Bullying andYouth Suicide PreventionJudith Springer, Psy. D. Clinicaland Professional Board Member, SPTS
Workshop Objectives • Provide basic information about suicide and suicide prevention. • Discuss relationship between suicide prevention and bullying prevention. • Define educators’ crucial, although limited, role in schools’ suicide prevention efforts • Review the roles of parents and students in suicide prevention.
Each year, there are approximately 10 youth suicides for every 100,000 youths in the United States.Each day, there are approximately 11 youth suicides in our country.Every 2 hours and 11 minutes one person under the age of 25 completes suicide.One preventable death is one toomany.
A Personal Perspective The other side of facts and figures
SUICIDAL BEHAVIOR Attempt to solve a problem of intense pain with impaired skills
(Shneideman, 1985) CHARACTERISTICS OF SUICIDE
Youth Suicide is a Preventable Mental Health Problem • Research shows that clues or warning signs can be detected by others. • Research has demonstrated that restriction of lethal means can reduce attempts. • Clinical evidence identifies suicidal thinking as crisis thinking that can be altered by crisis intervention techniques. • Evidence demonstrates the effectiveness of medication & cognitive behavioral treatment for symptoms of depression.
Suicide Prevention Strategies Awareness Education about Identification Support and Response
What is a “Competent” Prevention Community? • Concern for youth suicide prevention is shared by all community members. • All members can recognize signs of risk. • The community has a coordinated fabric of prevention activities that are integrated into established community services. • All members know how and where to get help when a community member is in need, and are willing and able to do so .
Essential Partner in Prevention: A Limited but Critical Role TheSchool
What educators need to be able to do • Understand basic information about suicide • Know their role in their school’s suicide prevention strategy • Recognize students who may be at risk • Understand crucial, but limited, role of identification and referral
Red: Warning Signs Yellow: Risk Factors Green: Protective Factors
Risk Factors: Non-Clinical • Age • Sex • Race • Sexual orientation • “Giftedness” • Family • History of suicide • Abuse • Exposure • To death of peer • Recent Stressors • Loss • Trouble- E.g. being bullied or bullying others • Change – transition • Access to means
How can Bullying Affect Students Who are Targeted? • Short-term • Sadness, fear, anger, pain, loneliness, and embarrassment • School avoidance; academic problems • Long-term • Internal expressions like depression and eating disorders • External expressions may include poor grades, aggression and violence • Very rarely but tragically, suicide attempts and completions; homicide.
Is Bullying a Suicide Risk Factor? • What research tells us about connections between bullying and suicidal ideation • Targeted students are 2-9x more likely to report suicidal thoughts than non-bullied peers. • Students who bully are also at increased risk for suicidal behavior. • Students who both bully and are bullied are at the highest risk.
Vulnerabilities for Bullying • Most common targets: • Sexual orientation • Race • Body Size • Gender presentation • Other targets: depressed, learning disabled, socially awkward, developmentally delayed, obese • BOTTOM LINE? These are also risk factors for suicide.
Association between LGBTQ and Bullying and Suicide • Rate of suicidal ideation and attempts are higher for sexual minority youth • LGB youth about 3x more likely to make attempt or ideate than non-LGB youth(Silenzio et al, 2007) • 50% of sexual minority youth get bullied, threatened, assaulted by peers (D’Augelli, 1998; Freedman, 2011)
Clinical Risk Factors • Psychiatric diagnosis • Drug / alcohol use • Previous attempt
Most Common Diagnoses in Teen Suicide MALE FEMALE (N=213) (N=46) Depression 50% 69% Conduct Disorder 43% 24% Anxiety 19% 48% Substance Abuse 38% 17%18- to 19-year olds* 60–67% 13% Brent et al. 1999, Shaffer et al. 1996
Access to Means… Most Preventable Risk Factor
Demographic Family Clinical Exposure Stressors When Risk Factors Converge Accessto Means
Warning Signs F = Feelings A = Actions C =Changes T = Threats S= Situations
Feelings • Hopelessness • Anger • Worthlessness • Emptiness • Excessive worry
Actions • Trying to get access to guns or pills • Risky or dangerous behaviors • Increasing drug/alcohol use • Getting into fights • Writing suicidal messages on social networking sites
Changes • One of the most significant warning signs in adolescents • Changes in moods, actions or behaviors • Recent prescription, change in psychiatric medication
Threats • Specific verbal statements :I want to die, I want to kill myself • Worrisome innuendos • Themes of death /destruction in school assignments
Situations • Situations that may serve as a trigger- when a student’s coping skills are really challenged, especially: • Loss – e.g. family death or divorce; breakup • Change • Getting into trouble
Protective Factors Personal, behavioral, or situational characteristics that help students become resilient despite risks.
Protective Factors Caring relationship with at least one trusted adult Sense of connection/meaningfulparticipation in school 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
Fostering Protective Factors • Teach students it is okay to ask for help. • Give students permission to talk abouttraumatic events like suicide. • Help students identify trusted adults. • Encourage participation inschool & community activities • Acknowledge student efforts • Be a good listener, as often as you can
DEALING WITH AT-RISK STUDENTS Making it Real… • BRAD • James • Elena • Conner
Helping At-Risk Students • Pay attention to who your students are, not just how they perform academically • Notice their appearance • Observe their social skills / relationships • Monitor their behavior changes
DEALING WITH AT-RISK STUDENTS Making it Real… • Brad • James • ELENA • Conner
What About Elementary School Students? • Suicide by children is very rare. • About four children in 500,000 kill themselves • every year. • The suicide rate for 10-14 year olds • is on the rise.
What About Suicide Prevention for Elementary Students? 1. Don’t teach “Don’t tattle.’ 2. Do teach , “Ask for help if you or someone else is getting hurt” and “Friends help friends.” 3. Focus on promoting helpful behavior and preventing bullying and hurtful behavior. 4. Encourage children to identify least one trusted school adult. 5 Teach social emotional skills – e.g. self-calming and problem-solving skills.
Educators’ Role in Review • Learningsigns of risk in students • Identifyingat-risk students • Referringto appropriate resources
What About Parents? Parents need to be able to: • Understand school’s policies and procedures • Recognize signs of trouble in their children • Know what to do and where to go for resources • Understand how to respond to other at-risk youth
Do Students Have a Role in Suicide Prevention? • Awareness of warning signs • Strategies for getting help • personally • Knowledge of ways to help peers • Awareness of school and community resources • Identification of caring adults
Frequently Asked Questions nswering Common Questions Is there any crossover between bullying prevention programs and suicide prevention programs?
Frequently Asked Questions Are School Programs That Address Suicide Safe?
Frequently Asked Questions Is Talking about Suicide Just a Way for Someone to Get Attention?
Frequently Asked Questions Can Talking about Suicide Plant the Idea in the Minds of Vulnerable Teens?