Grief Recovery Inc.

1. Grief Recovery Inc. Helping People Grieve and Grow 4622 Still Meadow Dr. Saginaw, MI 48603 (989) 249 - 4362

2. Perhaps the most valuable resultof all of education is the ability tomake ourselves do the things wehave to do, when it ought to be done, whether we like it or not

3. Suicide • Suicide is NOT about death • Suicide IS about ending pain

4. Suicide Statistics

5. Recent Statistics • 14 teens complete suicide every day in the U.S. (X by 4.5) • Suicide is a common thought to 62% of U.S. Adolescents • The 10 to 14 age group has increased 567% since 1952 • The 10 to 14 age group has increased 120% since 1980. • Within a typical classroom, it is likely that 3 students (one boy and two girls) have made a suicide attempt in the last year. • Up to 60% of high school students report having suicide ideation • Source: Mich. Assoc. of Suicidology, Oct. 1997

6. Female Risk of Suicide by Grade Level

7. % Risk by Gender

8. National Statistics • A school of 2,000 students experiences a completed suicide on average every four years • For every 9 females to attempt, one completes • For every 4 males that attempts, one completes • Only 5% of all suicides are mental health patients • What we need to teach our students and staff to do is to encourage each other • 98% of the time, healthy students will not kill themselves just because a friend does. The students at risk are the students who were at risk before the incident occurred. • Students abusing alcohol and other drugs • Students who are being abused/family stress/series of frustrating events

9. Developmental AssetsGrades 6 - 12 • Low – 14% of children have 0 – 10 assets • Avg – 62% of children have 11 – 20 assets • High – 20% of children have 21 – 25 assets • Excep – 4% of children have 26 – 30 assets

10. The Power of Assets Against Risk Taking Behaviors

11. Suicide in The Middle School • Nearly one in three 7th and 8th graders has seriously thought about suicide • In regards to adolescent suicide, females in 8th grade (43%) are most likely to have seriously thought about killing themselves • In regards to adolescent suicide, 8th grade females are most likely to make a plan for suicide • 14% of 7th and 8th graders report that they have tried to kill themselves • In the past twelve months, 3% of Maine high school students made a suicide attempt that resulted in an injury, poisoning, or overdose that required treatment by a doctor or nurse • Source: health Risk behavior Among Maine Youth, spring 2000

12. Myths About Teen Suicide • Youth who talk about suicide rarely attempt it • Talking about suicide will make it happen • The tendency toward suicide is inherited • Teenage suicides happen at night • Suicidal people leave notes • If a person want to commit suicide nothing can stop him/her • Once a teen has been suicidal he/she is never out of danger

13. Confidentiality • Research shows that people who completed a suicide has told 2 to 4 people of their planned demise. • We must not be sworn to secrecy!!

14. Why Don’t We Have Suicide Prevention Programs ? • I’m the only one in my school and/or community who is willing to learn about suicide • What if I don’t diagnose the student at risk ? • What if I mis-diagnose the student at risk ? • My administrator is afraid to deal with suicide • I am worried that if I discuss suicide with a suicidal student it will encourage him/her to commit suicide • The community doesn’t acknowledge that teen suicide is a problem

15. Native American Suicide Rates • Tribes on reservations in the West and Northwest have suicide rates that are four times the national average • Tribes in the Midwest have suicide rates that are below their state averages • The youth suicide rate is overall about 1.5 times higher than national rate. • Men ages 15 to 24 account for 65% of all suicides among Native Americans • source: University of Minnesota, Kiosk Study

16. Suicide in African American Youth • Experts fear that if the alarming increase in suicide of Black American Youth continues, it will be the leading cause of death by 2003 of Black Adolescents • According to Dr. George Gaines of the Health Department of The City of Detroit: “there are unique causes” • “The slave experience/middle passage – engrained a hypertension into their culture’ • “Double consciousness – African and American – two thoughts, two ways of life” • “Living with the struggle – Cultural depression. Because of past hurts and some times present hurts they experience • Most experts claim that two main reasons for Adolescent Black suicide in America are related to economic and living conditions

17. Latinos and Suicide • Hispanics are a very diverse population. There are such great differences that it is hard to isolate symptoms different from other cultures. • However, a close study of the literature reveals two influential concepts, especially to Hispanics: • Religion – A sin against God • Family – Many have strong family systems Hispanics born outside the U.S. are at a lower risk Source: Dr. orlando Villegas, MAS Conference, 1998

18. Latinos and Suicide • According to the Southwest Detroit Hispanic Community: “As Hispanics Americanize, they become more vulnerable to suicide.” Research seems to suggest that they may be right. • A study conducted by the University of california shows that “the longer Hispanics are in the U.S., the more vulnerable they are to suicide.” • Basically they are coming from a strong family system to a country with a weak family system.

