Depression and Suicide: Important Information for Educators

1. Depression and Suicide: Important Information for Educators A Safety and Violence Prevention Curriculum Module Two

2. Click on link below to access the handouts and resources for this module through Google Drive: • Print out and Complete the quiz on page 1 then continue with the slide show. • https://docs.google.com/a/elginschools.org/file/d/0B73APt_4GQIydzVhM2syVWl2dVU/edit?usp=sharing

3. Quiz: Question #1 True or False? Most people who attempt suicide are just looking for attention. False Suicide attempts are rarely used as means to get attention from others. Rather, an individual sees suicide as the only feasible option for ending their pain. 3

4. Quiz: Question #2 True or False? Girls attempt suicide more often than boys. True Girls are more likely than boys to experience depression, to consider suicide, to make a plan for suicide and to attempt suicide. Boys have a higher rate of completed suicide than girls because they tend to use more lethal means such as guns and hanging compared to swallowing pills.

5. Quiz: Question #3 True or False?Children can’t really be depressed; they don’t have anything to worry about. False Depression is a change that occurs in the brain’s chemistry and is a brain disorder. Depression is an illness that affects how a person thinks, reasons, feels and acts.

6. Quiz: Question #4 Fill in the Blank In Ohio, suicide is the ______ leading cause of death among 15-24 year olds. a.) 2nd b.) 3rd c.) 4th d.) 5th a.) 2nd Suicide is the second leading cause of death for 15- to 24 year-olds in the state of Ohio. Youth suicides in Ohio have increased 18 percent since 2001.

7. Quiz: Question #5 True or False?Alcohol and drug use is related to depression and suicide. True Students who abuse substances are often trying to mask their emotions and use alcohol and drugs as coping mechanisms.

8. Quiz: Question #6 True or False?Asking students if they are suicidal will just put those thoughts into their heads. False Talking with students about their suicidal thoughts or ideas is one of the only ways to accurately understand their subjective reality and to understand the degree to which they are presently depressed or thinking about suicide as an option. Asking students if they are feeling depressed or suicidal may show them that you care for them.

9. How do I identify a student who is experiencing depression?

10. Recognizing Depression in Students: Changes in Behavior • May appear irritable or angry as opposed to depressed • Have volatile moods, angry outbursts, or rage • Lose interest in activities they previously enjoyed • Withdraw from family and friends • Abuse substances

11. Recognizing Depression in Students: Changes in Appearance Noticeable weight gain or weight loss: eating disorders are correlated with depression. Changes in sleep: sleeping much more or much less than usual Disheveled appearance; lack of personal hygiene

12. Recognizing Student Depression: Changes in Performance Grades dropping in school Lack of interest in after-school activities or sports Skipping school, coming to school late

13. Recognizing Student Depression: Changes in Performance Delinquent behavior while at school, increases in disciplinary actions Feelings of worthlessness, guilt, difficulty concentrating, suicidal ideation

14. Suicidal Ideation • Suicidal ideation is present in 60 percent • of adolescents with depression. • In 2005, of Ohio teens polled: • 27 percent reported feeling depressed • 18 percent reported seriously considering suicide • 9 percent reported that they attempted suicide during the past year • Source: 2005 Youth Risk Behavior Survey Executive Summary, Ohio Department of Health, www.odh.gov

15. What are warning signs for student suicide? Look for the same warning signs as for depression, and: • Thoughts or writings of death or suicide • Giving away possessions or putting affairs in order • Locating weapons • Making comments such as, “You won’t have to worry about this when I’m gone,” or “I won’t be a bother to you much longer.” • Feelings of worthlessness

16. Whereas adults come to suicidal behavior often over the course of lengthy stressful events, Adolescents may become suicidal after experiencing an intense emotional event, a breakup with a boy/girlfriend, or becoming an outcast to friends.

