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Impact of Suicide on Youth and Families. The O nes We Miss. Video . Who would have thought this could happen?. Why are YOU here today?. Small group discussion: Introduce yourself What do you know about suicide? Share story with larger group if willing. What do we know?.

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Presentation Transcript


Who would have thought this could happen?

Why are you here today
Why are YOU here today?

Small group discussion:

Introduce yourself

What do you know about suicide?

Share story with larger group if willing

What do we know
What do we know?

  • Wisconsin – 5th highest in nation 10-14 year olds

  • Second leading cause of death – 15-24 yr. olds

  • National Rate = 8.76

  • Wisconsin Rate = 10.78

  • People who die in Wisconsin due to suicide are younger…

What else do we know
What else do we know?

  • Inpatient hospitalization for youth (15-24) is more than double than the nation.

  • However, E.R. visits are slightly lower than national rates

    What would this mean to you?

Learning objectives
Learning Objectives

  • Gain understanding of the phenomenology of suicide and its impact on children and adolescents.

  • Understand the warning signs, risk factors, and protective factors of suicide when assessing children and families.

  • Gain understanding of the scope of the problem facing Wisconsin.

  • Develop an awareness and understanding of who are the “Ones We Miss”, including children in out-of-home care and youth who are bullied.

The burden of suicide in wisconsin
The Burden of Suicide in Wisconsin

“Suicide affects an entire community and, because it is a complex issue, it will take a community to work on it.”

Pat Derer, President, HOPES

(Helping Others Prevent and Educate about Suicide)

The burden of suicide in wisconsin1
The Burden of Suicide in Wisconsin

  • Firearms most frequently used method

  • 1 of 4 have history of previous attempts

  • Over 33% had alcohol present in their system

  • Mental health – especially depression

  • 4:1 male to female suicide deaths

  • Cost – years lost to society (20,000 years/year)

Interesting data on wi
Interesting Data on WI

  • US rate declined 24% during 1995-2005

  • Wisconsin only 8% decline

  • Firearms = 60% of completed youth suicides

  • But….88% hospitalizations for O.D. & cutting

  • So….most lethal methods = no hospitalization

    Rates of attempts, mortality, and self-reported risk among youth is unacceptably high

Who are we missing
Who are we missing?

Male deaths outnumber female deaths

  • use more lethal methods

  • are not hospitalized

    What else do we know about male adolescents?

Specific risk for males
Specific Risk for Males

  • Relationships

  • Access and ability to use lethal means

  • Murder – Suicide

  • Socially isolated

  • Family history

  • Mental illness or substance abuse

  • Divorce

  • Homosexuality

Risk factors and warning signs
Risk Factors and Warning Signs

Small group discussion:

What do you know about:

Risk factors?

Warning signs?

List on flip chart and post on wall when finished

Suicidal behaviors
Suicidal Behaviors

  • Suicide

  • Suicide Attempt

  • Suicide Ideation

  • Suicide Plans

Ones we miss
Ones we miss…..

  • 55% talked about suicide within a month of their suicide

  • 45% did not

  • 73% who died DID NOT mention intent or ideation during last contact w/ a professional

  • Those who did:

    60% - spouses

    50% relatives

    18% caregivers

Self injurious behavior sib
Self-Injurious Behavior (SIB)

  • Severe

  • Stereotype

  • Socially Acceptable/ Emblematic

  • Superficial/Moderate


  • Attempt suicide much younger than previously thought

  • Hanging is the most common method

  • Don’t express suicidal intent or signs of depression

  • Have conflicts with parents


Warning signs/Risk Factors:

  • Past attempts/threats

  • Past violent aggressive behavior

  • Cognitive immaturity/impulsivity

  • Little to no supervision

  • Bringing weapons to school

  • Recent experience of humiliation/shame

  • Bullying

  • Victim of abuse/neglect

  • Witnessing violence in the home

  • Themes of death/preoccupation with violence

  • Poor peer relationships

  • Vandalism, cruelty to animals, fire setting


What separates those who attempt from those that think about it?

