Presentation on theme: "Mental Health America of Illinois (MHAI)"— Presentation transcript:
1 Mental Health America of Illinois (MHAI) Suicide Prevention & Awareness in our Youth:It Only Takes OneMental Health America of Illinois (MHAI)Carol Gall, MAExecutive Director
2 Who is Mental Health America of Illinois? *Formerly Mental Health Association in IllinoisStatewide, non-profit organization founded in 1909 – Celebrating over 100-Years of Service in Illinois!Mission is to promote mental health, work for the prevention of mental illnesses, advocate for fair care and treatment of those suffering from mental and emotional problems.Engage in public education, prevention, and advocacy.
3 Presentation Topics Mental Illnesses Defined Mental Illnesses and SuicideThe Impact of SuicideSuicide vs. Self-InjuryRisk & Protective Factors of SuicideSymptom Management StrategiesResourcesQuestions
4 mental illnesses look like? What domental illnesses look like?
5 These are the FACES OF MENTAL ILLNESSES: Heath Ledger – Depression, AnxietyPete Wentz – Depression, possible Bipolar DisorderOwen Wilson – Bulimia NervosaDrew Barrymore – Depression, Substance AbuseDrew Carey – Depression, multiple suicide attempt beginning at age 18Angelina Jolie – Depression, self-harmHalle Berry – Depression, previous suicide attemptJim Carrey – DepressionRussell Brand – Bulimia NervosaCatherine Zeta-Jones – Bipolar II
6 Mental Illnesses Defined A health condition that changes a person’s thinking, feelings, and/or behavior (or all three) and that causes the person distress and difficulty in daily functioning1 out of 5 adults and teens suffer from a mental illness each yearWarning signs:marked personality change,inability to cope with problems and daily activities,strange or grandiose ideas,excessive anxieties,prolonged depression and apathy,marked changes in eating or sleeping patterns,thinking or talking about suicide or harming oneself,extreme mood swings—high or low,abuse of alcohol or drugs, andexcessive anger, hostility, or violent behavior.
7 STIGMA Mark of shame or discredit, mark of disgrace Why is stigma harmful?Makes coping more difficultPrevents people from seeking and receiving treatmentWhat can we do?Change our language - crazy, insane, etc.Phrases - Somebody has bipolar, they ARE not bipolarShare, empathize, learn and understand
8 Understanding Depression Sad, low mood“Please understand”:Can’t eat, angry, cry, mood swings, thoughts of harming self“Cotton”:Wearing long sleeves, no eye contact, different, never spoke, writing lists, cried, bandages, thoughts about death, lost will to liveChange in appetiteChange in sleep patternAngry/irritableSocial withdrawal - activities, friendsPoor concentration - gradesFeelings of guilt/worthlessnessRestlessness/moving slowlyFeelings of hopelessnessThoughts of harming selfSelf-harm vs. suicide
9 Understanding Depression Depression is a treatable medical illness, not a weakness or a moral failure, that often runs in familiesTreatment success rates are between 80% to 90% for depression.Clinical depression is a common and serious disorder of mood, that is pervasive, intense and attacks the mind and body simultaneouslyDepression can be triggered by health conditions and/or environmental and behavioral stressors
10 Depression in YouthRecent surveys indicate that as many as one in five teens suffers from clinical depression. Mental Health AmericaChildren under stress, who experience loss, or who have attention, conduct or anxiety disorders are at higher risk for depression. American Academy of Child & Adolescent PsychiatryChildren whose parents have been diagnosed with affective disorders are far more likely to be diagnosed with a mental illness- especially an affective disorder – than their peers whose parents do not have mood disorders. Psychiatric Times, 1999
11 Symptoms of Depression in Children & Adolescents Irritability and/or depressed moodLoss of interest in usual activitiesLow energy and/or restlessnessPoor concentrationSleeping too much or too littleWeight loss or weight gainFeeling hopeless and helplessFeeling worthless and guiltyPersistent physical symptoms that don’t respond to treatment such as headache, stomachache, chronic pain, constipation, etc.Thoughts of death or suicide
12 Typical Adolescence Typical vs. Depressed Adolescence Struggle for independence, limit testingIdentity struggleLess affectionate toward parents, “occasional” rudeness“Occasional” moodinessIncreased responsibilityLimited thoughts of the futureTypical vs. Depressed AdolescenceSymptoms of depression are more persistent and interfere with daily living, particularly when they last for more than two weeks.Adolescent depression interferes with acquisition of necessary life long skills developed during adolescence.
