1. Office: 573-7447 HOTLINE: 596-LIFE
SPEAKER: __________________
Welcome to the SAFE:TEEN Youth Suicide Prevention presentation. My name is ___ and this is ____. We represent the SAFE:TEEN Coalition from the Injury & Violence Prevention Program at the El Paso County Department of health & Environment. We collaborate with the Suicide Prevention Partnership and many other agencies to address the critical public health issue of Teen Suicide in our community.
Before we get started, we would like to recognize that suicide is a very sensitive topic. If at any time you feel the need to take a break, please feel free to exit the room and utilize support staff for follow-up discussion. (click to next slide)
Office:
HOTLINE: 596-LIFE
El Paso County Department of Health & Environment
Injury & Violence Prevention Program 25

2. Essential Questions
What are the warning signs of depression and suicide?
How can I help?
Who else can help?

3. Faces of Suicide
As you watch the pictures on the screen, listen closely to the lyrics of the song “How Do You Get So Lonely.”
All of the pictures are of individuals who have completed suicide in the Colorado Springs area over the last several years.

4. Faces of Suicide
What did you notice?

5. True and False – Clicker Activity
You will hear a series of statements
Decide whether the statement is true or false
Use the clicker to respond

6. National Youth Suicide Facts
Third leading cause of death for people ages 10-24
Gay and lesbian youth are 200% more likely to attempt
Alcohol is involved in up to 70% of suicides
A million youth suicide attempts occur each year
SPEAKER: ___ Lindsey ____________________
(click and read bullet)
Discussion Points:
year old rates are rising fastest. Rose 120% from
Why suicide rate increasing? Research states there are many reasons including:
More accurate reporting
Easier access to firearms/ drugs
Neurological damage caused by mothers drug use or nutritional deficiencies
Babies with low birth rates and more vulnerable neurological systems now surviving
Development of medications enabling more people with mental illnesses to marry or mate
Earlier appearance of puberty in last two decades, related depression
(click to next slide)
Nationally, the youth suicide rate has tripled over the past 30 years 32

7. Youth Suicide in Colorado
2nd Leading Cause of Death for people ages10-34
Females ages have the highest rate of suicide attempts
13.6% of high school students seriously considered attempting suicide in the last 12 months (2005 YRBS)

8. Youth Suicide in El Paso County
Suicide is the SECOND leading cause of death for people ages 10-24
There were 106 youth suicides from
In 2005 there were 21 teen suicides
SPEAKER:
As we look at a youth suicide in our region compared to the nation, (click) suicide is the second leading cause of death for teens versus the third nationally and (click and read bullet)
(Click and Read Bullet)
Preliminary Statistics from the 2004 show a 64% increase in the number of completed suicides in our community (123 suicide deaths in 2004, versus 75 in 2003).
Some additional facts regarding youth suicide in our region include:
In Colorado, for every homicide there are three suicides. Nationally, for every two homicides there are three suicides.
We present statistics to you with the understanding that knowing the numbers helps with the definition and how to target prevention efforts. (click to next slide) 34

9. Closer to Home
Film: Break the Silence

10. Film Discussion
What were the common threads in the three different stories?
What was missing?
The person committing suicide did so for relief from the pain. But, what is the aftermath?

