Presented by Samaritans a program of Family and Children’s Service of the Capital Region, Inc.

1. Gatekeeper Suicide Prevention Education in the Gay, Lesbian, Bisexual and Transgendered Communities Presented by Samaritans a program of Family and Children’s Service of the Capital Region, Inc.

2. Objectives • Become familiar with Samaritans work in the community • Learn about suicide statistics and risk factors specific to the GLBT Community • Learn about global risk factors and warning signs for suicide • Learn what you can do to help someone who is suicidal

3. 689-4673 (HOPE) 11 a.m. – 11 p.m. Daily We listen when you need it most.

4. How Samaritans Helps the Capital District

6. Samaritans Crisis Helpline Services • Crisis Helpline 689-4673 (HOPE) • Community Suicide Prevention Education • Direct Services to Suicide Survivors • Outreach • Support Group • Hope and Remembrance Ceremony

7. Listening I’m worried…. I’m lonely… I’m angry…

8. Emotional Stress Physical Illness Drugs and Alcohol Anger Depression Losing Hope Confused Divorce or Breakup Pain Anxiety Death of a loved-one Financial Issues Abuse Job loss No one is listening to me!!

9. Crisis is Universal

10. Suicide Prevention Education Program

11. Section 1: Dispelling Suicide Myths

12. Fact or Myth?People who talk about Suicide are unlikely to complete suicide.

13. MYTH People who talk about Suicide are unlikely to complete suicide. Fact Talking about suicide is a warning.

14. Fact or Myth?Teenage boys are the age group most likely to complete suicide.

15. MYTH Teenage boys are most at risk for suicide. Fact The elderly are at highest risk for suicide.

16. Fact or Myth? • Males are most likely to be suicidal?

17. Myth: Males are more likely to be suicidal. • Women think about suicide more often then men. In fact, women attempt suicide three times more often than men. • However, Men complete suicide more often than women because they chose more lethal means of suicide.

18. Methods of Suicide by Gender Data Source: Office of the Chief Medical Examiner. (2005). Suicides in Alberta 2003. Edmonton, AB: Alberta Justice, Office of the Chief Medical Examiner.

19. Fact or Myth? • Suicide happens without warning.

20. Myth: Suicide happens without warning. • Fact: Most suicidal people give many clues and warning signs regarding their suicidal intention. • Warning Signs: Actions/behaviors that are cause for immediate seeking of professional help.

21. Fact or Myth?Talking with someone about suicide may encourage them to complete suicide.

22. MYTH Talking with someone about suicide may encourage them to complete suicide. Fact Talking may provide relief from painful emotions.

23. Fact or Myth? • Suicidal people are fully intent on dying.

24. Myth: Suicidal People are fully intent on dying. • Fact: Most suicidal people are undecided about living or dying – this is called suicidal ambivalence.

25. Myth or Fact? • Improvement following a suicide attempt or crisis usually means that the risk is over.

26. Myth: Improvement means the risk is over. • Fact: Most suicides occur within days or weeks of improvement, when the individual has the energy and motivation to actually follow through with his/her suicidal thoughts.

27. True or False? Most suicides occur around the winter holidays – in December.

28. FALSE . Data Source: Office of the Chief Medical Examiner. (1998-2005). Suicides in Alberta, 1999, 2000, 2001, 2002, 2003. Edmonton, AB: Alberta Justice, Office of the Chief Medical Examiner.

29. Section 2: Suicide Statistics

30. 90% of people who die by suicide are suffering from one or more psychiatric disorders: Major Depressive DisorderBipolar Disorder, Depressive phaseAlcohol or Substance Abuse*SchizophreniaPersonality Disorders such as Borderline PD*Primary diagnoses in youth suicides. Core Competencies Curriculum AAS/SPRC and the American Foundation for Suicide Prevention

31. Why do people consider and/or complete suicide? For relief from unbelievably painful mental, emotional or physical suffering.

32. Suicide in America • 11th leading cause of death in the USA • 3rd leading cause of death for ages 15-24, and 2nd leading cause of death for ages 25-34 • Approximately 30,000 people die by suicide in the United States Each Year • 734,000 people attempted suicide

33. Suicide in the Capital District ALMOST 2 People per WEEK kill themselves in the Capital District • NYS Department of Health, 2000-2002.

