March 2016

Information for Educators

Understanding Suicide

Suicide is when people direct violence at themselves with the intent to end their lives, and they die as a result of their actions. A suicide attempt is when people harm themselves with the intention of ending their lives but they do NOT die as a result. Many more people survive suicide attempts than die, but some suffer serious physical injuries. Survivors of suicide attempts may also have depression and other mental health problems. Suicide also impacts the health of the whole community because friends and family members experience shock, anger, guilt, and depression. Medical costs and lost wages also figure into the total cost of suicide.

Suicide Statistics

Suicide is a significant public health problem in the US. It is the 10th leading cause of death for people of all ages and the second leading cause of death for young people aged 15-24, more common than anything other than accidents. In NY, suicide is the third leading cause of death for ages 10-24. Over twice as many people die by suicide in NY than by homicide. Approximately 1:6 high school students seriously consider attempting suicide, according to the CDC, and 1:13 attempts suicide one or more times. LGBT youth attempt suicide at a rate 2-4 times higher than that of their heterosexual peers.

Who is at Risk for Suicide?

While there is no single cause of suicide, there are risk factors that increase the chances:

• Previous suicide attempt(s)
• Alcohol or drug use
• History of depression, anxiety disorder, PTSD, or other mental illness
• Family history of suicide or violence
• Physical illness
• Access to a means to kill oneself, e.g., guns, knives, medications
• Feeling alone

People with more than one risk factor are at greater risk. Often a triggering event (i.e., something that causes shame or despair) makes an attempt more likely. While women are more likely to express suicidal thought and to make nonfatal attempts, men are more likely to die from suicide. Younger adults (aged 18-29) more often have suicidal thoughts, suicide plans, and suicide attempts than those 30 or over.

These might indicate more immediate risk for suicide:

Marked changes in behavior

• Talking about, writing about or making plans to die or to kill oneself
• Looking for a way to kill oneself (e.g., online research, looking for a gun)
• Talking about feeling hopeless or having no reason to live
• Displaying severe or overwhelming pain or distress

When there are signs of IMMEDIATE risk, be sure to provide constant supervision of the student until a mental health contact can take over. Provide the mental health person with any other information you might to help with the evaluation process.

What should you do if you are concerned about a student being at risk for suicide?

• Consult with the school’s mental health support staff about your concerns.
• Reach out to the student. Listen to his/her concerns without judgment. Use I-statements to express your concern, such as “I feel concerned because you have not been acting like yourself recently.” Urge the student to see the school mental health person offer to go along if necessary.
• Do not be afraid to directly mention the word “suicide.” Years of research and experience by suicide professionals have shown that talking about suicide does NOT plant the idea in a teen’s mind.
• For mental health professionals: assess the student for risk of suicide, collaborate with administrators to make decisions about next steps, notify and involve the parents/guardian, be sensitive to family and/or cultural issues.
• Take care of yourself. Find someone in whom you can confide and ask for help when you need it.

Bullying and Suicide

The relationship between bullying and suicide is complicated. Research has shown that youth who report frequently bullying others and those who report being bullied frequently are both at increased risk for suicide-related behavior. Those who engage in bullying and have been bullied have the highest risk for suicide of any group involved in bullying. Bullying can be a stressor which contributes to the sense of hopelessness and helplessness that raises the risk of suicide. There is insufficient evidence to say that bullying directly causes suicide-related behavior; most youth who are involved in bullying do NOT engage in suicidal behavior. Many of the same factors that increase vulnerability to bullying are also present in youth at risk of suicide, including relationship problems, lack of connectedness to school, alcohol and drug use, physical disabilities/learning differences, lack of access to resources, exposure to violence, family conflict, and emotional distress.

To read more about this issue, go to the CDC publication entitled The Relationship Between Bullying and Suicide: What we Know and What it Means for Schools here.

Suicide Postvention

The following article is a must read for all counselors/school administrators on the steps to take when handling a suicide death of a student/staff member. Information is given if this occurs on and off school grounds. This protocol is easy to follow and provides practical steps on how to proceed after the death.

Connect Suicide Prevention Project: Postvention Response
Connect Suicide Prevention Project, Protocols for Postvention, Community Response to Suicide, 12.15.2009, NAMI, www.theconnectproject.org

The Suicide Prevention Resource Center (SPRC) also has a toolkit available for schools to use after a suicide has occurred.
You can access it here.

First and foremost, the Crisis Response Team will need to have a plan in place to address the suicide.

Here are some valuable tips when informing students and staff:

• Follow a plan given by the Crisis Response Team
• If there is a group of students who was close to the deceased, bring them together in a small group and tell them separately.
• Announce to small groups of students by a teacher/staff person who is familiar with the students. The announcement should be done at the same time with small groups of students. There should be a written statement that all leaders read to their group of students so that the same message is given to all students.
• No large assemblies/PA system notification.
• Announce early in the day so school support is available.
• Be honest and direct with common statement about the death.
• Provide counseling/support.
• Do not close school.
• Have a plan in place for monitoring at risk students.
• Give funeral details
• Send a note to parents to inform them of the death which includes the following:
• Accurate information
• Steps school has taken and recommended steps for parents
• Contact information for more support
• Give resources that are available if parent notices unusual behaviors with their child
• Give funeral details

Internet/Social Networking Websites
Make sure that parents contact facebook (www.facebook.com) or other online media to change profile into “memorial status.”

Memorial Services and Remembrances
“Suicide contagion can occur when events (such as memorial services and media coverage) glorify the life or sensationalize the death of the individual. This increases the risk factors for youth who are depressed, troubled, or at increased risk for suicide. Media reports, as well as memorial services, are two of the biggest factors that contribute to suicide contagion. It is a human tendency to overstate the positive qualities of the deceased while at the same time minimizing or even ignoring less positive attributes, particularly their decision to take their own life. Yet this inclination can increase the risk level of suicide for survivors.”

Safe Space after a suicide:
Many schools have a designated a “safe space” for students to have privacy, write in a common journal or express their thoughts through art. These places can have staff present with the idea that students may need time to collect their thoughts.

Self-care skills:

• Get plenty of rest.
• Maintain proper diet and nutrition/ drink plenty of water.
• Exercise
• Use relaxation skills
• Be gentle with yourself/others.
• Seek out supportive people.
• Avoid use of alcohol or other substances.
• Ask for help.

Establish a Comprehensive Approach to Suicide Prevention in Your School, including:

• Schoolwide programs that promote connectedness and emotional health
• Policies and procedures for helping students who are in crisis
• Postvention protocol
• Parent/guardian education and involvement
• Student programs (e.g., SEL and health curricula, peer leadership)
• Screening for at-risk students
• Staff training

The Substance Abuse and Mental Health Services Administration (SAMHSA) has published a toolkit for high schools interested in preventing suicide. Find it here.

Resources

For more information, email Penny Williams at pwilliams@ocmboces.org or Kathy Miller kamiller@ocmboces.org