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Suicide Prevention Training . Jennifer Myers, MA Coordinator of Suicide Prevention Services [email protected] Counseling & Human Development Center Byrnes Building, 7 th Floor 803-777-5223. Take care of you. Employee Assistance Program: 1800-822-4847. Intro and Purpose.

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Suicide Prevention Training

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Suicide Prevention Training

Jennifer Myers, MA

Coordinator of Suicide Prevention Services

[email protected]

Counseling & Human Development Center

Byrnes Building, 7th Floor

803-777-5223


Take care of you.Employee Assistance Program: 1800-822-4847


Intro and Purpose

  • To educate about the signs of suicide

  • To inform you of how to respond if you are concerned a person may be suicidal or in emotional distress

  • To empower you to feel confident to intervene

  • To connect you with resources


Exercise: Personalizing Crisis


Basic Terms & Definitions

  • Suicidal Ideation – Thinking about suicide

  • Suicide threat – Stating intent to kill yourself

  • Suicide attempt – Any act or behavior intended to end your life

  • Intentional self-harm – Behavior related to self harm but absent of the intent to kill oneself

  • Completed/died by suicide – suicide death

  • Survivor of suicide – friend or family member of deceased


Facts About USC Students (NCHA*)

  • In the past year, USC students:

    • 41% experienced hopelessness

    • 59% reported feeling very sad

    • 26% felt so depressed it was difficult to function

    • 4.6% seriously considered suicide (1,349 students or 26 students per week)

    • 0.5 % attempt suicide (147 students or approximately 3 per week)

*American College Health Association’s National College Health Assessment 2010


Facts: Depression & USC Students*

  • Felt things were hopeless

    *American College Health Association’s National College Health Assessment 2010


Facts: Depression & USC Students*

  • Felt very lonely

    *American College Health Association’s National College Health Assessment 2010


Facts: Depression & USC Students*

  • Felt very sad

    *American College Health Association’s National College Health Assessment 2010


Facts: Depression & USC Students*

  • Felt so depressed that it was difficult to function

    *American College Health Association’s National College Health Assessment 2010


Facts: Suicidal Thinking & USC Students*

*American College Health Association’s National College Health Assessment 2010


Facts: Self Harming Behaviors & USC Students*

  • Intentionally Cut, Burned, Bruised, or otherwise injured yourself

    *American College Health Association’s National College Health Assessment 2010


Facts: Suicide Attempts*

  • Attempted Suicide

    *American College Health Association’s National College Health Assessment 2010


What we know about people who die by suicide

  • Men are 4 times more likely than women to die by suicide

    • Women are 3 times more likely to attempt

    • In college students, this gender difference is less apparent

  • 80% of those who die by suicide in college are not receiving treatment through the counseling center

  • 90% had one or more mental disorder

  • 50% had alcohol in their system at the time of death


  • Why people die by suicide?

    • Feelings of hopelessness are more predictive of suicide than depression

    • Perceived burdensomeness

    • Thwarted Belongingness

    • Suicide is not chosen; it happens when pain exceeds an individual’s resources for coping with pain


    Discussion

    • Is there a stereotypical “suicidal person”?

      • What would this person look like? What would they wear? How would they act? How would they talk?

    • Myths about Suicide

      • No one can stop a suicide, it is inevitable.

        • If people in a crisis get the help they need, they will likely never be suicidal again.

      • Suicidal people keep their plans to themselves.

        • Most suicidal people communicate their intent sometime during the week preceding their attempt.


    National Suicide Statistics at a Glance

    • Suicide Rates Among Persons Ages 10 Years and Older, by Race/Ethnicity and Sex, United States, 2002-2006,

    • Source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention


    National Statistics at a Glance

    • Percentage of Suicides Among Persons Ages 10-24 Years, by Race/Ethnicity and Mechanism, United States, 2002-2006

      • Source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention


    Racial & Ethnic Disparities

    • Among American Indians/Alaska Natives ages 15- to 34-years, suicide is the second leading cause of death.