34. Are Gay, Lesbian, Bisexual and Trangendered people at a higher risk for suicide? • Yes – they are at a higher lifetime risk for suicidal ideation • Yes – they are at a higher risk for suicide attempts • Yes – it is estimated that 30% of youth that die by suicide identify as GLBTQ

35. Comparing Lifetime Suicide Plans and Attempts • Gay and Bisexual Men: • 21.3% report having made a suicide plan • 11.9% report a prior suicide attempt • General Male Population: • ~ 12% report having made a suicide plan • ~2.3% report a prior suicide attempt Paul et al. (2002)

36. Which GLBT population is most at risk for suicide? • Youth • Why? Greater Emotional Distress • Developmental life transitions: coming out • Social and Cultural stressors: stigmatization, victimization, and antigay hostility

37. Section Two: Risk Factors and Warning Signs for Suicide

38. Risk Factors within Gay and Bisexual Men: • Native American • Bisexual Men • Men who do not identify as any particular sexual orientation • Less education • Lower annual income • Less than full-time employment • Parents had a drug or alcohol problems • Experienced physical or sexual abuse as a child

39. Additional Risk Factors: • Younger at time of coming out • Early repeated antigay harassment • Recent first sexual experience with another man • Recent disclosure of one’s gay or bisexual identity to others

40. Risk Factors for GLBTQ Youth: • Hopelessness (9x as likely report suicidality) • Methamphetamine use (3.5 x as likely to report suicidality) • Homelessness (4x as likely report suicidality) • In-School Victimization (almost 3x as likely to report suicidality)

41. Additional Specific GLBT Youth Risk Factors: • Youth who are least likely to reveal their sexual orientation to anyone • Males with more feminine gender characteristics • Those who recognized same-sex sexual orientation at an earlier age • Those who have been sexually abused • Those who in the past year identified as GLBT • Family Problems

42. Risk Factors for Suicide Desire Capability Intent

43. Suicidal Desire • Expressing Suicidal Ideation: wanting to hurt self and/ or others • Expressing Psychological Pain • Hopelessness • Helplessness • Perceived Burden on Others • Expressing Feeling Trapped

44. Suicidal Capability • History of Suicide Attempts • Exposure to someone else’s death by suicide • History of or current violence to others • The means are available for hurting self or others • Currently “high” or intoxicated • Substance Abuse • Acute symptoms of mental Illness • Recent and dramatic mood change • Out of touch with reality • Extreme Agitation or Rage • Increased Anxiety • Decreased Sleep • Recent Acts and/or Threats of Aggression

45. Suicidal Intent • Attempt is in progress • There is a PLAN in place of how to hurt self or other • Preparatory Behaviors • Organizing personal affairs • Getting materials together needed to hurt oneself/other • Rehearsing the act • Expressed intent to die

46. Risk Factors for Youth • Parental psychopathology • depressive disorders, mood disorders • Family History of Suicidal Behavior • Life Stressors such as Interpersonal Losses • relationship breakup • argument with parents • Legal and Disciplinary problems • Physical and Sexual Abuse • Conduct Disorders

47. Risk Factors for Youth • Sexual/Gender Orientation • Juvenile Delinquency • Contagion or Imitation • exposure to media accounts of suicidal behavior • exposure to suicidal behavior in friends and acquaintances • Living alone/Runaways • Aggressive-impulsive behaviors

48. Imminent Warning Signs:actions/behaviors that are cause for the immediate seeking of professional help. • Someone threatening to hurt or kill him/herself, or talking of wanting to hurt or kill him/herself. • Someone looking for ways to kill him/herself by seeking access to firearms, available pills, or other means. • Someone talking or writing about death, dying or suicide, when these actions are out of the ordinary for the person.

49. Warning Signs • I – Ideation • S - Substance Abuse • P – Purposelessness • A – Anxiety • T – Trapped • H – Hopelessness • W – Withdrawal • A – Anger • R – Recklessness • M – Mood Changes

50. Protective Factors:may help to reduce the risk of suicide •  Connection with Health Care System •  Immediate Supports Available •  Good support systems: Family and Community •  Wants help •  Strong past coping skills •  Fear of self-injury or death •  Sense of Purpose •  Religious/ethical beliefs that prohibit suicide •  Positive engagement with a “helper” •  Children •  Built in rescue plan •  Future planning •  Future hope •  Ambivalence