  • Substance abuse (12.8 times)

  • Enduring hopelessness

  • Isolation

  • Reluctance to discuss suicidal thoughts

  • Psychopathology

General risk factors for adolescents
General Risk Factors for Adolescents

  • Previous suicide attempt

  • Mental Illness

  • Imitation

  • Family history of suicide

  • Sexual orientation

  • Sexual abuse

  • Other stressors

  • Incarceration

Protective factors
Protective Factors

  • Friends - most important protective factor

  • Supportive parent

  • School relationships

Are these ones we miss
Are these… “Ones We Miss”?

African American

The System


Native American






  • Ratio of attempts to completions: 4,000:1

  • Suicide attempt is NOT a statistical risk factor

  • Depressive episode IS a risk factor

  • Do not always have a precipitating event

  • May attempt while recovering from depression

  • Panic attacks ARE a risk factor


  • Ratio of attempts to completions: 500:1

  • Attempts ARE statistical risk factor

  • Often kill themselves within a few hours of a precipitating event:

    • Anxiety

    • Legal problems, relationships, humiliating experience, etc.

  • Aggressiveness IS a risk factor

Are these some of the ones we miss
Are these some of the “Ones We Miss”?

African American

The System


Native American

Native American




Possible reasons for increase
Possible Reasons for Increase

  • Stigma around mental health

  • Non-native workers

  • Removed from “community”

  • Historical oppression

  • Intergenerational trauma

Protective factors1
Protective Factors

  • Culture

  • Tradition

  • Community

  • Family

Richard cardinal1
Richard Cardinal

  • Risk Factors?

  • Protective Factors?

  • Commonalities to youth in the system today?

Are these some of the ones we miss1
Are these some of the “Ones We Miss”?

African American

African Americans

The System


Native American




African american youth
African American Youth

  • Historically lower rates than whites

  • This is changing – 10-14 year olds greatest increase

  • Why?

    • Better knowledge, attention, reporting

    • Same as white counterparts

    • Structural barriers to health care

    • Attitudinal barriers

    • Economics/employment

African american youth1
African American Youth

  • Access to firearms

  • Isolation from social institutions

  • Protective factors: family, church, school, community

Are these some of the ones we miss2
Are these some of the “Ones We Miss”?

African American

The System



Native American




Lgbtq youth

  • Extremely high rate of depression, suicidal thoughts, and suicide attempts

  • 30% of all adolescent suicides

  • Primary cause (reported by LGBT teens) is negative family interactions

  • “One’s We Miss”…………….

Are these some of the ones we miss3
Are these some of the “Ones We Miss”?

African American

The System


Native American






The bullied and the bullies
The Bullied and the Bullies

Definition of Bullying:

Unwantedaggressive behavior that is intentional and that involves an imbalance of power or strength. Typically repeated over time.

Physical: hitting, tripping, breaking possessions

Verbal: name calling, threatening, taunting

Social/Relational: shunning, gossip/rumors, cyber bullying

Profile of a bullied child adolescent
Profile of a Bullied Child/Adolescent

Two main groups: The Passive Victim

The Provocative Victim

LGBTQ Youth:

Teens bullied 26 times/day

31% threatened or injured last year

Impairs their education

2-4 times as likely to attempt suicide

28% drop out of school

4 of 5 say they don’t know ONE supportive person at school


  • Bullies are usually “loners”

  • They have low self-esteem

  • Bullying is the same as conflict

  • Most bullying is physical

  • It isn’t serious

  • Most likely to happen in urban school

  • Most likely to happen on the bus

  • Most kids who are bullied tell an adult.

  • Bullied kids learn to deal with it on their own.

Small group discussion
Small Group Discussion

Of children in your care (past or present)…

  • Which youth are “at risk”?

  • Identify specific risk factors

  • Identify protective factors

What can we do
What can we do?

The Question Model

  • Ask the question(s)

  • Listen and respond

  • Act or refer

Now what do you do with w hat you know
Now, what do you do with what you know?

large group discussion

  • Who do you have on your team?

  • Who makes the decision regarding the “act/refer”?

Whew that is a lot of information
Whew! That is a lot of information!

  • Suicide in WI

  • Risk factors

  • Warning signs

  • Protective factors

  • The “ones we miss”

  • Special risks for children and youth in care

  • How to ask the questions

Resources (American Foundation for Suicide Prev.) (Suicide Prev. Resource Center) (Mental Health of WI) (Helping Others Prev. & Educate) (Suicide Prev. ActionNetwork USA)