) • Social Networks • CF Policy • Self Care • Resources

3. DEFINITIONS • Suicidal Ideation • Persistent, repetitive, and preoccupying thoughts about suicide leading up to a suicide or suicide attempt. • Suicide Attempt • A deliberate, life-threatening act against oneself with the intention of causing their own death. • Suicide • A deliberate act against oneself that results in death.

4. CF Suicide Statistics • CF suicide rate (males) has been validated to 2008 and the four year average is 17.8/100 000. • Standardized suicide mortality rate to 2004 comparing the male CF to the general Canadian male population of the same age is approximately 80% • The CF suicide rate is 20% lower than the Canadian population.

5. Common Myths & Facts About Suicide

6. Common Myths & Facts About Suicide “Suicide comes without warning!” MYTH or FACT? MYTH

7. Common Myths & Facts About Suicide “People considering suicide really want to die.” MYTH or FACT? MYTH

8. Common Myths & Facts About Suicide “Suicide is an act of courage or cowardice.” MYTH or FACT? MYTH

9. Common Myths & Facts About Suicide “Once a person is suicidal, they will never change their mind.” MYTH or FACT? MYTH

10. Common Myths & Facts About Suicide “Someone who has attempted suicide doesn’t really want to die; they’re just trying to get attention.” MYTH or FACT? MYTH

11. Common Myths & Facts About Suicide “Improvement following a suicide attempt or intervention signifies that the risk has passed." MYTH or FACT? MYTH

12. Common Myths & Facts About Suicide “Talking to someone about their suicidal feelings will cause them to attempt or complete suicide." MYTH or FACT? MYTH

13. Common Myths & Facts About Suicide "Most people who are suicidal suffer from depression, mental health or addiction problems." FACT MYTH or FACT?

14. Understand and increase awareness. How Can You Help?

15. Precipitating Events • Divorce or relationship failure • Grieving / loss of someone close • Academic or professional failure • Addictions / substance misuse • Physical, emotional abuse/family violence • Financial problems • Legal problems

16. Healthy Reacting Injured Ill Mental Health Continuum Model Calm & steady Confident in self & others Getting job done In control physically, mentally, emotionally Behaving ethically and morally Sense of humour Fit, fed, rested Relaxing & recreating Socially active Trouble sleeping Irritability Anger, Impatience Nervousness, anxiety Muscle tension Headaches Low energy Poor concentration Negative attitude Forgetfulness Procrastination Often late for work Increased swearing Decreased productivity Noticeable fatigue Angry outbursts Panic attacks Forgetting important things Impaired decision making Taking risks Inappropriate aggression Insubordination Absenteeism Increased accidental injuries Severe memory lapses Cannot concentrate Avoiding or withdrawing Regular panic attacks Loss of control Cannot perform duties Indications of suicidal thoughts, intentions Legal charges Significant change in behaviour

17. Risk Factors(Stats Can, Langlois,Morrison,2002)VARY WITH AGE, GENDER • Depression or other mental health concerns • Alcohol and/or other drug use • Previous suicide attempts • Family history of suicide behaviour • Isolation or withdrawal • Impulsivity • Suicidal ideation

18. Warning Signs

19. Soon, I’ll get some peace. Die now or later… what’s the difference? I wrote my will. I’m a loser…I’m useless. You’ll be better off without me. Thanks for everything you’ve done for me. I  won’t be needing these things anymore. Indirect Messages

20. I want to end it all. I’m going to kill myself. Life doesn’t mean anything to me anymore. I’d be better off dead. I just can’t take it anymore. I’ll never be able to get out of this. All of my problems will end soon. Direct Messages

21. Trouble sleeping Lack of appetite General malaise Extreme fatigue Shortness of breath Low or monotone voice Physical Signs

22. Changes in behaviour and/or personality. Isolation, withdrawal, sadness. Abuse of alcohol, medications or other drugs. Reduced job performance or academic results. Difficulty making decisions, lack of focus/concentration. Neglect of personal appearance or hygiene. Psychological & Behavioural Signs

23. WORK FAMILY SPORT SPOUSE FRIENDS 1. Person at risk seeks solutions… As someone outside the spiral, we see the support… Someone who is suicidal, sees this… SPORT SUICIDE 2. Flash SPOUSE ALCOHOL FAMILY FRIENDS WORK SUICIDE SPORT FRIENDS 3. Ideation ALCOHOL SPOUSE SUICIDE FRIENDS ALCOHOL 4. Rumination SUICIDE 5. Crystallization SUICIDE THE SUICIDAL PROCESS

