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Ending A Deadly Silence Suicide PreventionGatekeeper Training

Insert your name and agency

What to Look ForWhat to DoHow to HelpAdapted with permission from the Washington State Youth Suicide Prevention Program and the Maine Youth Suicide Prevention ProgramPrevention is often a matter of a caring person with the right knowledge being available in the right place at the right time.

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 someonewho dies by suicide

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

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

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

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

2005 National Statistics32,637 suicides (89.4 per day)

3rd 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 minutesSource: AAS, USA Suicide: 2005 Official Final Data

2007 Florida StatisticsOver 2,000 deaths (2,570 = 7 per day)

3rd leading cause of death for 25-34 y.o.

3rd leading cause for 15-24 y.o.

Suicide rate consistently is about double the homicide rate

69% of all suicides were among ages 25-64Source: DOH, Florida 2007 Vital Statistics Report

Not Just Statistics Statistics alone dont paint the whole picture

Suicide is devastating to family, friends, and communities

Opportunities to help

Understanding People in Crisis Why Everyone Is Vulnerable

PressuresAssets Stressors are infinite Assets are finite

A Person May Feel TheyCant stop the painCant think clearlyCant make decisionsCant sleep, eat or workCant make the sadness go awayCant see the future without painCant see themselves as worthwhileCant get someones attentionSource: AAS @ www.suicidology .org

Cup Full of ProblemsEach cup represents a problemthat a person may be having.Only rule is that the cupscannot be stacked inside one another.

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

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

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:HopelessnessHelplessnessPerceived burden on others

Warning Signs and CluesWhat To Look ForThe red flags that something is wrong

Changes in a persons behavior, feelings, and beliefs about oneself that are maladaptive or out-of-character

P PurposelessnessA AnxietyT TrappedH Hopelessness

W WithdrawalA AngerR RecklessnessM Mood Change

Source: American Association of Suicidology, November 2003

I IdeationS Substance Abuse

Some Signs Demand Immediate ActionTalking 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

In SummaryThere 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 dont want to die they want to end their pain

Protective FactorsPositive conditions personal and social resources feeling connected

Promote resiliency and reduce the potential for suicide

Ability to manage or cope with adversity or stress

Youth ElderlyPositive connections to schoolCoping and problem solving skillsAcademic achievementFamily cohesion/stabilityHelp-seeking behaviorsGood relationships with other youthPositive self worth and impulse control

Supportive family relationshipsSense of purpose and identity Involvement in community activitiesAbility to live independentlyBetter preparation for retirement, interests and support networks outside of workplace

What To DoIntervention- 3 Basic Steps

SHOW YOU CARE

ASK THE QUESTION

GET HELP

Adapted with permission from the Washington Youth Suicide Prevention Programhttp://www.yspp.org

SHOW YOU CARETrust 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!

Ask The Question Dont assume they arent the suicidal type

Be direct. It sounds like youre 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 Dont have to solve all their problems but you must get help

Suicide Paraphrase Activity

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

ResourcesSupportive friends Family membersClergyMental Health AgencyCounselor or therapistFamily physicianLocal hospital emergency roomCrisis Center 9-1-1

1-800-SUICIDE1-800-273-TALK

Additional ResourcesFlorida Suicide Prevention CoalitionYouth Suicide Prevention School-Based Guide, FMHICommunity Health DepartmentAddiction Help Line 1-800-758-5877FL Abuse Hotline 1-800-96ABUSEElder Abuse 1-800-962-2873Domestic Violence Hotline 1-800-500-1199Suicide Prevention Resource Center1-877-YOUTHLINE2-1-1Elder Helpline 1-800-955-8770Parent HelpLine at 800-352-5683

Group Role Play

ConclusionIt doesnt take aprofessional to save a life

We are all gatekeepers

Preventing suicide is everyones business yoursand mine

Together we can end this deadly silence

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

Note to trainer: Make sure to have participants sign in on the sign in sheet want to make sure to have an email address if possible

Gatekeeper training is about learning basic suicide prevention and intervention skills, in much the same way that CPR is used to intervene in medical emergencies.

Just as people who are trained in CPR do not replace the need for doctors or emergency rooms, gatekeepers do not replace the need for mental health services or crisis centers.

Gatekeepers are simply caring individuals recognizing the potential for suicide and taking action to ensure that people at-risk receive the help they need.

Training reviews the impact of suicide on our families and communities helps increase our ability to know what to look for, what to do, how to help. After an attempt or suicide death it is common to find that different people held different pieces to the puzzle.Likely that no one person had enough knowledge about the number of risk factor, was aware of enough of the warning signs, or observed enough behaviors to be absolutely sure that suicide was a real possibility. That is why we all need to be educated and willing to talk more openly when something in our gut raises a red flag or when we recognize the clues.The more people that know what to look for, what to do, what to say, and how to access, obtain, or arrange for appropriate professional help the more likely we will be of preventing suicide of saving lives.

Through research we know that suicide communications are often not made to professionals. In fact, in one psychological autopsy study only 18% had told professionals of their