National Conference 2015

We Need to Talk About Suicide: Coping with the Trauma of a Learner’s Suicide and Building Resilience

Martin Gallen, Educational Psychologist, Donegal ETBMartin Gallen, Educational Psychologist, Donegal ETB

What influences our Mental Health……

Reaching Out; Awareness Training on Suicide Prevention in Reaching Out; Awareness Training on Suicide Prevention in Ireland, 2010Ireland, 2010

Vulnerable mental health results in protective factors lessening and risk Vulnerable mental health results in protective factors lessening and risk factors increasing for suicidefactors increasing for suicide

Social SupportSocial SupportAs age increases,increases, self reported levels of

social support decreasedecrease.

PresencePresence of One Good of One Good Adult was a key indicator of Adult was a key indicator of how well a young person is how well a young person is connected, self-confident, connected, self-confident,

future looking and can cope future looking and can cope with problems with problems

AbsenceAbsence of One Good of One Good Adult was linked to higher Adult was linked to higher

levels of distress, anti- social levels of distress, anti- social behaviour and increased risk behaviour and increased risk

for suicidal behaviour for suicidal behaviour

One One Good Good AdultAdult

Creating a Coping, Supportive and Caring Ethos

Physically Safe Environment

Equip learners to deal with mental health problems and seek help for same (MINDOUT)

SPHE programmes- Grief and Loss - Stress/Anger/Conflict Management;- Problem Solving- Communication Skills/Help Seeking- Decision Making- Alcohol and Drug Prevention (Foroige)

Psychological Safety

Mentoring Programmes (One good Adult)

Policies/Inclusion/Anti-bullying/Cyber bullying

Restorative Practices

In-centre Counsellor

Books/Resources

Psychological SafetyLiaison with external agencies (developing

good communication pathways)

Staff TrainingMental Health Issues (JIGSAW – Level 1 & 2)Child Protection TrainingSuicide Awareness (ASIST and safeTALK

training)Signs and Symptoms of

stress/anxiety/depression

Risk Factors for suicide

Reaching Out; Awareness Training on Suicide Prevention in Ireland, 2010

Vulnerable mental health

Hopelessness – no positive view of the future

History of suicidal behaviour

Suicide and/or DSH in a family member/relative or friend

Diagnosis of a serious illness e.g. terminal illness or long-term pain

(presence of 4 key factors outlined below may increase the likelihood of impulsive

deaths by suicide)

Stress – acute or prolonged which can result in a real or perceived sense of overwhelming loss or hopelessness which can trigger fleeting thoughts of suicide

Impulsivity – past behavioural patterns of acting without thinking about consequences

Past or current substance abuse or misuse

Access to means of suicide

PAGE 15 RESPONDING TO CI GUIDELINES IN YOUTHREACH AND CTCs

Unexpected reduction in academic performance

Change in mood and marked emotional instability, either more withdrawn, less energy or more boisterous, talkative, outgoing

Withdrawal from relationships, separation from friends or break-up of a relationship

Getting into trouble at the centre, discipline problems, suspension or expulsion; trouble with the law

Loss of interest in usual pursuits, study, relationships

Ideas and themes of depression, death or suicide

Hopelessness and helplessness

Giving away prized possessions

Information about self-harm or intention to self-harm coming to centre staff attention

Notes or online posts found about a desire for death, an ‘impossible situation’, or an end to problems

A growing interest in death or death by suicide

Steps to take when concerns arise (PAGE 15 RESPONDING TO CI GUIDELINES)

Concern is reported to the designated staff member, or a Guidance Counselling and Psychological Services Practitioner serving the centre

A meeting takes place with the reporting staff member or learner

A meeting takes place with learner* (see R15, R16 & R17),

A judgement is made about the seriousness of the situation

Where concern appears unfounded, feedback is given to the original referee and a monitoring plan is drawn up for the learner. After an agreed period, the situation is reviewed to ensure there are no underlying issues that need to be addressed

Where a concern is confirmed, it is reported to the coordinator/manager, leading to a consultation with the Guidance Counselling and Psychological Services Practitioner (GP&PS), or with local Child and Adolescent Mental Health services

Coordinator/manager informs parents or caregivers as a matter of urgency

Coordinator/manager and guidance counsellor may seek a consultation with their local Child and Adolescent Mental Health Service

Management plan, appropriate to the risk level is established, with onward referral to the family GP.

