1. Suicide/Depression ACT Acknowledge the signs of a suicide Respond with Care Tell a responsible/trustworthy adult

2. Acknowledge the signs of a suicide  Don’t hesitate to raise the subject.  Talking about it will not put the idea in someone’s head  Be direct in a caring, non-confrontational way “Are you thinking suicide?” “Do you really want to die?” “Do you have a plan?” “Do you have the means to carry out the plan?”

3. Respond with Care  Often, suicidal thinking comes from a wish to end deep psychological pain and death seems like the only way out.  Let the person know you care  Talk about your feelings and ask about his/hers  Listen carefully “I am worried about you, about how you feel.” “You mean a lot to me. I want to help.” “I am here if you need someone to talk to.”

4. Tell a responsible/trustworthy adult  Never keep the suicide a secret!  It is better to risk a friendship than a life.  Do NOT try to handle the situation on your own.  You can be the most help by referring your friend to someone with professional skills – but you can continue to offer support!  Say things like: “I know where we can go and get some help.” “Let’s go and talk to someone who can help…let’s call a crisis line.” “I can go with you to get some help. You are not alone.”

5. What is NOT Helpful  Ignoring or dismissing the issue “Oh, let’s talk about something else.”  Acting shocked or embarrassed “You aren’t REALLY thinking of suicide, are you?”  Challenging or debating “So go ahead; see if things really DO get better!” “Don’t you know that it is wrong to kill yourself?”  Giving harmful advice “Let’s go and get drunk and forget about all of our problems”

6. What IS Helpful  Show you care – Listen carefully! “I’m concerned about you…how do you feel?”  Ask the question – Be direct (but caring & non-confrontational) “Are you thinking about suicide?”  Get help – Do not leave him/her alone “You’re not alone. Let me help you.”

7. Facts or Myths about Suicide  True or False: One out of every ten youth attempts suicide  True or False: One out of five youth seriously considers suicide  True or False: Talking about suicide will “cause” someone to actually do it

8. Facts  A person commits suicide every 15 minutes  A suicide attempt is made every minute!  Over 32,000 people in the U.S. kill themselves each year  5.2% of high school students have made suicide attempts  17.2% of high school students have had thoughts  On an average day, 84 people die from suicide  On an average day, 1,900 people attempt  Over 60% who commit suicide suffer from depression  Suicide is the 2 nd leading cause of death in 15-24 year olds  Suicide is the 3 rd leading cause of death in 10-14 year olds

9. Myths about Suicide MYTH: “People who talk about killing themselves need attention and would never actually commit suicide.” FACT: Most people who commit suicide have given some kind of verbal clue or warning. Some studies show that as many as 2/3 of successful suicides share their intentions before doing it.

10. Myths about Suicide MYTH: “Suicidal people are mentally ill- only crazy people commit suicide” FACT: It is true that suicide is associated with depression, alcoholism and schizophrenia; but, most people who commit suicide could not be diagnosed as mentally ill. Only about 25% are actually psychotic.

11. Myths about Suicide MYTH: “The majority of suicides are among minority groups and are from the lower socio-economic class” FACT: Suicide crosses all socio- economic classes. There is some evidence that middle- class people have lower rates than upper-class. Whites have suicides rates from 50-100% higher than African- Americans and Hispanics.

12. Myths about Suicide MYTH: “Suicide rates are highest around Thanksgiving and Christmas.” FACT: Suicide rates are actually lowest in the winter months and the highest in the Spring months.

13. Myths about Suicide MYTH: “Improvement following a suicidal crisis means the risk for a suicide is over.” FACT: Signs of improvement must be interpreted cautiously in patients. In severely depressed patients, the lifting of depression many give the patient energy to act and it may represent the relief in finally making the decision to end one’s life.

14. Suicide, by Gender Age adjusted rate per 100,000 Females Males Average 0 Note: Data are age adjusted to the 2000 standard population. Source: National Vital Statistics System - Mortality, NCHS, CDC. 2010 Target 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001

15. Leading Means of Suicide Among Males, 2001 Source: National Vital Statistics System - Mortality, NCHS, CDC.

16. Leading Means of Suicide Among Females, 2001 Source: National Vital Statistics System - Mortality, NCHS, CDC.

17. Suicide, by Race and Ethnicity Age adjusted rate per 100,000 White 0 Source: National Vital Statistics System - Mortality, NCHS, CDC. 2010 Target 1991 1993 1995 1997 1999 2001 American Indian Hispanic Black Asian NOTE: American Indian includes Alaska Native; Asian includes Pacific Islander; Black and White exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Data are age adjusted to the 2000 standard population. 1990 1992 1994 1996 1998 2000 Obj. 18.1

18. Suicide Among ages 15-17, 2001 Death rate per 100,000 0 NOTE: American Indian includes Alaska Native; Asian includes Pacific Islander; Black and White exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Data are age adjusted to the 2000 standard population. Source: National Vital Statistics System - Mortality, NCHS, CDC. 2010 Target Average American Indian Asian Hispanic Black White Females Males

19. Suicide Attempts by Students in Grades 9-12, by Gender Percent Females Males Average 0 SOURCE: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC. 2010 Target 1991 1993 1995 1997 1999 2001 Obj. 18.2

20. Warning Signs – Behavioral (Actions)  Suicide-Risk Behaviors  Increased risk taking  Cutting or other self-mutilating behavior  Withdrawal from usual activities  Personality changes  Verbal threats/warnings I wonder what heaven is like? Things will be better soon I wonder what things would be like without me I want to sleep and never wake up  Making final arrangements  Loss of interest in hobbies, sports, school, etc.  Writing notes or poems about death/suicide  Lower grades  Change in eating habits – increase or decrease  Change in sleeping habits – increase or decrease

21. Warning Signs –Emotional (Feelings)  Feelings of worthlessness  Loss of self-esteem  Feeling of inappropriate guilt  Persistent sad or irritable mood/anger  Suddenly happy after a long depression

22. Warning Signs – Cognitive (Thoughts)  Wanting to escape a bad or intolerable situation  Decreased concentration

23. Warning Signs – Physical (Body)  Physical ailments Stomach aches Headache

24. Resources  School counselor  Crisis telephone hot-line  Teachers  Parents  Hospital emergency room staff  Call 911