BUILDING COMPETENT COMMUNITIES FOR YOUTH SUICIDE PREVENTION Maureen M. Underwood, LCSW

1. BUILDING COMPETENT COMMUNITIES FOR YOUTH SUICIDE PREVENTION Maureen M. Underwood, LCSW maureenunderwoodlcsw@gmail.com Society for the Prevention of Teen Suicide

2. Workshop Leader • Maureen M Underwood LCSW • Lead author, Lifelines Suicide Prevention Trilogy • Previous coordinator, NJ Youth Suicide Prevention Program • Clinical director, Society for the Prevention of Teen Suicide

3. Workshop Objectives Review information about youth suicide , including bullying as a risk factor Relate youth suicide prevention to bullying initiatives Describe the role of the “competent community” in youth suicide prevention Outline how community members can participate in the prevention effort Help you better recognize youth who may be at risk

4. Is Bullying a Suicide Risk Factor • Frequent exposure to bullying or victimizing others related to high risks for: • Depression • Suicidal ideation • Suicide attempts Klomek etal. (2007). Bullying, depression and suicidality in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry ; 46(1);40-49.

5. Students Involved In Bullying: Increased Risk for Suicide (12mos) Compared to Youth Not Involved in Bullying Middle School High School Ideation: Targeted students: 3.9x Students who bullied: 2.9x more likely Bully/Targeted students: 4.9x more likely Attempts Targeted students: 4.3x more likely Students who bullied: 3.1x Bully/Targeted students: 5.7x • Ideation: • Targeted students: 3x more likely • Students who bullied: 4.1x more likely • Bully/Targets: 6.6 x more likely • Attempts • Targeted students: 2.1x more likely • Students who bullied: 4.4x • Bully/Targeted students: 7.5x Data from Massachusetts, 2009

6. Victimization-Suicidality Pathway

7. What School Strategies Help Reduce Bullying? • Research clearly shows that the key to reducing bullying (and creating lasting, positive change in school climate) is to get everyone in the school community involved in building a competent, caring community.

8. Why Talk about Youth Suicide? Third-leading cause of death in adolescents Second-leading cause of death among college students There are 50 to 200 attempts for every completion Almost 7% of high school students report making a suicide attempt Over 14% of high school students report suicidal thoughts

9. In Simpler Numbers … Every year, there are approximately 10 youth suicides for every 100,000 youth Every day, there are approximately 11 youth suicides Every 2 hours and 11 minutes, a person under the age of 25 dies by suicide

10. . Why have a “community Plan”?

11. A ‘Competent’ Youth Suicide Prevention Community • Community leaders/key stakeholders are committed to welfare of all members of the community • Everyone in community is committed to preventing youth suicide • Everyone knows where to get help when a community member is in need

12. Includes: • Community leaders • All segments of the community: • Government • Law enforcement • Education • Recreation • Clergy • Business • Community service agencies

13. Focuses on: • Developing community awareness of dimensions of the problem • Engaging community & school leaders • Assessing needs & existing services • Developing action plans that target identified needs & anticipate emerging ones

14. Starting at the beginning: What Do You Already Know About Youth Suicide… …and what do you want to know?

15. AnsweringCommon Questions

16. Answering Common Questions Aren’t mental health professionals the only ones who can really help suicidal kids?

17. Answering Common Questions Can Suicide Really be Prevented?

18. Answering Common Questions Is Talking about Suicide Just a Way for Someone to Get Attention?

19. Answering Common Questions Can Talking about Suicide Plant the Idea in the Minds of Vulnerable Teens?

20. Answering Common Questions Are School Programs That Address Suicide Safe?

21. Understanding Suicide “A problem well-defined is a problem half- solved”

22. Suicide An attempt to solve a problem of intense psychic pain with impaired problem-solving skills

23. Characteristics of Suicide

24. Overlap Theory of Suicide Risk

25. Red: Warning Signs Yellow: Risk Factors Green: Protective Factors

26. Warning Signs F = Feelings A = Actions C = Changes T = Threats S= Situations

27. Feelings • Hopelessness • Anger • Worthlessness • Emptiness • Excessive worry

28. Actions • Trying to get access to guns or pills • Risky or dangerous behaviors • Increasing drug/alcohol use • Getting into fights

29. Changes • Changes in moods, actions or behaviors • Recent prescription of medication with depression as potential side effects • Adjustment/changes in antidepressant medications

30. Threats • Specific verbal statements: I want to die, I want to kill myself • Worrisome innuendos • Themes of death /destruction in school assignments

31. Situations • Situations that may serve as a trigger- when a student’s coping skills are really challenged, especially: • Loss • Change • Getting into trouble

32. How a Suicide Crisis Develops • Series of problems • Attempts to deal with them perceived as unsuccessful • Suicide seen as consistent with self-image • Suicide perceived as viable option

33. Tunnel Thinking Making the shift in thinking that can lead to the perception of suicide as an alternative S

34. THE PERFECT STORM

35. Suicide Risk Factors v. Protective Factors

36. Protective Factors • Contact with a caring adult • Sense of connection • Positive self-esteem and good coping skills • Access to care for emotional/physical problems, substance abuse • Cultural/religious beliefs that discourage suicide and promote self-preservation

37. Fostering Protective Factors • Teach children it is okay to ask for help • Give children permission to talk about traumatic events like suicide • Help children identify trusted adults • Encourage participation in school & community activities • Be a resource to parents

38. Provides an effective initial response to potentially suicidal students Knows where to refer students for additional assistance The Competent School Community in Suicide Prevention

39. Suicide Prevention Strategies Identification Support and Response Education

40. The Lifelines Program Program Goal: To develop the school-based expertise and supports needed for responding to the problem of adolescent suicidal behavior

41. Lifelines Objectives 1. To increase the probability that persons who come into contact with potentially suicidal adolescents: a. can more readily identify them b. know how to respond to them c. know how to rapidly obtain help for them d. will be consistently inclined to take such action 2. To make sure troubled youth are aware of and have access to helping resources so that they are inclined to seek help as an alternative to suicide

42. Lifelines Components Administrative Readiness Consultation Faculty and Staff Training Parent Workshop Student Curriculum

43. Curriculum Learning Objectives To present relevant facts about suicide To alert students to signs of suicide risk in peers and encourage serious responses To outline ways to respond to troubled peers To demonstrate positive attitudes about intervention and help-seeking behavior To identify resources

44. Identifying risk factors & warning signs Knowing and protective factors Your Role as Community Members

45. Putting It All Together The competent school community engages all members in suicide prevention activities The competent school community can increase the effectiveness of responses to at-risk teens, their families, and friends

46. Additional Resources www.sptsusa.orgSociety for the Prevention of Teen SuicideFocuses on resources for the competent school community www.sprc.orgSuicide Prevention Resource CenterNational resource www.afsp.orgAmerican Foundation for Suicide PreventionPrinted materials & resources www.suicidology.orgAmerican Association of SuicidologyData, resources, links