19. Latinos and Suicide • Religion and family are major factors in the prevention of Hispanic suicide. Dr. orlando Villegas states “this is true 99 out of 100 times.” However, if a Hispanic was suicidal, they would be rare if they: • 1. Talked to a friend • 2. Talked to a teacher The most likely people a Hispanic will talk to is: • A family member • Church clergy

20. Caution ! • Practitioners must be careful to realize that ethnicity is a complex factor in determining suicide risk.

21. Suicide and The Gay Adolescent • Most studies show that the Gay Adolescent is 2 to 3 times more likely to make a suicide attempt • Some studies claim that they are 5 times more likely to make a suicide attempt • It is reported that 30% of Gay Youth who come to youth services are on prescribed medication for depression • 30% of Gay Youth who have come out of the closet have themselves reported making serious suicide attempts.

22. Our Goals Today • Recognize causes of suicide • Assess suicidal risk • Take general steps to help • Getting parents and the community involved • Understanding the suicidal person • Grief after suicide • Brain chemistry and the suicidal person • You can make a difference !!!

23. Social-Cultural Factors • More guns in U.S. households than adults • Western culture glorifies violence • 62% of men use guns to kill themselves • 40% of women use guns to kill themselves • 3 million children in U.S. are abused and neglected • 1 out of 4 women who attempt suicide have been raped • Source: National Bureau of Statistics

24. Main Causes of Suicide • Substance Abuse • Break up of the family • Depression • Feelings of insecurity • Illness • Broken love affairs • Economic conditions – poverty or wealth

25. Why Are They Thinking Suicide ? • Relief from problems • End of a burden • Solution to problems • Revenge

26. How to Recognize APotential Suicide Individual • Poor self concept • Usually an antisocial isolate. They are introverted and become withdrawn • A drastic change of behavior • Usually will make open threats or lay clues for ending their life • Excessive use of alcohol or other drugs • Change in habits of appearance • Gives away prized posessions • Poor communications with family and friends • A history of prior acts of suicide

27. What To Look For • Previous Attempts • Scratching or superficial cutting of the body • Themes of death or depression in writing, art, talk • Verbalization of intentions • Recent significant loss • Discord in home • Sudden decline of academic performance • Acute personality changes • Statements like “I’d be better off dead,” “nothing matters,” “I won’t be a bother to you much longer,” etc. • Feelings of hopelessness and rejection

28. Danger Signs Review • Talking or joking about suicide • Statements about being reunited with a deceased loved one • Statements about hopelessness, helplessness, worthlessness • Preoccupation with death. In the person’s music, literature, art, etc. • Writing letters or leaving notes referring to death or “the end” • Suddenly happier, calmer • Loss of interest in things once cared deeply about • Giving away prized possessions

29. Danger Signs Cont. • Unusual visiting or calling people one cares about - saying their good byes • Self destructive behavior (alcohol or other drug abuse, self injury or mutilation, promiscuity) • Risk taking behavior (reckless driving/excessive speeding, carelessness around bridges, cliffs or balconies, or walking in front of traffic • Having several accidents resulting in injury. Close calls or brushes with death. Obsession with guns or knives.

30. Suicide: How We Can Help • Be a good listener • Evaluate the individual • Don’t suggest that they go and do it • Accept every feeling and complaint the person expresses • Don’t be afraid to ask the person directly • Beware of fast recoveries • Be supportive and affirmative • Seek further consultation • Help the person realize that a completed suicide is irreversible • Remind the person that depressed feelings do pass • Never leave the person alone in an acute crisis

31. Suicide AssessmentSLAP • S - How SPECIFIC is the plan • L - How LETHAL is the proposed method • A - Have they ACQUIRED the means or how AVAILABLE is the means • P - What is the PROXIMITY of helping resources when and where the person plans to attempt

32. Prevention Tips • Remove guns from the home - less likely for students to act on impulse • Early detection of substance abuse • Family therapy for families experiencing multiple stressors • Upon signs of depression - evaluating for psychiatric disorder • Listen, Listen, Listen

33. How Can I Help ?Review • Be direct • Be willing to listen • Be non-judgemental • Get involved • Don’t dare • Don’t act shocked • Don’t be sworn to secrecy • Recognize your limitations

34. Do’s and Don’ts ReviewTalking to a person in crisis • Don’t • Sound shocked • Stress the shock on family and friends • Engage in a philosphical religious debate • Assume responsibility for a person’s actions

