1. BUILDING COMPETENT COMMUNITIES FOR YOUTH SUICIDE PREVENTION
Maureen M. Underwood, LCSW
Society for the Prevention of Teen Suicide
5 minute intro 1

2. Workshop Leader Maureen M Underwood LCSW
Lead author, Lifelines Suicide Prevention Trilogy
Previous coordinator, NJ Youth Suicide Prevention Program
Clinical director, Society for the Prevention of Teen Suicide

3. Workshop Objectives
Review information about youth suicide , including bullying as a risk factor
Relate youth suicide prevention to bullying initiatives
Describe the role of the “competent community” in youth suicide prevention
Outline how community members can participate in the prevention effort
Help you better recognize youth who may be at risk
Exercise- where would you rather be? Allow 5 minutes 3

4. Is Bullying a Suicide Risk Factor
Frequent exposure to bullying or victimizing others related to high risks for:
Depression
Suicidal ideation
Suicide attempts
Klomek etal. (2007). Bullying, depression and suicidality in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry ; 46(1);40-49.

5. Students Involved In Bullying: Increased Risk for Suicide (12mos) Compared to Youth Not Involved in Bullying
Middle School
High School
Ideation:
Targeted students: 3x more likely
Students who bullied: 4.1x more likely
Bully/Targets: 6.6 x more likely
Attempts
Targeted students: 2.1x more likely
Students who bullied: 4.4x
Bully/Targeted students: 7.5x
Data from Massachusetts, 2009
Ideation:
Targeted students: 3.9x
Students who bullied: 2.9x more likely
Bully/Targeted students: 4.9x more likely
Attempts
Targeted students: 4.3x more likely
Students who bullied: 3.1x
Bully/Targeted students: 5.7x

6. Victimization-Suicidality Pathway
Pre-existing Vulnerabilities
Victimization
Depression
Suicide ideation, attempts, completions
Show Ryan YouTube clip here

7. What School Strategies Help Reduce Bullying?
Research clearly shows that the key to reducing bullying (and creating lasting, positive change in school climate) is to get everyone in the school community involved in building a competent, caring community.

8. Why Talk about Youth Suicide?
Third-leading cause of death in adolescents
Second-leading cause of death among college students
There are 50 to 200 attempts for every completion
Almost 7% of high school students report making a suicide attempt
Over 14% of high school students report suicidal thoughts 8

9. In Simpler Numbers …
Every year, there are approximately 10 youth suicides for every 100,000 youth
Every day, there are approximately 11 youth suicides
Every 2 hours and 11 minutes, a person under the age of 25 dies by suicide 9

10. Why have a “community Plan”?.
Why have a “community Plan”?

11. A ‘Competent’ Youth Suicide Prevention Community
Community leaders/key stakeholders are committed to welfare of all members of the community
Everyone in community is committed to preventing youth suicide
Everyone knows where to get help when a community member is in need

12. Includes: Community leaders All segments of the community: Government
Law enforcement
Education
Recreation
Clergy
Business
Community service agencies

13. Focuses on:
Developing community awareness of dimensions of the problem
Engaging community & school leaders
Assessing needs & existing services
Developing action plans that target identified needs & anticipate emerging ones

14. …and what do you want to know?
Starting at the beginning:
What Do You Already Know About Youth Suicide…
What brings community members together- what they know and what they want to know-
…and what do you want to know?

