Teen Age Suicide – Recognizing the Signs

1. Teen Age Suicide – Recognizing the Signs Instructors: Joseph J. Marchese J.J.Marchese & Associates, Inc. Albany, New York jjmtrainer@aol.com

2. Objectives At the completion of this program participants will be able to: • Explain the scope and impact of the teen suicide problem in the U.S. • Identify teen suicide risk factors and warning signs • Describe the methods of intervention that are available to an officer who is dealing with a suicidal teen • Use techniques for evaluating a teenager for suicidal risks • Describe the sources of information that are available to determine whether a teen is suicidal J.J. Marchese & Assicuates, Inc.

3. Suicide Myth Quiz Please answer the following questions either TRUE or FALSE

4. True or False • Once someone is suicidal, he or she will be suicidal forever. • If someone tried to kill themselves once, there is a much smaller chance that they will try again. • Suicidal people clearly want to die. • It is a bad idea to ask people if they are suicidal. Talking about suicide might give them the idea that they should kill themselves. J.J. Marchese & Assicuates, Inc.

5. True or False 5. If a depressed or suicidal person feels better it usually means that the problem has passed. 6. Young men are at the highest risk of killing themselves. 7. People who talk about killing themselves will never do it. It's a way of letting off steam. Those who kill themselves don't normally talk about it. They just go ahead and do it. J.J. Marchese & Assicuates, Inc.

6. Without divulging the specifics – Have you ever had to deal with a successful suicide? J.J. Marchese & Assicuates, Inc.

7. How did this situation impact … • You • The victims family • Significant others • The community • Your agency J.J. Marchese & Assicuates, Inc.

8. Impact of Teen Suicidal Behavior • Suicidal behavior endangers others as well as the suicidal person • Suicidal behavior may have multiple causes (bio, psycho, social/familial) and impacts people at all levels • One successful teenage suicide may result in additional suicides (cluster or copy cats) • In addition to the loss of the suicide victim, teenage suicides may leave a lasting scar on the family, the school, responding officers and the community J.J. Marchese & Assicuates, Inc.

9. What types of activities could be interpreted as suicidal behaviors? J.J. Marchese & Assicuates, Inc.

10. Examples of Suicidal Behaviors • Reckless Driving • Drunk (Buzz) Driving • High Risk Sports Activities (Dare Devils) • EG; Reckless Skiing • Reckless Stunts – “Jackass” • Suicide by Cop • Excessive Alcohol and Drug Use • Fighting (You-tube Fights) J.J. Marchese & Assicuates, Inc.

11. Teen Suicide Statistics • 11th leading cause of all deaths in the US • Suicide is the third leading cause of death for young people age 10-24 years old • Persons aged 15-24 accounted for more than 60% of the increase in the overall suicide rate • Suicide risk is greatest among young white males • Suicide rates among young black males has increased most rapidly U.S. Center for Disease Control J.J. Marchese & Assicuates, Inc.

12. Teen Suicide Statistics • The suicide rate for kids ages 10 to 14 has doubled over the last 10 years • 28.3% of students reported that they felt so sad or hopeless almost every day in a two week period that they stopped doing some usual activities • In a 12 month period prior to a CDC Survey 19% of students had seriously considered attempting suicide U.S. Center for Disease Control J.J. Marchese & Assicuates, Inc.

13. A 1997 study of 16,000 high school studentsfound that: • 20.5 percent had seriously thought about attempting suicide • 15.7 percent had made a specific plan • 7.7 percent had made one or more actual suicide attempts • 2.6 percent had made a suicide attempt that resulted in an injury needing medical attention National Education Association J.J. Marchese & Assicuates, Inc.

14. J.J. Marchese & Assicuates, Inc.

15. What does this mean? Students are over 60 times more likely to fall victim to suicide than be a victim of homicide in their school. Yet we still focus more on school violence than suicide prevention. In fact…

16. The FBI notes…Almost all school shooters were suicidal at the time of their actionsThe School Shooter a Threat Assessment PerspectiveFBI Critical Incident Response Group CIRG, National Center for the Analysis of violent Crime (NVAVC) September 2000 U. S. Secret Service notes… Most attackers had difficulty coping with significant losses or personal failures. Many had considered suicide. Threat Assessment: A guide to Managing Threatening Situations and Creating Safe Schools - May 2002

17. “Suicidal behavior is the end result of a complex interaction of psychiatric, social and familial. There are more suicidal attempts and gestures than actual completed suicides. One study indicates that there are 23 suicidal gestures and attempts for every completed suicide.”Carol Watkins, MD Baltimore Maryland J.J. Marchese & Assicuates, Inc.