Forward Planning Key to managing is planning

Quick and effective reaction

Sense of control

Normality returns as soon as possible

Effects on learners and staff are limited.

Avoids “helicopter or paratrooper syndrome”

DocumentsDocuments•Responding to Critical IncidentsResponding to Critical Incidents: : Guidelines for Youthreach & Community Training Centres

•Responding to Critical IncidentsResponding to Critical Incidents: : Resource materials for Youthreach & Community Training Centres

Available at: http://www.youthreach.ieAvailable at: http://www.youthreach.ie

Develop a Critical Incident Plan

Step 1 - Defining a critical incident

Step 2 - Creation of a coping, supportive and caring ethos in the centre

Step 3 - Creation of a critical incident management team

Step 4 - Communication of Plan

What is a Critical Incident

“A critical incident is any incident or sequence of events which overwhelms the normal coping mechanism of the centre”

(NEPS 2014)

3 Levels of Incident1. Death of a student or staff member who was

terminally ill; death of a parent, or sibling; fire or damage to school property

2. Sudden death of a learner or staff member

3. Accident/event involving a number of students; a violent death; an incident with high media profile; event that involves a number of schools

What level?Suicide of a resource person/tutor

Suicide of a former learner

Suicide of a current learner

Suicide of a learner with high media interest

More than one suicide

What is the goal of a CI Plan?

To return the centre to the pre-incident, normal state as soon as possible

Reduce the immediate and long term detrimental impact on learners, tutors and families

First 48 hours crucial/3 weeks vulnerability.

Selection of MembersThe success of the crisis management team can depend on the selection of members

The roles can be rewarding but also considerable stress

Review members of team regularly

Possible RolesTeam Leader

Staff Liaison

Learner Liaison/Counsellor

Parent Liaison

Community Liaison

Administrator

Media

Role of Psychological Support Staff

PlanningPlanning

Information & advice Information & advice

Support – best to come from Support – best to come from familiar facesfamiliar faces

ScreeningScreening

Role of HSE/NEPS• HSE CI management team• Involved when there is a significant impact in the wider

community• Psychosocial provision (Psychological First Aid) v service

provision• Referral pathways• HSE/NEPS working group on the provision of psychosocial

response

Short term actionsEstablish as many facts as possible

Locate CI plan and NEPS publications

Contact appropriate agencies (NEPS,ETB,HSE)

Gather list of parent/guardian contact numbers and begin to text/ ring parents

Possibly dedicate a room for parent drop in

Nominate a staff member to stay in parent room

Arrange cover for tutors on CI Team and convene a CI meeting and delegate tasks

Inform all staff when possible

Maintain routine for other learners

Medium termStaff meeting to outline schedule for the day, update

staff on developments, assign roles

Contact with bereaved family

Decisions re: closure and funeral arrangements

Support to staff

Support to learners

Return of learners

Guidelines following a suicide Terminology

Age appropriate facts

Inform close friends relatives separately

Avoid glorifying the victim and sensationalising the suicide

Encourage help-seeking behaviour

Key messages for learnersSuicide is never a valid option

No criticism of the person but separate the person from the behaviour

Feeling low is temporary. Suicide is permanent

Suicide is the intention to change life not to end it

Suicide is the act of a person for which we cannot take responsibility.

AdolescentsAdolescent’s concept of death becomes more

abstract.

Death is seen as irreversible and personal, mortality is acknowledged.

May feel an array of emotions and death adds to confused emotions

R11: Reactions to a critical incident

How to helpListen

Reflect on justice/injustice, fate etc.

May seek support from outside the family

Allow them to express grief in their own way

General support to Learners

Acknowledgement

Communication

Time to process information

Make the loss real

Develop emotional coping skills

Critical Incident PlansCI plans should be reviewed regularly

Copies of plan readily available

Personal copy – team members

New/temporary staff alerted to plan

Inform parents

PositivesGreater awareness of Mental Wellbeing

Greater numbers of young people seeking help