    • Suicide rates among American Indian/Alaskan Native adolescents and young adults ages 15 to 34 (20.0 per 100,000) are 1.8 times higher than the national average for that age group (11.4 per 100,000).

    • Hispanic & Black, non-Hispanic female high school students reported a higher percentage of suicide attempts (11.1% and 10.4%, respectively) than their White, non-Hispanic counterparts (6.5%).

      Source: Centers for Disease Control and Prevention,

      National Center for Injury Prevention and Control


    Additional Considerations

    • There is a range of cultural and spiritual beliefs about suicide

    • View regarding seeking psychological services

    • Pressures, support systems, coping mechanisms, psychological symptoms may vary


    Special Population-LGBTQ

    • LGBTQ individuals are at higher risk for suicidal thinking

      • There is no tracking system of sexual orientation or gender identity in completed suicides

  • Sexuality or gender identity does not create the higher risk itself.

  • Those who are at higher risk:

    • Early disclosure of sexuality

    • Hiding sexuality

    • Lack of Family Acceptance

    • Bullying or Harassment

    • Conflict with Spiritual Beliefs

    • Low self esteem, struggle with personal acceptance

    • Isolation


  • Special Populations-Veterans

    • Markers for suicide risk are noticeably higher in student veterans than general student population

    • 10 years of combat has resulted in increase in

      • Substance abuse

      • PTSD

      • Depression

    • An estimated 20% of Veterans have struggled with PTSD or depression

    • May not disclose suicidal thinking


    Acute Warning Signs

    • These are indicators that a person is suicidal

      • Someone threatening, talking about, or stating they intend to hurt or kill themselves

      • Someone looking for ways to kill themselves: Seeking access to pills, weapons, or other means

      • Someone talking or writing about death, dying, or suicide

      • Rehearsing a suicide attempt

        Take all Warning Signs Seriously


    Direct Verbal Cues

    • “I’ve decided to kill myself.”

    • “I wish I were dead.”

    • “I’m going to commit suicide.”

    • “I’m going to end it all.”

    • “If (such and such) doesn’t happen, I’ll kill myself.”


    Indirect Verbal Cues

    • “I’m tired of life, I just can’t go on.”

    • “My family would be better off without me.”

    • “Who cares if I’m dead anyway.”

    • “I just want out.”

    • “I won’t be around much longer.”

    • “Pretty soon you won’t have to worry about me.”

    • “You won’t see me anymore.”


    Additional Warning Signs

    • I Ideation

    • S Substance Abuse

    • P Purposelessness

    • A Anxiety

    • T Trapped

    • H Hopelessness

    • W Withdrawal

    • A Anger

    • R Recklessness

    • M Mood Change

      Take all Warning Signs Seriously


    Risk Factors

    • Previous Suicidal Behavior

    • Impulsivity

    • Significant substance use or dependence

    • Family History of Suicide

    • Previous History of Psychiatric Diagnosis

    • Eating Disorder

    • History of abuse (sexual, physical, emotional)

    • Chronic pain

    • Recent Discharge from inpatient psychiatric treatment


    Situational Triggers

    • Loss of any major relationship

    • Death of a spouse, child, or best friend, especially if by suicide

    • Being fired, failing classes, rejection or expulsion from a program

    • Sudden unexpected loss of freedom/fear of punishment

    • Diagnosis of a serious or terminal illness


    The Good News

    • Some aspects of college are protective factors

    • These include:

      • Presence of Social Supports

      • Improved problems solving & coping skills

      • Access to treatment and other helpers

      • Hopeful about the future

      • Fear of social disapproval


    ASK Directly about Suicide

    • Common ways to ask:

      • “Are you thinking about suicide?”

      • “Do you want to kill yourself?”

      • “Sometimes when people are sad as you are, they think about suicide, Have you been thinking about suicide?”

