1. RESPONSE Staff In-service Presented by Donna Jezewski, LSW of Berea Childrens Home and Kathleen Kern, Ph.D of Lorain County Board of Mental Health ©2008 Journum

2. Suicide is the third leading cause of death among youth aged 15-24 in the US.

3. Students have access to more “identifiers” in a school setting than in any other.

4. Addressing depression and suicidal behavior/ideation directly and responding immediately will help reduce the risk of suicide.

5. Recognizing the Barriers to Helping Behavior Knowledge BehaviorAttitudes

6. Top 5 Reasons Teens Don’t Seek Help 1. “I would not know what to say to an adult about my problems.” 2. “I believe I can handle my problems on my own.” 3. “I would be afraid of being hospitalized.” 4. “I don’t feel close to any adult at school.” 5. “I thought it would go away.” Cigularov, et al.

7. Myths Talking about suicide with teens will give them ideas Most teenagers will not reveal they are suicidal Teenagers who talk about suicide do not attempt or complete suicide Parents are often aware of child’s suicidal behavior

8. Although over half experience psychopathology - primarily major depression - there is no clear definition of a suicidal person. Past attempts increase the likelihood of future attempts or completion particularly w/in the first year. A sudden interest or disinterest in religion, giving things away, and/or saying goodbye may indicate suicidal intent. Problems with the law/school and substance abuse, particularly alcohol are also correlated with suicidal behavior. Identification

9. AAS Consensus Warning SignsWarning Signs IIdeation S Substance Abuse P Purposelessness A Anxiety T Trapped H Hopelessness W Withdrawal A Anger R Recklessness M Mood Changes American Association of Suicidology

10. Focus on Ideation –Ideation is defined as self-reported thoughts of engaging in suicide or suicidal behaviors. –In a school environment, ideation may be expressed in writing assignments, notes and/or verbal exchanges with peers or staff. –Ideation may also be expressed through terminal statements - “I wish I were dead,” “People would just be better off without me…”

11. Suspect Suicide? - Five Steps 1. Establish rapport. 2. Discretely, but directly, ask the question, “Are you thinking about suicide?” 3. If “yes,” then do not leave this person alone. 4. Offer some comforting things to say (examples in your packet). Do not attempt to counsel the student. 5. Contact or take the student to the suicide contact or counselor at your school. Tell Administrator.

12. Did he cover the 5 steps? Were there attitudes that got in the way of his helping this student? The Coach

13. Suspect Suicide? - Five Steps 1. Establish rapport. 2. Discretely, but directly, ask the question, “Are you thinking about suicide?” 3. If “yes,” then do not leave this person alone. 4. Offer some comforting things to say (examples in your packet). Do not attempt to counsel the student. 5. Contact or take the student to the suicide contact or counselor at your school. Tell Administrator.

14. Discussion Point Attitudes and Behaviors What are some attitudes that you have observed or held that might get in the way of getting help for students? Why not helpful? Counter attitude?

15. Discussion Point Attitudes and Behaviors What are some behaviors that you have observed or demonstrated that might get in the way of getting help for students? Why not helpful? Alternate Behavior?

16. If a student answers “no” to the question, “Are you thinking about suicide?” : …but you still suspect the student may be suicidal, contact the front office or take the student to the suicide contact. …and you are convinced the student isn’t suicidal. Contact administration and counseling anyway and convey the student’s warning signs. RESPONSE Considerations

17. Let’s Review-The Warning Signs ISPATHWARMISPATHWARM

18. Review Barriers – Knowledge, Behavior and Attitudes Ex. Knowledge Ex. Attitude + Counter Ex. Behavior + Alternate 5 Steps In Lorain County if a child or an adult is at risk of suicide, call 1-800-888-6161

19. Thank You! Donna Jezewski, LSW of Berea Childrens Home (Donna.Jezewski@bchfs.org and Kathleen Kern, Ph.D of Lorain County Board of Mental Health (kkern@lcmhb.org) ©2008 JournumDonna.Jezewski@bchfs.org