24. Ask if the person is thinking about suicide: ask how, where and when The more detailed the plan, the faster you need to act. Listen… let the person know that you care and understand. Keep safe, disable plan (intervene). Encourage the person to get help… link to resources Go with them if they need support. Follow up. Get the information and support you need in order to be better equipped to help. What To Do / Intervention

25. ACEUS Army Center for Health Promotion and Preventative Medicine Ask Ask about suicidal thoughts. Know warning signs and if present, ask if person is thinking about killing themselves. Care Understand that person may be in pain. Active listening may cause some relief. listen for what, where, and when explore ambivalence Take action by removing any lethal means. Escort Take person to someone who can help. helping professionals (see references for complete list) chain of command identify support systems

26. What NOT To Do • Pass judgment. • Make false promises. • Challenge the person to do it. • Minimize their feelings. • Give advice or try to solve their problems. • Try to physically intervene

27. Confidentiality could risk the possibility of prevention or intervention. The responsibility of maintaining confidentiality could be overwhelming for the person helping/assisting. Confidentiality

28. What Can YOU do? HEALTHY Performing Well Constructive Input Appropriate Behaviour REACTING Absenteeism Negative Attitude Swearing Impatience INJURED Anger / Conflict Not Performing Injuries Insubordination ILL Significant Changes Not Functioning Suicidal Thoughts Get to know personnel. Foster healthy environment. Set example. Watch for behaviour changes. Advocate. Minimize stressors. Identify unhealthy situations. Support. Intervene – Consult – Identify Resources - Refer Involve resources. Follow MELs. Maintain contact & ensure support. Deal with unacceptable behaviour. Minimize rumours. Maintain contact. Ensure adequate resources / support. Follow Medical Employment Limitations Include member in Unit activities. You can…

29. Key Role of Leaders HEALTHY Performing Well Constructive Input Appropriate Behaviour REACTING Absenteeism Negative Attitude Swearing Impatience INJURED Anger / Conflict Not Performing Injuries Insubordination ILL Significant Changes Not Functioning Suicidal Thoughts Foster healthy climate. Reduce barriers to help-seeking. Deal with performance issues promptly. Identify and resolve problems early. Demonstrate genuine concern. Example of personal accountability. Involve members in social support. Follow employment limitations. Maintain respectful contact. Seek consultation as needed. Respect confidentiality.

30. FRIEND TRAINIED IN SUICIDE AWARENESS HELP LINE FAMILY CARING PERSON Social Network

31. 911 Padres Local Police Military Police Hospitals / Medical Clinics Mental Health Services Health Promotion Member Assistance Program (MAP) 1-800-268-7708 Employee Assistance Program (EAP) 1-800-387-4765 Family Resource Center (MFRC) Health Units Resources

32. CF Policies CFAO 19-44 Suicide Prevention http://admfincs.mil.ca/admfincs/subjects/cfao/019-44_e.asp DAOD 5017-0 Mental Health http://admfincs.mil.ca/admfincs/subjects/DAOD/5017/0_e.asp

33. It is important to reduce the effects of an intervention experience. self reflection and self monitoring of thoughts and feelings after the event writing/journaling, talking and sharing basic self care principles enough sleep/rest, good nutrition, and physical activity participate in activities you enjoy, have fun, humour spiritual renewal take a break from routine connect with nature Self Care

34. CONCLUSION • Do not judge • Listen, understand, aid. • Be direct: ASK the question. • If ‘yes’ then ask how / when / where? • Consider safety… yours and theirs. • Know your personal limits. • Know and utilize available resources.

35. Suicide Awareness & Intervention Workshop QUESTIONS or COMMENTS?

36. HLIS Data Social Wellness • Your health - Our mission • Votre santé - Notre mission

37. Reasons for Seeking Help from a Mental Health Professional

38. Causes of MH Related Problems

39. Background: Suicide (HLIS 2008/9)

40. Relationship Satisfaction, Family Violence and Abuse 82% of survey respondents were currently in a relationship. Of those, 91% were either extremely, very, or somewhat satisfied with this relationship. 15% of CF personnel who responded had experienced at least one type of physical or sexual abuse in their current relationship. Males reported being on the receiving end of this abuse more commonly than females while males and females were equally reported to be perpetrators. A history of emotional or financial abuse was more common with 19% of CF personnel stating they were responsible and 25% stating their spouse was responsible.

41. Anger Management: HLIS 2008/9 78% of CF personnel rarely or never found themselves struggling with levels of anger that interfered with their ability to do their job or with personal relationships.However, 18% reported that anger sometimes and 4% reported that anger often created this problem.