14 God, Let Me Die, Just for Tonight I’m scared, I’m lonely and confused.No one understands me, no one knows what I go through in thisshell of a body.I love, I hate, I sing, and I cry- but none of that means anything.I want an escape, I want to fly away- away from a world ofconfusion and pain.God-please let me die, but just for tonight.I’m too afraid to die forever.That makes me even more upset with myself- my fear andlack of courage.But maybe tomorrow, when I come back, I’ll be happy.Maybe.But God- please let me die, just for tonight…
15 This poem signifies a young woman’s inner struggle with wanting to end the pain and suffering, but not wanting to end her life. Sometimes, when there is no hope that a situation will get better, death seems like a rational solution. There was still hope within this individual, but sometimes that hope runs out if they don’t receive help.This person suffered silently with her depression, like so many others, for several years of her life. Fortunately, she was able to express her pain through poetry, which served as a type of release. She wasn’t diagnosed with depression until 5 years later.
16 Suicide and Mental Illnesses Research has shown thatmore than 90% of people who kill themselves have depression or another diagnosable mentalor substance abuse disorderat the time of their death.
17 Depression & SuicideClinical depression is one of the most common mental illnesses and affects nearly 19 million Americans each year (1 in 5 Americans)Most people who have depression do not die by suicide; HOWEVER…Having major depression increases suicide riskDepression is HIGHLY treatable
18 Depression & SuicideEach year, around 5,000 young people, ages 15-24, lose their lives to suicide.The rate of suicide for this age group has nearly tripled since 1960, making it the third leading cause of death in adolescents and the second leading cause of death among college-age youth.4 out of 5 individuals give CLEAR warning signs before a suicide attempt.-Mental Health America
19 More teenagers and young adults die from suicide than cancer, heart disease, AIDS, birth defect, stroke, pneumonia and influenza, and chronic lung disease COMBINED.The Surgeon General Report on Mental Health, 1999
21 Suicide is a Serious Public Health Problem In 1999, former Surgeon General Dr. David Satcher declared suicide a national public health problemIn 2001, the National Strategy for Suicide Prevention was completed
22 Suicide in IllinoisSuicide is the 12th leading cause of death in Illinois1,177 people committed suicide in Illinois in 2009; 773 died by homicideIn the U.S. around 36,000 people die by suicide as compared to less than 15,000 deaths by homicideSuicide is the 3rd leading cause of death for adolescents and young adults (ages 15-24)70+ years highest suicide rate in IL15 – 19 years highest attempt rate in ILSuicide Prevention Resource Center (SPRC)
23 Suicide in Illinois Illinois Suicide Prevention Alliance (ISPA) Dedicated to reducing suicide in Illinois by raising public awareness, lessening the stigma surrounding it and making treatment accessible.In 2004, passed the Suicide Prevention, Education & Treatment Act in Illinois to develop and implement the Illinois Suicide Prevention Strategic Plan.*The Illinois Plan can be downloaded from the Illinois Department of Public Health website.
25 Key DefinitionsSuicide – self-inflicted death with evidence that the person intended to dieSuicide attempt – self-injurious behavior with a non-fatal outcome & evidence the person intended to dieSuicidal ideation – thoughts of serving as the agent of one’s own deathSuicidal intent – subjective expectation and desire for a self-destructive act to end in deathDeliberate self-harm – willful self-inflicting of painful, injurious acts without intent to die
26 Self Injury Typical onset of self-injury is puberty Self-injurious behaviors often last 5 – 10 years, but can persist longer without treatmentSelf injurious behavior is a way for people to cope with or relieve painful or hard-to-express feelings – self-destructive cycle beginsGoal is typically emotion regulationGenerally not a suicide attempt, BUT if goes untreated, can lead to suicide attempts
27 Self Injury vs. SuicideGoal of behavior is emotion regulation, very different from intention to die, but also escaping painIf behavior helps individual reach goal, individual will continue behaviorCutting, burning, banging head, scratching, carving, etc.From DBT perspective - Individual is lacking skills to effectively: 1) interact on an interpersonal basis, 2) tolerate distress, 3) regulate emotions, and 4) be mindful of when to use these skillsClients often report not recognizing what preceded desire to self-harmGoal is usually also to escape unbearable painBelieve behavior will lead to death, whether actions are lethal or cause minimal harmFeel trapped, hopelessRange in timing exists – planned out thoroughly, all the way to spur of the moment decisionUsually warning signs, whether timing of planning is short or longMay be self-harming behavior that accidentally leads to suicide
29 Who is Most At-Risk for Suicide? More men than women die by suicide, BUT attempts are higher in womenWomen attempt suicide 2 – 4 times as often as menMen die by suicide 4 times as often as womenHighest rates among White, Non-Hispanic menYoung people ages 10 – 19In 2003 – 20049% increase in boys aged 15 – 19 years old32% increase in girls aged 15 – 19 years old75.9% increase in 10 – 14 year old girlsOver age of 65, 4 attempted suicides for every 1 suicide deathYoung & Young adults 15-24, attempted suicides for every 1 suicide death
