Not one more stopping the suicide epidemic
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Not One More! Stopping the Suicide Epidemic. Suicide is…. The Enemy Within. Play video clip “The Enemy Within” Available from the California Highway Patrol. Definition of Suicide.

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Not One More! Stopping the Suicide Epidemic

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Not One More!Stopping the Suicide Epidemic


Suicide is…..


The Enemy Within

  • Play video clip “The Enemy Within”

  • Available from the California Highway Patrol


Definition of Suicide

  • “Suicide is a conscious act of self-induced annihilation, best understood …as a needful individual who defines an issue for which the suicide is perceived as the best solution.”

  • Dr. Ed Shneidman, Suicide as Psychache, 1993


Suicide Survivors

  • Spouse

  • Significant Others

  • Parents

  • Children

  • Extended family

  • Grandparents

  • Lovers

  • Friends

  • Co-Workers

  • Classmates

6:1

  • Family members and others who survive following the death of their loved one by suicide:


Nationwide Statistics2004 data

  • One suicide every 16 minutes

  • 11th ranking cause of death in the US

  • 811,000 suicide attempts every year

  • 5 million living Americans have attempted suicide

  • Firearms used in 52% of suicides


Suicide in Specific Populations


LE Suicide Rate

LE LODD Rate

LE Homicide Rate

Law Enforcement Suicide Compared


Retired Comparison Group

Retired LE

Retired LE - Medical Disability

Law Enforcement and Retirement


Write a Name Exercise


“It takes only the smallest of changes to shatter an epidemic’s equilibrium.”

Malcolm Gladwell in the “Tipping Point”


The Tipping Point:Agents of Change

  • The Law of the Few

  • The Stickiness Factor

  • The Power of Context


The Law of the Few

  • Connectors

  • Mavens

  • Persuaders


The Stickiness Factor

Courage is taking the first step

Let us help each other live

Just do something!

  • Advice that is practical and personal also becomes memorable…


The Power of Context

  • Epidemics strongly influenced by their situation

  • Circumstances and conditions

  • Particulars of environments

Kitty Genovese

Graffiti


Courage

Communication

Awareness

One Voice


“Suicide is completed in inches not in leaps”

Attempt

Gesture

Ideation

Completion


Exercise

Write down the 3

most important things in your life.


Myths?

Don’t mention suicide

  • Happens without warning

  • Low risk after mood improvement

  • Once suicidal, always suicidal

  • Only experts can prevent it

  • Runs in the family

  • No note = no suicide


More Myths..

  • Suicide is not preventable

  • Only certain “types” of people become suicidal

  • Don’t talk about suicide or they will “do it.”

  • Antidepressants cause people to be suicidal


Phil’s Letter to Mom


Life’s Most Valuable

________

My mind

________

My family

________

My work


Loss

change

important

perceived

intolerable

  • Loss or changein animportantrelationship

  • To avoid or endperceivedpain

  • Escapeintolerablesituation

  • Gain attention

  • Manipulate

  • Punish others/Punish self

  • Become a martyr


Social Support SystemWarning signs

  • Separation from family or friends

  • - Geographic, legal, temporary

  • Loss of significant others

  • A loner or newcomer

  • Rejected by peers

  • Feels like people don’t care


Loss due to death or divorce

Marital problems or a bad relationship

Terminal illness

Guilt over partner’s death

Legal Problems

Feeling alone

Sexual Accusations

Disability/Retirement

Internal Affairs Investigation

Financial Problems

Arrest

Loss of Employment

PTSD

Why Police Officers Commit Suicide

L

O

S

S

.


Loss of Rational Thinking

  • Lack of sleep

  • Stress or anxiety

  • Substance Abuse

  • Immaturity

  • Psychosis:

    Command hallucinations

    Alien control

    Religious preoccupation


Change in sleep

Change in appetite

Loss of energy, motivation

Loss of interest in pleasurable activity

Apathy

Deterioration of personal appearance

Deterioration of job performance

Frequent physical complaints

Preoccupation with death

Symptoms of Depression

Hopelessness and Helplessness


It is from PTSD that the unseen wounds of an officer begin to manifest. Since we do not see these battle scars, we sometimes

try to pretend they do not exist. Trying to pretend doesn’t make the pain go away.

PTSD

  • Intense arousal after a traumatic event

  • Overwhelms coping mechanisms

  • Leaves the responder feeling helpless and out of control

  • Posttraumatic stress is not prejudiced

  • PTSD invades the mind with almost constant thoughts about the event


It’s Everybody’s Business

Do Something!

  • The student will be able to list the signs & signals of a person who is at risk of suicide.


