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, 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

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

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


Intro and purpose

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

Exercise: Personalizing Crisis


Basic terms definitions

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

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

Facts: Depression & USC Students*

  • Felt things were hopeless

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


Facts depression usc students1

Facts: Depression & USC Students*

  • Felt very lonely

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


Facts depression usc students2

Facts: Depression & USC Students*

  • Felt very sad

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


Facts depression usc students3

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

Facts: Suicidal Thinking & USC Students*

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


Facts self harming behaviors usc students

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

Facts: Suicide Attempts*

  • Attempted Suicide

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


What we know about people who die by suicide

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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    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

    How to NOT ask the Question

    “You’re not suicidal, are you?”


    Follow up questions

    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.


    Discussion1

    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

    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 do1

    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 do2

    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

    Role Play Exercise


    Making a bit report

    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

    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

    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


    Boundaries1

    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

    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

    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

    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

    Thank you

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