11. Important Information to Know
Risk Factors
Warning Signs
Critical Warning Signs
ACT- What you can and should do

12. Identifying Risk Factors
Significant Loss
Death of close friend or family member
Divorce or separation, end of a relationship
Job loss
Family History of Mental Illness
Change in Lifestyle/Finances
Legal Trouble
Physical, Mental, or Sexual Abuse
Previous Attempt
Self-Injury
SPEAKER: As we identify some of these situational clues, we want to reiterate that having one of these risk factors doesn’t necessarily mean that a person is in danger of killing him or herself; it just means that a person is more vulnerable. That person may need help finding healthy ways of coping with problems. (click)
Traumatic situations, such as experiencing a significant loss, can make people less able to cope when bad things happen and less confident that life can change for the better. This contributes to your sense of hopelessness. (If Time: Can anyone think of any other types of loss that someone might be suffering from?) (click)
Biologically, if mental illness runs in a family, someone might be more likely to suffer from it. Also, a family history of suicide models that behavior, increasing a person’s risk as a suicide survivor. Making one suicide attempt also puts a person at higher risk for a subsequent attempt. (click)
Significant changes in a person’s lifestyle or financial situation can intensify the feeling of hopelessness and loss of control. (click)
As well as coping with legal situations and stressors.(click)
Living with physical or sexual abuse causes significant pain for a person to deal with. (click)
A previous suicide attempt is probably the number one risk factor for a subsequent attempt. Someone who has attempted suicide in the past is far more likely to attempt again than someone who has never attempted. If you know that an individual has attempted suicide in the past and is currently demonstrating some warning signs, you need to get help for that person right away. (Click)
Self-Injury, which includes cutting, burning, carving, etc., is something that is becoming more and more of an issue, particularly in schools. While most self-injurers report that they are not attempting suicide, self-injurious behavior can be potentially lethal. Statistically, self-injurers have higher suicide rates than the general population. It is possible that some of these other risk factors could be underlying issues which are causing a person to self-injure. (Click to next slide)
(Click to next slide)
A PREVIOUS SUICIDE ATTEMPT IS THE #1 RISK FACTOR FOR SUICIDE! 38

13. Self-Injury Deliberate, non-lethal harm to self
Cutting, burning, carving, hair-pulling
External Expression of Internal Pain
5th leading reason for ER visits
Not necessarily a suicide attempt, but 40% of self-injurers have suicidal ideations or suicide attempts in their lives.
Self-injury is similar to alcoholism. When an alcoholic gets depressed, they drink more. When a cutter gets depressed, they are more likely to resort to permanent self-harm or suicidal thoughts.

14. Additional Risk Factors
Social Stressors
Social Isolation
Bullying
Peer Pressure
Parent Pressure
Gender Identity Issues
Access to Firearms
Chronic Illness
SPEAKER: As we identify some of these situational clues, we want to reiterate that having one of these risk factors doesn’t necessarily mean that a person is in danger of killing him or herself; it just means that a person is more vulnerable. That person may need help finding healthy ways of coping with problems. (click)
Traumatic situations, such as experiencing a significant loss, can make people less able to cope when bad things happen and less confident that life can change for the better. This contributes to your sense of hopelessness. (If Time: Can anyone think of any other types of loss that someone might be suffering from?) (click)
Biologically, if mental illness runs in a family, someone might be more likely to suffer from it. Also, a family history of suicide models that behavior, increasing a person’s risk as a suicide survivor. Making one suicide attempt also puts a person at higher risk for a subsequent attempt. (click)
Significant changes in a person’s lifestyle or financial situation can intensify the feeling of hopelessness and loss of control. (click)
As well as coping with legal situations and stressors.(click)
Living with physical or sexual abuse causes significant pain for a person to deal with. (click)
A previous suicide attempt is probably the number one risk factor for a subsequent attempt. Someone who has attempted suicide in the past is far more likely to attempt again than someone who has never attempted. If you know that an individual has attempted suicide in the past and is currently demonstrating some warning signs, you need to get help for that person right away. (Click)
Self-Injury, which includes cutting, burning, carving, etc., is something that is becoming more and more of an issue, particularly in schools. While most self-injurers report that they are not attempting suicide, self-injurious behavior can be potentially lethal. Statistically, self-injurers have higher suicide rates than the general population. It is possible that some of these other risk factors could be underlying issues which are causing a person to self-injure. (Click to next slide)
(Click to next slide)
A PREVIOUS SUICIDE ATTEMPT IS THE #1 RISK FACTOR FOR SUICIDE! 38

