1. Baseline Survey Before the training begins, please fill out the baseline survey and put your completed survey in the box provided. Thank you!

2. Ending A Deadly Silence Suicide Prevention Gatekeeper Training Insert your name and agency

3. What to Look For What to Do How to Help Adapted with permission from the Washington State Youth Suicide Prevention Program and the Maine Youth Suicide Prevention Program Prevention is often a matter of a caring person with the right knowledge being available in the right place at the right time.

4. Silent Epidemic Serious public health problem Preventable Neither random nor inevitable Research shows that during our lifetime: 20% of us will have a suicide within our immediate family 60% of us will personally know someone who dies by suicide

5. Attitudes and Beliefs: Taboo Nature of Suicide Taboo subjects: suicide, rape, child abuse, mental illness, drug and alcohol abuse, incest Myths of Taboo Subjects History of suicide – sin, crime, mental illness

6. Truth Or Myth Survivors at lower risk MH professionals only ones who can help More common with the rich No correlation between drugs, alcohol and suicide As many as 2 youth attempts to every death

7. Most suffer from depression More Floridians die by suicide than homicide Most have made up their minds More suicides during Christmas holidays People who are suicidal tend to hide it

8. Need to take all talk seriously Suicide rates for 15-24 year olds have more than doubled since the 1950s while other rates stayed about the same Asking may encourage the idea Elderly have the highest rate Important not to break the trust of confidentiality

9. 2005 National Statistics 32,637 suicides (89.4 per day) 3 rd leading cause of death for young Americans 15-24 years old 3.8 male deaths by suicide for each female death 3 female attempts for each male attempt Suicide claims a life every 16.1 minutes Source: AAS, USA Suicide: 2005 Official Final Data

10. 2007 Florida Statistics Over 2,000 deaths (2,570 = 7 per day) 3 rd leading cause of death for 25-34 y.o. 3 rd leading cause for 15-24 y.o. Suicide rate consistently is about double the homicide rate 69% of all suicides were among ages 25-64 Source: DOH, Florida 2007 Vital Statistics Report

11. Not Just Statistics Statistics alone don’t paint the whole picture Suicide is devastating to family, friends, and communities Opportunities to help

12. Understanding People in Crisis Why Everyone Is Vulnerable Pressures Assets Stressors are infinite Stressors are infinite Assets are finite Assets are finite

13. A Person May Feel They Can’t stop the pain Can’t think clearly Can’t make decisions Can’t sleep, eat or work Can’t make the sadness go away Can’t see the future without pain Can’t see themselves as worthwhile Can’t get someone’s attention Source: AAS @ www.suicidology.org

14. Cup Full of Problems Each cup represents a problem that a person may be having. Only rule is that the cups cannot be stacked inside one another.

15. Depression and Suicide Depression often goes undiagnosed until a crisis occurs Be concerned if significant changes are noted, symptoms last 2 weeks or longer Change in eating/sleeping, isolating, difficulty making decisions, feelings of hopelessness, irritability, anger, vague physical complaints

16. Risk Factors Include Previous suicide attempt – family history of suicide Mental disorders, particularly mood disorders (depression) Alcohol and other substance abuse Easy access to lethal means Impulsive and/or aggressive tendencies History of trauma or abuse

17. Loss – job, financial, relationship Lack of social support and sense of isolation Stressful life events Certain cultural and religious beliefs Exposure to and influence of others who died by suicide Psychological pain: Hopelessness Helplessness Perceived burden on others

18. Warning Signs and Clues What To Look For The red flags that something is wrong Changes in a person’s behavior, feelings, and beliefs about oneself that are maladaptive or out-of-character

19. P – Purposelessness A – Anxiety T – Trapped H – Hopelessness W – Withdrawal A – Anger R – Recklessness M – Mood Change Source: American Association of Suicidology, November 2003 I – Ideation S – Substance Abuse

20. Some Signs Demand Immediate Action Talking or writing about suicide or death Verbal clues – open talk about suicide Isolating from friends and family Putting affairs in order – giving away cherished possessions Exhibiting a sudden and unexplained improvement after being depressed Source: The Suicide Prevention Resource Center

21. In Summary There is no typical suicide victim There are no absolute reasons for suicide There are no all-inclusive predictive lists of warning signs or a definitive method for determining if someone is or is not suicidal Suicide is always multi-dimensional Most people don’t want to die – they want to end their pain

22. Protective Factors Positive conditions – personal and social resources – feeling connected Promote resiliency and reduce the potential for suicide Ability to manage or cope with adversity or stress

23. Youth Elderly  Positive connections to school  Coping and problem solving skills  Academic achievement  Family cohesion/stability  Help-seeking behaviors  Good relationships with other youth  Positive self worth and impulse control  Supportive family relationships  Sense of purpose and identity  Involvement in community activities  Ability to live independently  Better preparation for retirement, interests and support networks outside of workplace

24. What To Do Intervention- 3 Basic Steps SHOW YOU CARE ASK THE QUESTION GET HELP Adapted with permission from the Washington Youth Suicide Prevention Program http://www.yspp.org

25. SHOW YOU CARE Trust your judgment Be Genuine - show them you truly care Share observations and concerns Concern can counter their sense of hopelessness Reflect what you hear LISTEN!

26. Ask The Question Don’t assume they aren’t the “suicidal type” Be direct. “It sounds like you’re thinking of killing yourself - Are you thinking about suicide?” Do they have a plan, the means to carry out the plan – more detailed the plan the greater the risk Don’t have to solve all their problems but you must get help

27. Suicide Paraphrase Activity

28. Get Help - How To Help Your support in building hope and finding help truly can make the difference between life and death. If you have any reason to suspect a person may attempt suicide or engage in self-harm, DO NOT LEAVE THE PERSON ALONE

29. Resources Supportive friends Family members Clergy Mental Health Agency Counselor or therapist Family physician Local hospital emergency room Crisis Center – 9-1-1 1-800-SUICIDE 1-800-273-TALK

30. Additional Resources  Florida Suicide Prevention Coalition  Youth Suicide Prevention School- Based Guide, FMHI  Community Health Department  Addiction Help Line 1-800-758-5877  FL Abuse Hotline 1- 800-96ABUSE  Elder Abuse 1-800- 962-2873  Domestic Violence Hotline 1-800-500- 1199  Suicide Prevention Resource Center  1-877-YOUTHLINE  2-1-1  Elder Helpline 1-800- 955-8770  Parent HelpLine at 800-352-5683

31. Group Role Play

32. Conclusion It doesn’t take a professional to save a life We are all gatekeepers Preventing suicide is everyone’s business –yours and mine Together we can end this deadly silence

33. Post-training Survey Please fill out the post-training survey and the training evaluation form. Put completed forms in the box provided.