Everyone in Job Corps Plays a Role in Suicide Prevention

_________________________________________________

Richard Lieberman MA, NCSPLos Angeles County Suicide Prevention Network

Loyola Marymount Universitylieberman_richard@lacoe.edu

1

Webinar Overview

Core components of JC Suicide Prevention Program

Scope of the problem National trends Job Corps perspectives Contemporary issues for schools and

Centers

2

Webinar Overview

Protective factors Risk factors & warning signs of youth

suicide Staff role in suicide prevention,

intervention and postvention Questions

3

Core Components of the Job Corps Suicide Prevention Program

PLANNING Expand crisis management team to

address suicide prevention and response Establish center-wide policies &

procedures for intervening with suicidal students

Utilize SIR system for surveillance

4

Core Components of the Job Corps Suicide Prevention Program

TRAINING All staff will participate in suicide

prevention training (SafetyNet) All students will participate in suicide

awareness and prevention training (Wellness Education Curriculum)

Contact federal/state/local resources for materials & brochures

5

Core Components of the Job Corps Suicide Prevention Program

ENVIRONMENTAL ACTIONS Ensure students have access to JC Health

& Wellness mental health staff; community resources and national hotlines

Remove access to means through security checks

6

Scope of the Problem:Suicide in US: 2011 NATIONAL TRENDS

In 2011, 5104 youth aged 10-24 (11.0) died by suicide in America

Suicide is the second leading cause of death for Job Corps-aged youth 16-24

Males are 4X more likely to die by suicide Females are 3X more likely to make an attempt 200 attempts for every completion The #1 environmental risk factor is the presence of a

gun

7

Scope of the Problem:Suicide in the Job Corps Suicide rates in Job Corps are generally well

below the national average. From PY 2009-13, 14 deaths by suicide, 7 on

center. From PY 2009-13, 91 percent of all suicide-

related incidents occurred on center, with the dormitory being the most common location for occurrences.

8

Directive: Job Corps Information Notice No 14-08Promoting Student Safety through Suicide Awareness and Prevention Lenita Jacobs-Simmons, Acting National Director Job Corps

Scope of the Problem:Cultural Issues

White American Indian/Alaskan Native African American males Asian/Pacific Islander Hispanic

9

Scope of the Problem:Cultural Issues for Crisis Response

Identify cultural-related needs of community.

Obtain community resources to meet diverse needs.

Have materials translated into native languages.

Have translators available. Know the traditions, rituals, and belief

systems of your diverse population.

10

Scope of the problem: Youth Risk Behavior Surveillance Survey*

29.9% felt sad or hopeless

17.0% seriously considered suicide 13.6% made a suicide plan

8.0% made one or more attempts 2.7% actually got to medical help

11

*CDC, 2013

Contemporary Issues in Suicide Prevention and Intervention

Bullying and suicide LGBTQ Social Media Non-Suicidal Self-injury (NSSI)

12

Contemporary Issues:Social Media Utilize students as "cultural brokers" to help faculty and

staff understand their use of social media. Train students in gatekeeper role, and specifically

identify what suicide risk looks like when communicated via social media.

Have staff work collaboratively with students to monitor social networks and provide safe messaging when important.

Encourage parents or guardians of minors to get involved in their child's social media.

13

Contemporary Issues:Social Media Monitor for high-risk students. Psycho-education:  Make use of social media to

post prevention messages, hotlines and community mental health resources.

Give students specific helpful language to include when making use of social media. 

Work with YouTube and Facebook to take down messages, disturbing images or language.

Utilize the Facebook application for concerns or issues with content.

14

Signs of NSSI Frequent or unexplained bruises, scars, cuts, or

burns. Consistent, inappropriate use of clothing

designed to conceal wounds (often found on the arms, thighs, abdomen).

Secretive behaviors, spending unusual amounts of time in the student bathroom or isolated areas on campus.

General signs of depression, social-emotional isolation and disconnectedness.

15

Signs of NSSI

Substance abuse Possession of sharp implements (razor

blades, shards of glass, thumb tacks, clips)

Evidence of self-injury in work samples, journals, art projects

Risk taking behaviors such as gun play, sexual acting out, drinking & driving, choking game

16

Responding to students who self-injureTips for Educators: DO

Connect with compassion, calm and caring. Understand that this is his/her way of coping

with pain. Respond with a “respectful curiosity.” Refer and offer to go with the student to your

school counselor, psychologist, social worker or nurse.

Discover the student’s strengths. Help to create circle of care at school.

17

18

Responding to Students who Self-InjureTips for Educators: DON‘T

Discourage self-injury, threaten hospitalization, use punishment or negative consequences.

Act shocked, overreact, say or do anything to cause guilt or shame.

Never publicly humiliate the student or talk about their SI in front of class or peers.

