1. Suicide Prevention Shadle Park HS, April 2, 2015
Dr. Dave Crump, Director SPS Chris Moore, Coordinator, SPS Sabrina Votova, Coordinator, Youth Suicide Prevention Program

2. Today’s agenda Signs and Symptoms Contagion and Glamorization
Communication
Community Resources
Questions & Answers
This is what we’ll cover in the time we have now.
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3. Myth or Fact?
Depression among adolescents is extremely rare, and the symptoms are so dramatic that it is obvious when depression affects a teen.
MYTH
Depression is actually relatively common among youth. Symptoms may be subtle, confusing, or hard to distinguish from normal adolescent behavior.
Ask the question then explain why this is a myth. Direct everyone to the parent depression booklet, particularly the information about watrning signs on pages 6 and 7.
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4. Normal adolescent behavior
Testing rules and limits
Touchy if asked too many questions
Moody at times
Easily embarrassed
Amplified emotions and reactions
Moving away from family – peer-oriented and motivated by peers' approval
One reason it can be hard to determine whether a young person is depressed is that normal adolescence is already a difficult time.
Explain these characteristics of normal adolescents and that kids are starting to behave in these ways younger than when we were children. Be sure to explain the idea of the “adolescent roller coaster” and that those amplified feelings may look disproportionate or silly from an adult perspective, but for the young person they are real and need to be addressed as such.
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5. Signs and Symptoms of Suicide
Increased use of alcohol and/or drugs
Changing normal routine, such as eating and sleeping patterns
Preoccupied with death, dying or violence
Feeling trapped and hopeless
Engaging in risky and/or self-destructive behavior
Giving away personal belongings
This is what we’ll cover in the time we have now.
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6. Signs and Symptoms of Suicide
Lack of or difficulty concentrating
Feelings of worthlessness or guilt
Impulsivity
Hyperactivity
Talking or joking about suicide
Mood swings
This is what we’ll cover in the time we have now.
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7. Signs and Symptoms of Suicide
Developing personality changes, such as becoming very shy or outgoing
Talking positively about death or romanticizing
dying (“If I were dead, people might love me more.”)
Saying things like, “I’d be better off dead”, “I wish I could disappear forever”, or “There’s no way out.”
Writing stories or poetry about death, dying or suicide
This is what we’ll cover in the time we have now.
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8. Depression
Depression is an illness that involves the body, mood, and thoughts
It effects the way a person eats, sleeps, thinks, and the way one feels about oneself, others and life
It engulfs your day to day life, interfering with one’s ability to work, study, eat and have fun
This is what we’ll cover in the time we have now.
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9. Youth depression: Facts
One in every 8 adolescents may have depression. Major depression is more common in higher-risk groups.
The majority of children and adolescents with depression do not get help they need.
Depression is a treatable illness that is not the person’s fault.
Treatment for depression includes counseling, sometimes with medication.

10. Signs of youth depression
Irritability
Persistent anxiety and/or feelings of sadness
A drop in school performance
Problems with authority
Indecision, lack of concentration
Poor self-esteem
Overreaction to criticism
Frequent physical complaints
These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression.
Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression.
Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well.
There is a more comprehensive list on pages 6 and 7 of the parent depression booklet.
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11. Signs of youth depression
Helplessness, hopelessness, sadness
Loss of interest in activities
Appetite or weight change
Sleep changes
Loss of energy
Easily loses temper
Anger or hostility
Self-loathing
Tearful, frequent crying
Withdrawal from loved ones
These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression.
Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression.
Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well.
There is a more comprehensive list on pages 6 and 7 of the parent depression booklet.
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12. Signs of youth depression
Problems at school
Running away
Drug and alcohol abuse
Fixation on suicide
Talking about death
Giving away prized/special possessions
These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression.
Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression.
Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well.
There is a more comprehensive list on pages 6 and 7 of the parent depression booklet.
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13. A time for caution When your depressed student begins to feel better.
These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression.
Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression.
Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well.
There is a more comprehensive list on pages 6 and 7 of the parent depression booklet.
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14. It’s more than just a bad day.
These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression.
Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression.
Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well.
There is a more comprehensive list on pages 6 and 7 of the parent depression booklet.
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15. Substance Abuse and Suicide
This is second only to depression as a risk factor!
Often goes hand in hand with mental disorders
More than 3 times more likely to consider, plan or attempt suicide
Among substance abusers, 11% had serious thoughts of suicide
These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression.
Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression.
Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well.
There is a more comprehensive list on pages 6 and 7 of the parent depression booklet.
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16. Myth or Fact? FACT There are gender differences in youth suicide risk.
While girls are more likely to attempt suicide than boys are, boys often choose more dangerous methods and are more likely to die from suicide.
Read the question and
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17. Signs of suicidal thinking: The FACTS
Feelings
Sad, lonely, hopeless, in pain, moody, irritable, increased depression
Actions
Pushing away friends and family, giving away important possessions, using alcohol/drugs, making unsafe decisions, looking at suicide plans, making art or writing about death, saying goodbye
Changes
Changes in school performance, appearance or hygiene, personality or attitude
Threats
Saying they’re going to kill themselves, saying goodbye
Situations
A recent crisis or trigger situation
There are several signs of suicidal thinking that we can be on the lookout for. We’ve broken them down to be easier to remember. FACTS stands for feelings, actions, changes, threats, and situations.
As you look at this list, you may notice that most of these are not always or only signs of suicidal thinking. Much in the same way that EMTs and other health care providers try to rule out the worst possible problem before investigating others, though, when we see these signs it’s important to get more information and see if the problem is suicide.
Talk through each of these, with examples if possible. You may also want to mention the book Thirteen Reasons Why, which is still somewhat popular with younger teens and sometimes assigned in class – it has some problems but does a good job of showing some of these signs in narrative form. (Read it before recommending it, though.)
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18. Myth or Fact?
Youth who talk about suicide aren't the ones who are serious about it; they are just trying to get attention.
MYTH
80% of youth who attempt suicide have talked about it or shown warning signs. These are other, more serious signs that a youth might be considering suicide:  
Talking about suicide, wishing they were dead or wanting to die
Talking about suicide plan
Read the question and ask for ideas about whether it is a myth or a fact.
While some suicide attempts seem sudden or unexplainable, we know that about 80% of
people who attempt suicide show some signs ahead of time. It’s a common myth that if
someone talks openly about suicide or asks for help, they’re not really suicidal and are
Just attention-seeking. This isn’t true.
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19. How do you support your child or loved one?
You must first understand what people (including yourself) may be feeling