35. Do’sTalking To A Person In Crisis • Do • Emphasize alternatives • Stay calm and understanding • Use constructive, open questions (how are you planning – open, are you thinking about killing yourself – closes) • Mention family as a source of support • Emphasize tackling problems one at a time • Develop a contract with the person • Emphasize that if he completes it, there is no second chance • Process all contacts with another counselor

36. Major Recovery GoalsFor The Person In Crisis • Get the person to normal functioning as quickly as possible • Help them gain control • Help them establish a sense of equilibrium • Help the re-establish a sense of trust • Help them regain hope

37. Personal Resource Survey • Friends I can count on • Family members I can share with • Relatives I am comfortable with • School people who are supportive • Clergy I trust and talk to • Any other caring person

38. Helping Those Left Behind • Major Issues: • Rejection • Shame • Blame • Loneliness • Guilt • Anger • Trauma

39. Dealing With The Survivors • Our goal is NOT to make suicide acceptable, but to free the stigma surrounding those who must cope • AND • If the survivors choose, they don’t have to cope in silence

40. Grief Reactions OfSurvivors Of Suicide • Shock • Denial • Guilt • Emotional Outburst/Irritability • Depression or Sadness • Anger

41. General Guidelines For Helping Survivors Of Suicide • Initiate Conversation – different grief • Don’t say “I know how you feel” • Listen non-judgementally • Let them know the death was NOT their fault • Provide grief information about suicide • Don’t let the survivors feel like they are alone • Let them know this will be a difficult time • Encourage them to be kind to themselves

42. Guidelines For HelpingSurvivors Of Suicide Part 2 • Don’t try to answer the question “why” • Recognize that survivors are often angry and you may be the recipient of their anger • Be aware of copy-cat syndrome • Inform survivors that the grief process is long lasting, averaging 24 months

43. Things To Keep In Mind For The Classroom Teacher When Discussing A Classmates Suicide • Encourage students to express their feelings • Try not to glamorize the act • Repeat NO ONE IS RESPONSIBLE • Reinforce that suicide is a tragedy • Don’t allow someone to become bigger in death than they were in life. • Suicide does not solve problems, it causes them • Stress there is no second chance for a completed suicide • Take note of students unusually upset by this discussion. Make referrals if necessary

44. A Few Suggestions When Working With Survivors • Keep a list of contacts • Let them cry • Don’t try to protect them – tell them “every thing will be okay” • Don’t try to “fix” the problem • Don’t tell them “its God’s will” • Don’t quote bible verses • Keep opinions about the completor being in Heaven or Hell to yourself • Remember, you don’t know how they feel • The survivors should not be told what to feel • Mention the completor by name • Know your limitations. Work in pairs if possible

45. Suggestions For Survivors • Structure your time, keep busy • Don’t label yourself as “crazy.” reassure yourself that you are normal and having normal reactions • Talk with others. Talking about it can help • Reach out. People do care. Spend time with others • If you choose to exercise, alter these periods with periods of relaxation • Avoid alcohol and other drugs

46. Suggestions For Survivors 2 • Realize that your family and close acquaintances are also under stress • Eat regular meals, even if you don’t feel like it • Get plenty of rest • Give yourself permission to feel rotten. It’s normal • If you like to write, keep a journal to express your thoughts and feelings • Avoid caffeine. Remember, you need sleep and caffeine interferes with ability to sleep

47. Suggestions For Survivors 3 • Don’t make any major life changes unless it absolutely must be made • Do appropriate things that feel good to you • Do make routine daily decisions. Regain control • Flashbacks are normal, don’t fight them. They usually decrease in time and become less painful • Maintain as normal a schedule as possible • Seek professional help if you feel overwhelmed. This is Not a sign of weakness

48. Suicide Specific Media Policy • Avoid providing specific details of method • Avoid romanticization of the suicide • Avoid descriptions as ‘unexplainable” • Avoid “simplistic” for the suicide • News stories concerning suicide should NOT be printed on the front page of any section of the newspaper • The word “suicide” should not be in the heading • The picture of the deceased should not be printed

49. Parent Meeting After A Student Suicide • Set perimeters before the meeting concerning: effective parenting skills suicide prevention skills Don’t turn the microphone over to the public many people have personal agendas problems of different religions Keep the media out of the meeting ! ! !

50. Memorials • Death from suicide • No announcement over the PA • No moment of silence • No school sanctioned tributes • Encourage close friends to celebrate life Source: Michigan Assoc. of Suicidology