15. Warning Signs for Suicide
Warning signs of depression
Noticeable CHANGES in Behavior/Habits
Uncharacteristic Risk-taking or Impulsiveness
Withdraw from activities
Alcohol or drug abuse
Problems in school
Self-Injury (Cutting, Burning, Carving)
SPEAKER:
Knowing the warning signs of a potentially suicidal person is essential in the effort to prevent a suicide from occurring. (click)
Warning signs are the actions or changes in behavior that a person may demonstrate when having suicidal thoughts. One of the things that makes suicide prevention so difficult is that what may be a warning sign for one person may not be for another person. The key is to look for deviations from “normal” behavior for that person. For example, if you knew someone who was a race car driver, risky behavior may not be an indication that someone is severely depressed or suicidal because that person takes risks for a profession. However, if this race car driver had been having a particularly difficult time lately, maybe his wife died of cancer and he is having financial trouble AND he starts make statements about not being around any longer, you may be concerned. It is important to look for combinations of warning signs and risk factors. (read the rest of the bullets then click)
Because of the stigma associated with depression, often the disease goes undiagnosed and/or untreated. We want to recognize that there are several different types of depression. (click) Everyone gets depressed or has the blues that last for short periods of time. Most people develop strategies for shaking off the blues and move forward. That’s “depression with a little d.”
Major depression or clinical depression is a serious health problem that affects the total person for longer periods of time. Depression often has a biological cause and is a lot more common then most people think. There are a number of different depressive disorders that can be effectively treated with proper diagnosis – reminding us how important it is to seek professional help.
Depression can change behavior, physical health, appearance, academic performance, social activity, and the ability to handle every day decisions and pressures. (click) Here are some of the signs that a person might be suffering from depression.
It is important to remember that Depression DOES NOT always lead to suicide. It can be readily treated with a high rate of success. Counseling by a professional may be enough. Other methods involving medication may be prescribed as well. Severe, suicidal depression is a real medical emergency and should be treated as such. Studies indicate that the best way to prevent suicide is through the early recognition and treatment of depression and other psychiatric illnesses. 40

16. Signs and Symptoms of Depression
Loss of interest in things previously important
Sadness or constant irritability
Changes in eating & sleeping habits
Weight loss or gain
Low energy or restlessness
Trouble thinking or paying attention
Crying a lot

17. Critical Warning Signs of Suicide
Terminal Statements
Preparing for not being here
Spending Money with no concern
Attending to wills, insurance etc.
Giving Away Possessions
Saying Good-bye
Obtaining Lethal Means
Sudden Unexpected Happiness
Obsession with Themes of Death
SPEAKER:
Next are the critical warning signs for ANY age group that might signal an immediate need for intervention. (click)
Terminal statements such as: “I just want to die” or “Nothing Matters.” Terminal statements are an indication of hopelessness. Many times, people can’t bring themselves to say directly, “I’m depressed and I want to kill myself” so they drop hints. Can you think of other ways that people would verbally express their intent? (“Life sucks” “It’s hopeless, nothing is going to help.” “I’m such a burden -- you’d be better off without me.”) (click)
Making unusual purchases that might include lethal means such as a gun or pills. People may spend some time thinking about how to kill themselves but once that thought turns to action and they acquire the means, this is a critical time for intervention. (click)
There are many ways to say goodbye. Giving away possessions is a common one for young people, while older people tend to make wills and funeral arrangements. One of the most tragic ways of saying goodbye – because it is so often missed as a warning sign – is having “one last perfect day.” Someone that may have been pulling away or withdrawing from all the activities, acting hostile or picking fights but suddenly wants to go to the movies or play golf or whatever it is to be with someone in an urgent way, having to do it TODAY, because he knows he won’t be here tomorrow, is a warning sign. (click)
It may sound odd, but someone that begins to act happy after a period of depression may be demonstrating their own relief of making the decision to end their life. (click)
And lastly, a significant obsession with themes of death. We understand that many young people choose to express themselves through clothing, music, etc but what we are looking for is the unhealthy obsession that can also include drawings, writing, etc – something out of the ordinary. (click to next slide) 45

18. Film:
Never Enough

19. Never Enough 1. What were some of the risk factors in Billy’s life?
2. What were some of the warning signs that Billy was suicidal?
3. What was good/bad about how Billy’s mom responded?
4. What was good/bad about how Jake, his friend, responded?