30 What to look for in a person who might be thinking about committing suicide…SIGNSTalking about wanting to dieUnusual neglect of personal appearanceSaying things like “Everyone would be better off if I weren’t around,” “There’s no point in living anymore,” etc.Giving away personal possessionsExpressions of rage/angerA sudden dramatic improvement in moodIncrease in self-harming behaviorsRISK FACTORSAccess to weapons (guns, knives, etc.)Substance abuseHistory of impulsive and/or aggressive behaviorsSigns of psychosis, bizarre thoughts, hallucinations, etc.Family history of suicide, recent exposure to another’s suicidal behaviorPrevious suicide attemptsRecent lossSexual orientationGLB youth as compared to heterosexual (or not sure) peers in IL (excluding Chicago) on YRBS:2x as likely to report depressive feelings3x as likely to report suicidal thoughts3x as likely to report suicide plans5x as likely to report suicide attempt
31 Risk Factor: ViolenceDomestic Violence Victims, Perpetrators and their FamiliesWomen exposed to acute or prior domestic violence are more likely than unexposed women to have made suicide attemptsApproximately half of U.S. homicides are followed by a suicideViolent family interactions is a significant variable in youth suicide and completionsViolent people have a history of self-destructive behavior
32 Risk Factor: Sexual Orientation Gay youth are 2 to 3 times more likely to attempt suicide than other young peopleSurvey questions related to sexual orientation found elevated risk of suicide attemptsYouth Risk Behavior Survey (YRBS)(Gibson, 1989) and (Remafedi et al, 1998)1989 was the first time sexual orientation was nationally recognized as a risk factor for suicide. Research since then has reinforced the basic message of the report: gay youth are more likely to attempt suicide than their heterosexual peers.Most surveys do not collect data related to sexual orientation. A 1998 Minnesota survey found that suicide attempts were reported by 28% of bisexual/homosexual males, 21% of bisexual/homosexual females, 15% of heterosexual females, and 4% of heterosexual malesBecause sexual orientation is not uniformly recorded on death certificates, data on completed suicides is not readily available.**ADD Data from YRBS
33 Risk Factor: Sexual Orientation It has been found that suicide attempts among youth identifying as GLBT are significantly associated with:Gender non-conformity StressOther psychiatric symptoms Lack of supportDropping out of school Family problemsHomelessness Substance abuseAcquaintances’ suicide attempts ViolenceEarly awareness of homosexuality(Remafedi, Farrow, & Deisher, 1991; Schneider, Farberow & Kruks, 1989; D’Augelli & Hershberger, 1993; Hershberger, Pilkington & D’Augelli, 1997; Remafedi, et al, 1998; Schneider, Farberow & Kruks, 1989; Nicholas & Howard, 1998)These risk factors have been identified in many studies and give clues as to where intervention and prevention can intercede in order to reduce suicidality among gay, lesbian, bisexual and transgender (GLBT) youth. Because gender non-conformity is a risk factor for GLBT youth suicide attempts it is probable that transgender youth also have an elevated rate of suicide attempts. Other risk factors in the list are brought on by society’s often hostile reactions to youth who come out. Homelessness is often the result of parents kicking children out of the home. Stress, violence, lack of support and dropping out of school could be the result of harassment and bullying in school.
34 Warning Signs of Suicide HopelessnessRage, uncontrolled anger, seeking revengeActing reckless or engaging in risky activities, seemingly without thinkingFeeling trapped - like there's no way outIncreased alcohol or drug useWithdrawing from friends, family and societyAnxiety, agitation, unable to sleep or sleeping all the timeDramatic mood changesGiving away personal possessionsTalking about death, suicide
36 Crisis Intervention for those who are Suicidal Create a safety planSeek professional helpRemember a crisis is temporary and an opportunity to impact changeSuicidal Behavior and AdolescenceThe 1st suicide attempt usually occurs before the age of 17Family cohesiveness and religiosity serve as protective factors for suicidal youth
37 How do we know if someone needs help? Seriously considering suicide, developed a planThoughts about death, thoughts about one’s own death, thinking about suicideNo thoughts of harming selfPassive thoughts - “I wish I were dead,” “My family would be better off without me”Beginning to seriously consider suicide, thinking about a planWants to die, has a plan, has access to method to implement plan
38 How can I help?Get an adult involved, someone you and the person trustsEncourage loved one to go to someone they trustSay, "I want you to live”Encourage them to get helpAsk direct questions without being judgmental. Determine if the person has a specific plan to carry out the suicide. The more detailed the plan, the greater the riskBe willing to listen, allowing them to express their feelings and accepting their feelingsGet involved, becoming available and showing interest and supportStay in contact with the person, do not leave them aloneBe aware and learn the warning signsDo NOT offer to keep secrets!