15. Answering Common Questions15

16. Answering Common Questions
Aren’t mental health professionals the only ones who can really help suicidal kids?

17. Can Suicide Really be Prevented?
Answering Common Questions
Can Suicide Really be Prevented?

18. Is Talking about Suicide Just a Way for Someone to Get Attention?
Answering Common Questions
Is Talking about Suicide Just a Way for Someone to Get Attention? 18

19. Answering Common Questions
Can Talking about Suicide Plant the Idea in the Minds of Vulnerable Teens? 19

20. Are School Programs That Address Suicide Safe?
Answering Common Questions
Are School Programs That Address Suicide Safe? 20

21. Understanding Suicide
“A problem well-defined is a problem half- solved”

22. Suicide
An attempt to solve a problem of intense psychic pain with impaired problem-solving skills

23. Characteristics of Suicide
Alternative to unsolvable problem
Colored by crisis thinking .
Presence of ambivalence
Thinking has irrational quality
Act of communication

24. Overlap Theory of Suicide Risk
Demographics
Family History
Previous attempt
Psychiatric problems
Stressors
Access to means

25. Red: Warning Signs
Yellow: Risk Factors
Green: Protective Factors 25

26. F = Feelings A = Actions C = Changes T = Threats S = Situations
Warning Signs
F = Feelings A = Actions C = Changes T = Threats S = Situations 26

27. Feelings
Hopelessness
Anger
Worthlessness
Emptiness
Excessive worry

28. Actions Trying to get access to guns or pills
Risky or dangerous behaviors
Increasing drug/alcohol use
Getting into fights

29. Changes Changes in moods, actions or behaviors
Recent prescription of medication with depression as potential side effects
Adjustment/changes in antidepressant medications

30. Threats
Specific verbal statements: I want to die, I want to kill myself
Worrisome innuendos
Themes of death /destruction in school assignments

31. Situations
Situations that may serve as a trigger- when a student’s coping skills are really challenged, especially:
Loss
Change
Getting into trouble

32. How a Suicide Crisis Develops
Series of problems
Attempts to deal with them perceived as unsuccessful
Suicide seen as consistent with self-image
Suicide perceived as viable option

33. Tunnel Thinking
Healthy problem solving
Unhealthy problem solving
Making the shift in thinking that can lead to the perception of suicide as an alternative S

34. THE PERFECT STORM

35. Suicide Risk Factors v. Protective Factors

36. Protective Factors Contact with a caring adult Sense of connection
Positive self-esteem and good coping skills
Access to care for emotional/physical problems, substance abuse
Cultural/religious beliefs that discourage suicide and promote self-preservation

37. Fostering Protective Factors
Teach children it is okay to ask for help
Give children permission to talk about traumatic events like suicide
Help children identify trusted adults
Encourage participation in school & community activities
Be a resource to parents

38. The Competent School Community in Suicide Prevention
Provides an effective initial response to potentially suicidal students
Knows where to refer students for additional assistance 38

39. Suicide Prevention Strategies
Identification
Support and Response
Education 39

40. The Lifelines Program Program Goal:
To develop the school-based expertise and supports needed for responding to the problem of adolescent suicidal behavior 40

41. Lifelines Objectives
1. To increase the probability that persons who come into contact with potentially suicidal adolescents: a. can more readily identify them b. know how to respond to them c. know how to rapidly obtain help for them d. will be consistently inclined to take such action 2. To make sure troubled youth are aware of and have access to helping resources so that they are inclined to seek help as an alternative to suicide 41

42. Lifelines Components Administrative Readiness Consultation
Faculty and Staff Training
Parent Workshop
Student Curriculum 42

43. Curriculum Learning Objectives
To present relevant facts about suicide
To alert students to signs of suicide risk in peers and encourage serious responses
To outline ways to respond to troubled peers
To demonstrate positive attitudes about intervention and help-seeking behavior
To identify resources 43

44. Your Role as Community Members
Identifying risk factors & warning signs
Knowing and protective factors 44

45. Putting It All Together
The competent school community engages all members in suicide prevention activities
The competent school community can increase the effectiveness of responses to at-risk teens, their families, and friends 45

46. Additional Resources
Society for the Prevention of Teen Suicide Focuses on resources for the competent school community
Suicide Prevention Resource Center National resource
American Foundation for Suicide Prevention Printed materials & resources
American Association of Suicidology Data, resources, links 46