18. 10% of Those Who Have Attempted Suicide Went on to a Later Completed Suicide J.J. Marchese & Assicuates, Inc. Carol Watkins, MD Baltimore Maryland

19. You Need to Know • Risk Factors • Warning Signs • Interventions • Evaluation J.J. Marchese & Assicuates, Inc.

20. Risk Factors • Previous suicide attempts • Suicide by a family member • Past psychiatric hospitalization • Recent loses – death, divorce, break-up • Social isolation – No relationship skills • Abuse – Mental, Physical & Sexual • Drug or Alcohol abuse – decrease in impulse control – self medicating depression • Exposure to violence at home – view violent behavior as a viable solution to life problems • Handguns in the home, especially if loaded J.J. Marchese & Assicuates, Inc.

21. Warning Signs • Significant alcohol or drug use • Thoughts about dying/afterlife • Sudden increase in moodiness • Withdrawal or isolation • Major changes in eating or sleeping habits • Feelings of hopelessness, guilt, or worthlessness • Poor control over behavior • The American Psychological Association and MTV Music Television have joined forces to create Warning Signs, a violence prevention program that helps kids identify suicide warning signs. J.J. Marchese & Assicuates, Inc.

22. Warning Signs • Impulsive, aggressive behavior • Drop in quality of school performance or interest in school • Lack of interest in usual activities • Getting into trouble with authority figures • Perfectionism • Giving away important possessions • Hinting at not being around in the future. • The American Psychological Association and MTV Music Television have joined forces to create Warning Signs, a violence prevention program that helps kids identify suicide warning signs. J.J. Marchese & Assicuates, Inc.

23. Interim Interventions LISTEN: • Encourage the child to talk to you or to some other trusted person. • Listen to the child’s feelings. Don’t give advice or feel obligated to find simple solutions. Try to imagine how you would feel in the child’s place. BE HONEST: • If the child’s words or actions scare you, tell him or her. If you’re worried or don’t know what to do, say so. Don’t be a cheerful phony. San Pedro CA Youth Coalition J.J. Marchese & Assicuates, Inc.

24. Interim Interventions SHARE FEELINGS: • At times everyone feels sad, hurt, or hopeless. You know what that’s like; share your feelings. Let the child know he or she is not alone. GET HELP: • Professional help is crucial when something as serious as suicide is considered. • Help may be found at a suicide prevention and crisis center, local mental health association, or through clergy. • Become familiar with the suicide prevention program at the child’s school. Contact the appropriate person(s) at the school. San Pedro CA Youth Coalition J.J. Marchese & Assicuates, Inc.

25. Basic Elements To Consider When Addressing A Suicidal Young Person: • One does not encourage suicide by talking about suicide 2. Suicidal tendencies are not inherited. Some young people fear that possibility. 3. If the suicidal student makes improvement, the suicide risk is decreased, but can still exist. 4. There is no such thing as "a lost cause" when someone is suicidal. 5. Never assume that talk of suicide is simply a manipulation for attention. What if you are wrong Teenage suicide.com J.J. Marchese & Assicuates, Inc.

26. Basic Elements To Consider When Addressing A Suicidal Young Person: 6. If the suicidal person is in counseling or therapy, don't assume they are safe from suicide. 7. Suicide never just comes "out of the blue." There are always personal reasons for the feelings. 8. Just because a person is suicidal doesn't mean suicide will always be an option. 9. Having previously failed an attempted suicide doesn't protect someone from another attempt Teenage suicide.com J.J. Marchese & Assicuates, Inc.