Suicide and Alcohol

  • Risk is 2-3x higher among alcoholics

  • 15-25% of suicides are completed by alcoholics

  • 50% of those who completed suicide were intoxicated

  • Among suicides of alcoholics, 89% were actively drinking at time of death


Indirect Verbal Clues

  • I can’t go on any longer

  • Nobody needs me anymore

  • I’m tired of life

  • You won’t be seeing me any more

  • I can’t take it any more

  • You’d be better off without me

  • I can’t take the pain


Indirect Suicide IndicatorsClues.... Clues.... Clues....

  • The “practice run”

  • Sudden religious interest/ disinterest

  • Substance abuse relapse

  • More confrontational with subject

  • Buying a weapon

  • Giving away possessions

  • Changes in social behavior

  • Reckless officer safety/behavior

  • Changes in personality


Direct Verbal Clues

  • I wish I were dead

  • You’d be better off without me

  • I might as well be dead

  • If ___doesn’t happen, I’m going to end it

  • I’m going to commit suicide

  • I’m going to kill myself


How Bad Is It?

Lethality lets you know how much help you need and

how fast you need it

How:

  • Is the plan specific?

  • Do they have the means?

  • Are the means lethal?

    History:

  • Prior attempts?

  • Any family history?

    Help:

  • Are they alone?

  • Are they drinking?


Intervention is Action

Do Something!

Respond!

A Silent

Code 3 Request for Help


Barricades to Seeking Help

  • Denial

  • Avoidance

  • Anger

Fear:

Will impact job

Command will be contacted

Hospitalization

Being labeled


Do’s of Intervention

  • Remain calm

  • Accept their feelings

  • Focus on central issue

  • Stay close

  • Emphasize temporary nature of problem

  • Explore resources

Hear what is being said

** Listen ** Listen ** Listen **


Don’ts of Intervention

Don't overlook signs!

Don't remain the only one helping!

  • Don’t sound shocked

  • Don’t offer empty promises

  • Don’t try to joke them out of it

  • Don’t debate morality

  • Don’t assume things will improve

  • Don’t leave person alone

  • Don’t keep it a secret


A Good Listener:

  • Copes with strong emotion

  • Is prepared to listen – time

  • Provides for comfort

  • Tolerates repetition

  • Listens carefully

  • Respect others perspective

  • Avoids interrupting

WAIT THINK RESPOND


The Question

  • Have you been thinking of

  • killing yourself?


Important Questions

How would you kill yourself?

When did you last think about suicide?

What is the closest you’ve come?

Have you ever attempted suicide?

Has anyone in your family attempted/completed suicide?

What are the odds that you will kill yourself?

What has been keeping you alive so far?

What do you think the future holds in store for you?


Referrals

  • Employee Assistance Program (EAP)

  • Health Care Plan


Suicidal Thoughts

Boxed In!

Relationship Difficulties

Do Something!

Depression/Trauma

Adverse Job Action

Alcohol Abuse


Do Something!

Do Something!

  • Continue C.P.R.:

  • Caring

  • Preserving Life

  • Referrals and Resources


Suicide Postvention


“Stigma spillover”

Survivor ReactionsHigh risk groups

Children/Siblings

Friends/Coworkers

Those who find the body

Those who witness the suicide

  • Parents

  • Spouses/Significant Others


Survivor Reactions“Survivor Syndrome”

  • Shock

  • Numbness

  • Denial of death as a Suicide

  • Religious concerns

  • Prolonged search for “Why??”

  • Fear of personal susceptibility


Survivor ReactionsEmotional

Guilt !

  • Shame

  • Anger

  • Responsibility

  • Blaming

  • Scapegoating

  • Abandonment


Survivor Reactions

  • Loneliness

  • Social Isolation*

  • Social stigma

  • Diminished social supports

  • Difficulty trusting others

  • Negative family relations

  • Over protectiveness


  • Play video clip “Suicide Interviews Take 2” stored on Disk #2


Suicide Is…


Cut off from support

Achievements minimized

Private shame and guilt

No honors or recognition

Support network collapses

Decreased benefits

The Cost of Suicide


“Hindering” Survivors

  • Denying the death as a suicide

  • Ignoring or not taking the problem seriously

  • Pressuring them to “get over it”

  • Self-medicating/Taking them drinking

  • Offering negative religious judgments

  • Being judgmental


Let them talk

I’m sorry for your loss…

How can I help?

Is there anyone I can call for you?

Since the suicide, what are the biggest challenges for you?

Use the loved one’s name.

Helping Survivors


Additional Help:

Help the group care about the person, and accept the choice he or she made

Refer individuals who are struggling excessively with anger, loss, or guilt

Don’t remain the only one helping


“Attitudes outweigh facts. Attitudes must change so that statistics can change.”KARL MENNINGER

  • Do Something!


Let us all have

the courage

to take a stand

Not One More…

Not One More…


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