Suicide The permanent solution to a temporary problem Objectives: Explore myths that stop us from dealing effectively with suicide. Review verbal & situational warning signs (“red flags”) of teens who are thinking of suicide. Understand the extreme importance to referring for help quickly. Explore OK things to say. Understand that suicide is a “permanent solution to a temporary problem.” Myths MYTH: if a person has made a decision to commit suicide, nothing will stop them. FACT: Most people who complete or attempt suicide do not want to die; they just want their pain to end. People thinking of suicide need someone to step in to help them find alternatives to dealing with their pain and their problems. Myths MYTH: Talking about suicide may lead someone to attempt suicide. FACT: Talking openly about suicide actually reduces the risk. Your honest care and concern can be a source of relief for the suicidal person, reducing the immediate danger. Myths Another myth about suicidal people is that once the initial depression or suicide attempt is past, the person is well and healthy again and doesn’t need to be worried about. Fact: The initial crisis may be over, but a suicidal person is still ripe for another attempt if there is no monitoring and follow-through by professionals. A certain amount of energy is needed to commit suicide. If a suicidal person’s depression seems to have lifted, it may lull those around him / her into a false security. Teen Suicide is becoming an even bigger problem It doesn't seem right that a teenager - who has lived for such a short time - would choose to die. But adolescents who can't get over their depression sometimes do kill themselves Since 1960, the number of teen suicide has increased 300%. Roughly 1 out of 10 people between the ages of 15 - 24 attempt suicide during some part of their adolescence Suicide is the third leading cause of death in young people. For every two homicides in the U.S. there are three suicides. 14 suicides take place each day or 5000 per year. Suicide threats & clues Suicide threats and clues: It has been estimated that up to 80% of all suicide victims have given some clues regarding their intentions. Direct clues: “I want to kill myself” Indirect clues: “I wish I could fall asleep and never wake up” Suicide Threats Take all suicide threats seriously: even if the person is laughing when mentioning suicide or a friend is daring him / her to do it or if the person is just beginning to think about suicide A refusal to take the suicidal person’s feelings seriously can be the triggering factor - it may be viewed as confirmation that nobody cares or understands. “Cry for help” A suicide or suicide attempt has often been described as a “cry for help”. It’s a message that is sent to significant others. Many teenagers who attempt suicide, don’t really want to die. They are ambivalent. There is an urge to die, but there is also an urge to live. A life can be saved if the “cry for help” is heard. Listening We need to know how to listen and what to listen for. It is not normal for teens to be constantly depressed. (Mood swings for a day or two are normal). However, for teens who are depressed for weeks and don’t snap out of it - this can be a warning sign or a “cry for help.” Understanding Depression and Its Connection to Suicide Depression is an emotional state in which people have extreme feelings of sadness, dejection, lack of worth and emptiness. Depression is not the blues. The blues are normal feelings that eventually pass. Feelings associated with depression last longer than a few weeks. For people who are depressed, no matter how hard they try, they can’t seem to “shake” their depression. Depressed Individuals Depressed individuals often feel and act hopeless and helpless. Most depression can be effectively treated (usually with a combination of medication and psychotherapy). With treatment, people can live productive lives. However, if left untreated, depression can be lethal. Warning Signs of Depression Significant changes in Chronic physical symptoms eating habits: or pains that do not respond Loss of appetite or to treatment. Overeating; Loss of motivation. Weight gain or loss. Feelings of guilt. Changes in sleeping Indecisiveness. patterns; sleeping more or Slowing of speech and body less. movement. Loss of energy or persistent Persistent thoughts of death lethargy; tired all the time. or suicide. A Study of Teens Who Completed Suicide found: In almost every instance, the adolescents had multiple, unexpected separations from their parents during the first three years of their lives. All felt that there was no real communication or there were no emotional ties in their families. More than 60% had attempted suicide previously. In 25% of the families involved, one of the parents had attempted suicide. A relative or a close friend had attempted suicide for 44% of the suicidal young people in this study. A Study of Teens Who Completed Suicide found: Nearly 66% of the youngsters were in families in which someone had suffered a serious illness, (usually in the two- year period prior to the attempted suicide). Many of the adolescents felt that they had to contend with an unwanted stepparent -- a feeling that was often mutual. About 85% of the adolescents had physical complaints (i.e. headaches, stomach aches, general malaise). Most parents of suicidal teenagers say that in retrospect, many of the warning signs were there. Common Characteristics for Teens Who Are Thinking of Suicide They suffer psychological or emotional pain that is so intense it seems as if it will never end. They feel that their pain and suffering will go on forever. Teens don’t have the perspective of living a lot of years or that everything in life changes. Their needs for security, achievement, trust, love, and friendship are frustrated. They see suicide rather than any other alternative as the solution for a problem. They need to stop the pain they feel by ending their awareness. They have difficulty problem solving. Common Characteristics for Teens Who Are Thinking of Suicide They see only two solutions to the problem: it is either solved or it is stopped by their death. They feel ambivalence: they want to live; yet they want to die. They give clues about wanting to commit suicide. They want to run away from the problems, fears, pain, and turmoil. Suicide is the ultimate runaway. They have a long pattern of coping poorly with problems. They can’t sort