27. Evaluating a Teen For Suicide • Has his personality changed dramatically? • Is he/she having trouble with a significant other? Or is he having trouble getting along with other friends or with parents? Has he withdrawn from people he used to feel close to? • Is the quality of his schoolwork going down? Has he failed to live up to his own or someone else's standards (school grades, for example)? • Are there signs of abuse? • Does he always seem bored, and is he having trouble concentrating? American Academy of Pediatrics J.J. Marchese & Assicuates, Inc.

28. Evaluating a Teen For Suicide • Is he acting like a rebel in an unexplained andsevere way? • Is she pregnant and finding it hard to cope with this major life change? • Has he run away from home? • Is the teenager abusing drugs and/or alcohol? • Is she complaining of headaches, stomachaches, etc., that may or may not be real? • Have his eating or sleeping habits changed? American Academy of Pediatrics J.J. Marchese & Assicuates, Inc.

29. Evaluating a Teen For Suicide • Has his or her appearance changed for the worse? • Is he giving away some of his most prized possessions? • Is he writing notes or poems about death? • Does he talk about suicide, even jokingly? Has he said things such as, "That's the last straw," "I can't take it anymore," or "Nobody cares about me?" (Threatening to kill oneself precedes four out of five suicidal deaths.) • Has he tried to commit suicide before? American Academy of Pediatrics J.J. Marchese & Assicuates, Inc.

30. Sources of Information • Arrest records (Types of Crimes & Behaviors) • Parents/guardians and family members • School – teachers/aides/administrators, counselors, coaches, classmates • Close Friends, Girl/Boyfriend • Personal Web-site • Community, neighbors, merchants • Mental health professionals* • Religious/Clergy* • Etc. *Confidentiality Issues J.J. Marchese & Assicuates, Inc.

31. Do Not Attempt to Deal With a Suicidal Teen Alone GET HELP: • Professional help is crucial when something as serious as suicide is considered. • Help may be found at a suicide prevention and crisis center, local mental health association, or through clergy. • Become familiar with the suicide prevention program at the child’s school. Contact the appropriate person(s) at the school. San Pedro CA Youth Coalition J.J. Marchese & Assicuates, Inc.

32. Review Pre-Test Results J.J. Marchese & Assicuates, Inc.

33. Question # 1Once someone is suicidal, he or she will be suicidal forever. FALSE People who want to kill themselves are "suicidal" only for a limited period of time. During this time they either move beyond it, get help or die.

34. Question # 2If someone tried to kill themselves once, there is a much smaller chance that they will try again. False As many as 80% of all completed suicides occurred after previous attempts. This is especially true for young people.

35. Question # 3Suicidal people clearly want to die. FALSE Ambivalence is a marked feature of a suicidal person. Many don't want to die, but simply want a way to escape an unbearable situation

36. Question # 4It is a bad idea to ask people if they are suicidal. Talking about suicide might give them the idea that they should kill themselves. FALSE People might think it's safer not to talk about suicide with someone considering it. On the contrary, talking will help them deal with some of the heavy issues involved and diffuse the tension. A willingness to listen shows that people care and are willing to help.

37. Question # 5If a depressed or suicidal person feels better it usually means that the problem has passed. FALSE If someone who has been depressed or suicidal suddenly seems happier, don't assume that the danger has passed. A person, having decided to kill themselves, may feel "better" or feel a sense of relief having made the decision. Also, a severely depressed person may lack the energy to put their suicidal thoughts into action. Once they regain their energies, they may well go ahead and do it.

38. Question # 6Young men are at the highest risk of killing themselves TRUE Males between the ages of 18 and 24 have the highest risk of killing themselves.

39. Question # 7 People who talk about killing themselves will never do it. It's a way of letting off steam. Those who kill themselves don't normally talk about it. They just go ahead and do it. FALSE Most people either talk about it or do something to indicate that they are going to kill themselves. J.J. Marchese & Assicuates, Inc.

40. Objectives At the completion of this program participants will be able to: • Explain the scope and impact of the teen suicide problem in the U.S. • Identify teen suicide risk factors • List at least ten of the fifteen suicide warning signs • Describe the methods of intervention that are available to an officer who is dealing with a suicidal teen • Describe the sources of information that are available to an officer to determine whether a teen is suicidal J.J. Marchese & Assicuates, Inc.

41. Questions ???? J.J. Marchese & Assicuates, Inc.