20. ACT: Acknowledge, Care, Tell
Acknowledge that you are seeing signs of suicide and that it is SERIOUS.
Care: let that person know that you are there for them and that you are concerned that they need help that you cannot provide.
SPEAKER: Speaker Two
We like to use the acronym ACT to help people understand that there is something they can do to help.
(click and read bullet)
(click to next slide)
Tell a parent/professional, either with that person or on their behalf. 74

21. Acknowledge A Take warning signs seriously
Let the person know that you are concerned by the seriousness of the issue
Ask “The Question”…DIRECTLY
SPEAKER:
There are some things that you can do and say to help someone that might be displaying some of the risk factors and warning signs of suicide.
(click and read bullet) The vast majority of people who talk about suicide are in serious emotional pain so always take talk of suicide seriously. Sometimes people use phrases that refer to suicide but have no intention of taking their life. If all of these statements are taken seriously, then it is less likely that people will use this type of language.
(click and read bullet) Everyone hates to ask the big question: “Are you thinking about suicide?” You can also say, “Are you thinking about hurting yourself.” Suicide is a life and death issue and we are all afraid that we will say the wrong thing but TALKING ALWAYS HELPS. That person may be relieved that you have asked and now has a open to to begin expressing their feelings. If you’re concerned about someone, take a deep breath and ask.
(click and read bullet) What shows that a person is being a good listener? (Eye contact, head nodding, attention) Show someone that you are there to listen. That you will take the time to help them.
(click and read bullet)
Click and read bullet)
(click and read bullet) It is very important to get professional help. Again, we are not asking anyone in this room to be a mental health professional. We are asking that you know the risk factors, warning signs, and resources so that you can find the help that is needed. Just as a person with a broken arm needs to see a doctor, a person with depression needs to talk to a professional. Just as CPR is meant not to cure someone but to keep that person alive until help arrives, so does your intervention with a suicidal friend. You can do CPR until you are ready to drop from exhaustion but if you don't get professional help, your friend will die. You can encourage and support your suicidal friend as best you can, but if you don't get professional help, your friend may die.
(click and read bullet) Suicide doesn’t happen overnight and it doesn’t go away overnight either. There are very effective treatment strategies using counseling, medication or a combination of both but it takes time to feel better. Be understanding and reassuring.
Again, (click) it’s important to remember that you can do everything in your power to help someone find a way to feel better but you CAN’T keep them alive. (click) The only person who can truly prevent suicide is the one who contemplates it.
(click to next slide)

22. Care C
Listen to the person’s issues
Do not be judgmental

23. Tell T Find out if the person has a plan Do not keep it a secret
Brainstorm alternatives for help
Do not leave the person alone
Tell a professional or someone who can help T

24. Don’t handle it alone -- get help now
Help is available in schools
Help is also available in the community
Local Health and Mental Health Care Providers
Suicide Prevention Hotline: 596-LIFE
Emergency Responders- 911 and Hospitals
Faith Based Clergy
SPEAKER: Speaker Two
We encourage people to think outside of the box when seeking help.
We have student resource cards to pass out to each one of you that has several numbers that you can call for assistance. (click to next slide) 75

25. Coping Skills
At your table, brainstorm different ways that teens can cope in a healthy way.
Positive coping skills are an essential skill and tool to deal with life’s ups and down without becoming overwhelmed!

26. Scenario: Find the risk factors Find the warning signs
Find the critical warning signs
Come up with a plan of action