17. Increased Likelihood of Suicide History Previous suicide attempts or gestures Family history of suicidal behavior Survivor of child abuse (physical or sexual abuse)

18. Increased Likelihood of Suicide Individual Factors Substance abuse or other mental health disorders Conduct disorders or disruptive behaviors Juvenile delinquency Sexual orientation (homosexual, bisexual and trans-gendered youth are 3-5 times more likely to commit suicide)

19. Increased Likelihood of Suicide Environmental Factors Life stressors (interpersonal losses, relationships) Access to firearms

20. Decreased Likelihood of Suicide Individual Factors Good coping skills and impulse control Sense of worth/confidence

21. Decreased Likelihood of Suicide Environmental/Family Factors Lack of access to means of suicide Stable environment Access and care for mental/physical/substance disorders Family cohesion Responsibilities for others/pets

22. Decreased Likelihood of Suicide School Factors Academic achievement Perceived connectedness to school Good relationships with other school youth Social integration/opportunities to participate

23. What do I doif I think a student might be severely depressed and considering suicide?

24. Depression and Suicide • Talk to the student – Show your concern. • If the student seems depressed, ask about his or her mood and feelings. Ask specific questions, such as: • How are you feeling right now? • How long have you been feeling this way? • Who can you talk to about how you are feeling? • You may notice specific behaviors that concern you: • Is the student talking or writing about death or suicide? • Has the student been giving away possessions? • Has the student made final arrangements?

25. Understanding Levels of Risk Once referred, a mental health professional will determine the level of risk: • Low-risk: vague suicidal ideation, no specific plans, low-level helplessness; • Medium risk: direct statements about suicide, some plans but still vague and no availability of supplies; • High-risk: detailed plans with lethal method, made final arrangements, suicide is the only alternative.

26. Procedures When Working with Suicidal Students • Interaction with student: • Gather information calmly • Communicate caring and support • Emphasize student’s worth • Do not leave students at risk alone • Do not promise secrecy

27. Procedures When Working with Suicidal Students • Get help, following school procedures • Get student to the school counselor or mental health expert • Be sure parents are contacted • Contact emergency services/local crisis center as necessary • 911 • County emergency mental health agency • Local suicide hotline • National suicide hotlines – for local hotline information: 1-800-273-TALK (8255); and 1-800-SUICIDE (784-2433)

28. Local Resources, Protocols, and Referral Information • Be familiar with school and community resources • Sources of local information: • NAMI-Ohio • County Behavioral Health Authority • Local ADAMH board • Refer to your handouts….

29. Try Out Your Skills • Role Play: Work with a friend. One of you is the teacher (Ms./Mr. Jones) and one is the student (Carla/Carlo). • Carla/o seems very down in the dumps. She/he has been coming late to your classes and keeps his/her head down during the entire class. You notice his/her weight significantly dropping and his/her withdrawal from peers at school. During lunch, Carla/o has been going to the nurse’s office with complaints of stomach aches. In one of your classes, Carla/o writes a poem in which s/he talks about the “killing the pain.” • How might you talk to Carla/o? • Take 5-10 minutes to role play this scenario.

30. Reminders • Show care and concern • Use concrete questions • Remember SAL • Specific plan and intent • Available means • Lethal means

31. Follow-up • Based on your conversation with Carla/o, what would concern you? • What is your plan to address this situation? • Who do you need to consult with? • What information do you need? • Who do you need to notify?

32. Educators have the capacity to substantially affect the life course of a student if they can identify and refer students who may be suicidal.

33. Educators: Should not promise secrecy or confidentiality if a student discloses suicidal thoughts; Should act swiftly upon learning of student suicidal thoughts or behaviors; Should take seriously student disclosures or threats; Must know the resources in their schools and communities in order to make appropriate referrals.

34. Click on Link and correctly complete the Google Form to obtain credit for completing this module. • https://docs.google.com/a/elginschools.org/forms/d/1EcBsF9Aja4KhM90RaSEhDHqMqY3kjQoLxoMdwDh5MgM/viewform • You will need to sign into your Elgin Local Schools Google Drive account.

35. education.ohio.gov For More Information

36. @OHEducation ohio-department-of-education OhioEdDept Ohio Teachers’ Homeroom