Agree to hold SI behavior confidential. Make deals in an effort to stop SI. Make promises you can’t keep.

18

After a Suicide: A Toolkit for Schools

Preventing Suicide:A Toolkit for High Schools

SAMHSA SPRC/AFSP19

Suicide Intervention No predictors of youth suicide so we must be

vigilant even with low risk Kids are not suicidal 24/7 and levels of risk can

change within hours Youth population is vulnerable to contagion Try to create a circle of care between student,

parent/guardian, center, community agencies Collaborating with Center crisis teams

20

Staff Role in Suicide Prevention

Do not be afraid to talk to students about suicide or self injury

Know the risk factors & warning signs Respond immediately, supervise the

student Have student escorted to mental

health staff Join the team in evaluating student

21

Suicide Prevention in the SchoolsProtective Factors

Strong individual coping and problem-solving skills

Strong sense of belonging and connection Interpersonal competence/success Family warmth, stability, support and

acceptance Positive connections at the Center Spirituality & religious involvement Access to mental health care & awareness of

crisis hotline resources

22

Continuum of Self-destructive Behavior

Behaviors:Suicide attempts

Self-injury

Alcohol/substance abuse

Thoughts

Stressors: Chronic

Mental Illness/Co-morbidity Warning signs

Stressors: Acute Precipitating Event

23

Risk Factors of Youth Suicide Alcohol/substance abuse Accessibility of means (i.e., guns, rope) Internal vulnerabilities

Psychiatric disorders Depression Conduct disorder

Previous suicidal behavior History of loss/trauma/victimization

External vulnerabilities (family/community) Hopelessness Impulsivity NSSI

24

Risk Factors of Youth Suicide SITUATIONAL CRISES (Precipitating

events) Loss (Death, divorce, transience,

romance, dignity) Victimization/exposure to violence Center crisis (disciplinary, academic) Family crisis (abuse, domestic violence,

running away, argument with parents) Suicide in community

25

Warning Signs of Youth SuicideAdolescents

Suicide notes/social media posts Threats Plan/method/access Depression

(helplessness/hopelessness) Risk-taking behaviors such as gun play,

alcohol/substance abuse, choking game)

26

Warning Signs of Youth Suicide Continued

Giving away prized possessions History of NSSI Death & suicidal themes Sudden changes in personality,

friends, behaviors

27

Staff Role in Suicide InterventionJob Corps Protocols

Maintain supervision throughout Collaborate with CMHC or Health & Wellness

staff trained in suicide assessment Contact Supervisor or HWC Person on Call (if

after hours or on weekends) Know the Symptomatic Management Guideline for

Non-Health Staff for Suicide Attempts/Threats Know your center’s SOP/COP for suicide risk

assessment

28

Staff Role in Suicide Intervention Utilizing Safety Planning

Identify circle of care of adults at home and at Center

Promote help–seeking behaviors Promote communication skill building Grief resolution Provide relevant

hotlines/websites/resources

29

New App! MY3

Staff Role in Suicide InterventionRe-entry Suggestions Have parent/guardian escort student back to Center first

morning following hospitalization/MSWR and conduct re-entry meeting.

Collaborate with members of crisis team. Obtain any records from hospital and have parent sign a

release of information form, if minor. Provide interventions:

Modify academic programming as appropriate. Identify on-going counseling resources on center or in the

community. Discover if student is on medications and monitor (with

parent consent, if minor). Notify student’s teachers as appropriate.

30

Staff Role in Suicide InterventionRe-entry Guidelines

Monitor student to make certain no bullying takes place in the Center as many students may know the student was hospitalized and word spread through social networking.

Monitor social networking sites collaboratively with students with cooperation of the parent.

Identify circle of adults in the Center and at home

Check in frequently during the first week the student returns to the Center.

31

Staff Role in Suicide InterventionLocal Resources

Emergency response teams Collaborating with law enforcement Culturally focused mental health

agencies Gay and lesbian mental health

agencies Annually update!

32

After a Suicide: A Toolkit for Schools

Suicide Prevention Resource CenterAmerican Foundation for Suicide Prevention

33

Staff Role in Suicide PostventionGuidelines

Replacing rumors with facts and honoring the family's request for privacy

Encouraging the ventilation of feelings Stressing the normality of grief and wide array

of stress reactions children demonstrate Discouraging attempts to romanticize the

suicide Identifying students at risk for an imitative

response Knowing how to make the appropriate referrals

3434

35

Staff Role in Suicide Postvention:Talking to Students

Reach out and provide comfort care Recognize basic needs and support problem

solving Validate feelings and thoughts Provide honest and timely information Connect student with systems of support Provide education about stress responses Reinforce strengths and positive coping

strategies

35

36

RESOURCES

National Lifeline800.273.TALK (8255)

SPRCwww.sprc.org

Trevor Project866.4-U-TREVOR