20. Feelings after a tragedy
Shock
Disbelief
Numb
Scared
Sad
Angry
Helpless
Guilt
Relief

21. Physical stress responses to a tragedy
Trembling or shaking
Dizziness
Pounding heart
Rapid breathing
Racing thoughts
Lump in throat; feeling choked up
Stomach tightening or churning

22. The Unknowing
The difficult part is not knowing what the person is feeling and experiencing…

23. Thinking of You
It is natural to feel nervous or even afraid of facing another person's painful feelings.
It is important not to let these feelings prevent you from doing what you can to help someone who is struggling.
The most important thing to do is simply to be there and listen and show you care.

24. What is Suicide Contagion and Glamorization?

25. Contagion Suicide
Grief + Over-identification Fixation ___________________ An increase in suicidal behavior among vulnerable people who have been exposed to suicide

26. Risk Factors for Contagion Suicide
A triggering event ~ a suicide +
Media coverage AND social media
Close friends and “close friends”
Vulnerable groups of students

27. Glamorization
News
Media
Social Media

28. Glamorization
Memorials
Yearbooks

29. What is a Suicide Pact
An agreement between two or more people to commit suicide together.

30. Dynamics of a Suicide Pact
Feelings of severe, emotional problems; hopeless and helpless
Support each other in living
Engage in mutual activities
Openly discuss feelings
Idea of suicide becomes easier
Efforts to support each other fall short
Efforts to get help from others fail
Lose hope

31. Ultimate Tragedy
These once supportive individuals encourage each other in suicidal behavior.

32. “Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”   
-Dr. Leo Buscaglia, Author and Motivational Speaker

33. Communicating
Verbal Communication
Non-Verbal Communication

34. Listen Without judgment Take what they say seriously
Do not be afraid to ask the question, “Are you thinking of committing suicide?”

35. What Not to Say “I KNOW HOW YOU FEEL.”
“Don’t feel ________.” (sad, angry, guilty)
“It will be better tomorrow.”
“Don’t cry.”
“At least you’re not hurt.”
“She’s in a better place.”
“We are all upset.”
“He’s out of his pain.”
“It could be worse.”
“You have to stay strong for your kids.”

36. Emotions Are Rarely Simple
Don't be distressed by differences in the your child responds. It may be different from yours!
One person may react very calmly.
Another may express strong feelings.
One person may have an immediate emotional response.
Another may be "numb" at first and respond emotionally later.

37. NON VERBAL – BODY LANGUAGE
Scientists say that body language accounts for 80% of the message we try to tell others and that what we actually say is only 20%.

38. How do you support your child or loved one?
Be understanding
Encourage physical activity
Encourage social activity
Learn more about depression
Get in treatment / Stay involved in treatment
Consider medication

39. Consult, consult, consult. Do not be afraid to ask for help
Consult, consult, consult! Do not be afraid to ask for help. You are not alone.

40. Community Resources: Crisis or Help Numbers
First Call for Help (FBH)
National Suicide Prevention Lifeline
The Trevor Project
Crisis Text Line
Children’s Home Society

41. Community Resources: Training
QPR Institute ASIST Networks for Life from YSPP

42. Community Resources: Websites
(healthy communities, suicide prevention)