it out. Detection / Awareness Detection / awareness: All school personnel (including teachers, paraprofessionals, administrators, support staff, bus drivers, cafeteria workers, etc.) who interact with students on a regular basis must know the warning signs of suicide and the importance of not keeping a secret about suicidal behavior. “Red flags” - take notice Loss of interest in friends and regular activities. Drop in school grades. Changes in eating and sleeping habits. Lack of interest in personal appearance. Cutting classes. Drug and alcohol abuse. Constant withdrawal to his or her room. A lack of interest in the future. “Red flags” - take notice Giving away prized possessions. A preoccupation with death and talk of suicide. Talk of being a “burden”. Making statements about helplessness, hopelessness. Loss of interest in hobbies, work, or school. Difficulty eating and sleeping. Self-destructive behavior. Giving things away, even their prized possessions. Verbal signs - take notice “I’m going to kill myself!” (Threatening to kill oneself precedes four out of five suicidal deaths.) “I don’t want to live any more.” “Soon I won’t be hurting so much any more.” “They’ll be sorry when I’m gone!” “I wish I never was born!” “I wish I could go to sleep and never wake up” “Do you think dying hurts?” “They’ll be better off without me!” Situational signs - take notice Loss of relationship. Breakup of relationship with boyfriend or girlfriend. Belief of not being wanted. Failure. Substance abuse. Emotional, physical or sexual abuse. Financial setbacks. Substance abuse and suicide Some teens who abuse alcohol or drugs are more likely to consider, attempt or succeed at suicide than are non-abusers. Substance use and abuse can be common among persons prone to be impulsive, and among persons who engage in many types of high risk behaviors that result in self-harm. The strongest risk factors for attempted suicide in youth are depression, substance abuse, & aggressive or disruptive behaviors. Younger persons who kill themselves often have a substance abuse disorder in addition to being depressed. Suicide is permanent Suicide is often seen as the only way to stop and obtain relief from the unbearable pain. Hopelessness is a strong predictor of suicide. Remember: Suicide is the permanent solution to a temporary problem. How to help a person who is suicidal Stay calm. Show you care. Ask the question: “Are you thinking about hurting yourself or committing suicide?” Get the person the help they need (quickly). Call for help ASAP (contact the therapist, supervisor/chain of command, Crisis Services). Help other kids be better responders: friends may turn to other friends for help. Let the person know you care Listen carefully! Don’t condemn - be willing to listen to feelings. “You mean a lot to me and I want to help”. “I don’t want you to kill yourself”. “I’m on your side and we’ll get through this”. Don’t minimize or trivialize or moralize. Don’t offer simplistic solutions (e.g. “All you need is a good night’s sleep;” or “Everything will be better in the morning”). It’s OK to say the word "suicide." Don't be afraid to say the word "suicide." Getting the word "suicide" out in the open may help the teen think someone has heard their cries for help. Remind him / her that no matter how awful their problems seem, they can be worked out, and you are willing to help. Responders have to ask the tough questions “Are you thinking of hurting yourself” ? “What thoughts or plans do you have”? “Have you thought about how you would do it”? “Do you really want to die or do you want the pain to go away” ? Things a helper can say “I know where we can get some help”. “You are not alone. Let me help”. “Let’s talk to someone who can help … let’s call your counselor, now.” “We’ll call for help” (call therapist ASAP, call supervisor / follow chain of command, call Crisis Services, etc.). More things a helper can say A teen thinking about suicide may need someone to take emotional charge: “I am here” “We will get you through this” “I will help you find someone to talk to” Remember: the more you engage, the less likely the person will kill themselves. Increase awareness among teens Kids may have a view that life is scarier than death (e.g. when they are flunking tests, having relationship problems that are going on for a long period of time, etc.). Help them find positive ways to deal with their problems. Suicide is the ultimate negative way of coping. Killing self is not like a movie or acting. Suicide is permanent. Increase awareness among other teens Dispel the myths. Help teens better understand what suicide and depression is all about. Sometimes kids / teens view suicide as a heroic act. They may believe suicide takes a lot of “guts.” Contagion Effect Beware of the Contagion Effect of suicides as well as possible suicide pacts. Teens are more likely to kill themselves if they have recently read, seen, or heard about other suicide attempts. “Copycat” suicides happen because kids don’t understand the reality of suicide. Those left behind Survivors of those who completed suicide try to cope with feelings of: Grief Anger Guilt Denial Regrets (for what they did and / or did not do) It does not have to happen Try to get across the point (continually) that this (suicide) does not have to happen. Try to empower the person … “You’ve made it for 15 years”. Try not to be judgmental - accept their situation as being painful. Protective factors that reduce the probability of suicidal ideation / action The World Health Organization report found the following protective factors: Good family relations and support. Good relationships with teachers and peers. Social integration and participation in school and community. Social skills and self-confidence. Willingness to seek help when difficulties arise. Suicide: The permanent solution to a temporary problem Lethality Prevention Quiz Your training record will be updated automatically upon successful completion of the Lethality Prevention Quiz. Please click here to complete the quiz. Lethality Prevention Quiz Your training record will be updated automatically upon successful completion of the Lethality Prevention Quiz. Please click here to complete the quiz. Lethality Prevention Quiz Your training record will be updated automatically upon successful completion of the Lethality Prevention Quiz. Please click here to complete the quiz.
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