      • “You look pretty miserable, I wonder if you’re thinking about suicide?”

      • “You know, when people are as upset at you seem to be, they sometimes wish they were dead. I’m wondering if you’re feeling that way, too?”

      • Note: If you cannot ask the question, find someone who can.


    How to NOT ask the Question

    “You’re not suicidal, are you?”


    Follow up questions

    • “Have you been thinking about how you would kill yourself?”

    • “How long have you been thinking about this?”

    • If a person has stated the means they would kill themselves with, take steps to remove the means.


    Discussion

    • Myths about suicide:

      • If you ask someone directly about suicide, you will put the idea in their head and might make them want to do it.

      • Truth is asking someone directly about suicide lowers anxiety, opens up communication, and lowers the risk of an impulsive act.

        • Most suicidal persons indicate experiencing relief if asked directly about suicide.


    What to do

    • If you observe any of the acute warning signs:

      • Between 8am to 5pm M-F: go with the student to the Counseling and Human Development center 7th Floor Byrnes Building

        803-777-5223

        • Another staff person should contact CHDC and inform them of the situation

      • After 5pm M-F or Saturday or Sunday, Contact the USC Police 911 (7-4215 for dispatch)


    What to do

    • If you observe warning signs other than the acute warning signs

      • CHDC Walk in hours 2-4pm M-F

      • Consult with CHDC 803-777-5223 or USC Police, 911 or 7-4215, regarding the risk

      • Refer the person to counseling

        • Assist them in calling &making an appointment

        • Walk with them to the appointment if needed

      • Inform other staff in your department

      • Follow Up with the person and pay attention to additional warning signs.


    What to do

    • Be willing to listen

    • Be non-judgmental

    • Be direct

    • Be available

    • Offer hope that options are available

    • Be actively involved in getting the person treatment

    • Take action to remove lethal means

    • Follow up (after they went to counseling center or other intervention)


    Role Play Exercise


    Making a BIT report

    • Reports to file:

      • http://www.housing.sc.edu/bit/

    • Additional Resources:

      • http://www.housing.sc.edu/lasd/pdf/BAGGuide.pdf


    Early Intervention

    • Assist residents in recognizing their signs of stress, anxiety, and depression

    • Help them to develop positive coping skills

    • Pay attention to isolated students and try to engage them. Keep them on your radar screen

    • Be aware of relationship break ups and support residents as appropriate

    • Refer to counseling


    Boundaries

    • You are not the therapist

    • You don’t have to make a safety plan with the person. You can be one part of a safety plan

    • Do not keep a persons suicidal communications or signs a secret

    • Use CHDC staff for consultation, specifically Dr. Bob Rodgers, Jennifer Myers, Dr. Toby Lovell


    Boundaries

    • Work together with others. Your role is not to “fix” the problem.

    • Set limits and boundaries on the amount of time you available or spend with a student

    • More is not always better


    Self Care

    • Take care of yourself

    • Use your support systems

    • Pay attention to your cues regarding stress

    • Take time away as needed

    • Know your positive coping mechanisms & use them frequently

    • Recognize and respect your limits

    • Use supervision to address your needs

    • Go to therapy for your own mental health concerns


    Campus Resources

    • Counseling and Human Development Center

      • 7th Floor Byrnes Building

      • www.sa.sc.edu/shs/chdc 803-777-5223

  • USC Police

    • 7-911 or 803-777-4215

  • Thomson Student Health Center

    • www.sa.sc.edu/shs 803-777-3175

  • Behavioral Intervention Team

    • www.sc.edu/bit 803-777-4333

  • Student Disability Services

    • 803-777-6142


  • Additional Resources

    • National Suicide Prevention Lifeline

      • 1-800-273-8255 (TALK)

      • www.suicidepreventionlifeline.org

    • Trevor Project (GLBT Youth)

      • 1-866-488-7386

      • www.thetrevorproject.org


    Thank you

    • Please complete the evaluation form


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