40 What works…a combination of… Counseling:Cognitive-Behavioral Therapy (CBT) and Interpersonal Therapy have shown to be very effectiveMedication:Antidepressant medication acts on chemical pathways of the brain related to moodSupport & Education:Groups, educational literature, support system
41 Cognitive Behavioral Therapy Interpersonal Therapy CounselingCognitive Behavioral TherapyCBT focuses on the child’s persistent cognitive distortionsIt is a brief approachOther components include:Affective EducationActivity PlanningProblem SolvingSocial Skills trainingSelf-instructional TrainingRelaxation TrainingCognitive RestructuringInterpersonal TherapyIt is also briefIt focuses on current relationshipsIt uses the therapy relationship to repair other relationshipsChange happens through insight and new interactions
42 MedicationPsychotherapeutic medications may make other kinds of treatment more effectiveHow long someone must take a psychotherapeutic medication depends of the individual and the disorderPsychotherapeutic medications are divided into 4 groups- antipsychotic, antimanic, antidepressant, and antianxietyBe sure to discuss potential benefits and side effects with your doctor and to report accurately the effect of the medication in follow up appointments.
43 Choosing the Right Provider Types of Health Care Providers Provide MedicationProvide CounselingPrimary Care Physician (MD)Psychiatrist(MD)Licensed Clinical Psychologist(Ph.D or Psy.D)Licensed Clinical Professional Counselor(LCPC)Licensed Clinical Social Worker(LCSW)Licensed Marriage and Family Therapist(LMFT)
44 Depression in the Classroom Frequent absencesExcessive tardinessInability to screen out stimuliInability to concentrateDifficulty with time pressures & multiple tasksDifficulty handling negative feedbackSudden drop in gradesDifficulty responding to changeRefusal to participate in school activitiesDifficulty interacting with others
45 Depression in the Classroom Peer group changeDefiantSocial anxietyFatigueIrritabilityFidgetyRestlessIsolatingDisruptiveQuiet
46 What Can You Do to Prevent Suicides? Know the warning signs and risk factorsAsk the “Suicide” questionKnow referral resources in your school and/or community
47 Classroom Management Strategies Ask parents what would be helpful to motivate and decrease pressure for studentConsult regularly with parents, school support staff, etc. ~ Don’t be the only person dealing with the student’s issuesDesignate a “safe” person in schoolGive advanced warning of major changes to students, if possibleShorten assignments or allow more time to completeBreak tasks into smaller parts
48 Classroom Management Strategies Provide refocusing assistance and promptsPreferential seating by a teacher or positive peerWord banks or alternative testing methods to accommodate for retrieval problemsProvide assistance to see assignments recorded accurately and all materials are packed2nd set of books to be left at homeKeep a record of their accomplishments and show them occasionallyPut corrections in the context of a lot of praise and support
49 Classroom Management Strategies Reassure student they can catch up, be flexible and realistic about your expectationsAvoid situations that might socially isolate or ostracize (allowing students to choose team mates)Encourage gradual social interactionLet them know you care without getting too personalDon’t make promises or lie to studentBe alert to suicidal thoughts and behaviors; take threats seriously
50 Classroom Management Strategies Find student’s strengths and focus on themDon’t ignore depressed student, it invites them to give upHelp students focus on positivesGive adolescents a “feeling vocabulary”Create a classroom environment where kids aren't meanGIVE FREQUENT & POSITIVE PRAISE
51 Enhancing Mental Health Connectedness to schoolPositive adult role models/relationshipsSports/ActivitiesSocial InterestModeling Stress ManagementCommunicationSetting Limits
52 Enhancing Mental Health Teach children feelings vocabularyBe accurate with your feedbackProvide constructive experiencesTeach them to take pride in themselves and their accomplishmentsEncouragementUse Positive and Kind HumorLAUGH
53 What Can MHAI Offer?Classroom/Community Seminars (for teens, children, faculty, parents, and other adult caregivers)Educational ActivitiesTreatment Resources and ReferralsMental Health Screenings for Youth and AdultsEducational Materials/Pamphlets**Please refer to the full list of MHAI’s scope of services to schools and communities.
54 Student Education EXAMPLE - Student Program Schedule: Day 1: -Depression and Suicide-Bipolar Disorder-How to Ask for Help-Where to Go for Help (Resources)Day 2:-Anxiety Disorders-Stress-Taking Care of Your Mental Health-Activity/Evaluation
57 Suicide is one of the most preventable causes of death. Remember, it only takes one person to save a life!For further information, contact:Mental Health America of Illinois (MHAI)Carol Gall, MA, Executive Directorx324Katie Mason, LPCProgram Director of Public Education and Disaster Mental Healthx322Information and Resource Line x310