Suicide Prevention
Resources
Presented by:
Stephanie Belford, LGSW
ASPEN Director
Objectives
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Participants will review WV suicide
statistics
Participants will be able to recognize risk
factors for suicide
Participants will become familiar with a
free suicide risk assessment
Participants will become familiar with
classroom prevention resources
Why Is This Important?
• Every 17 minutes another life is lost to suicidetaking the lives of more than 30,000 Americans
every year
• Every day 86 Americans take their own life
• Suicide is now the 8th leading cause of death in
America.
• For young people 15-24 years old, suicide is the
third leading cause of death
During our lifetime:
• 20% of us will have a suicide within our
immediate family.
• 60% of us will personally know someone
who dies by suicide.
Pieces of the Puzzle…
• An average of one youth (ages 15-24)
completes suicide every 2 hours and 2.1
minutes.
• If suicides completed by youth under age
15 are included, that increases to an
average of one every hour and 54.5
minutes.
How Does WV Compare?
• WV ranked 16th in the nation with an
overall suicide rate of 14.0 per 100,000
people. (CDC 2005)
• Among youth ages 15-24, the suicide rate
is 10 deaths per 100,000 people.
• Most common method of suicide was
firearms followed by suffocation.
WV Youth
Suicide is the 2nd leading cause of
death for WV Youth ages 15-24!
It is the 3rd leading cause of death
nationally.
Suicides by County
2000-2006 (ages 14-25)
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Kanawha-39 suicides
Cabell- 17 suicides
Berkeley- 12 suicides
Fayette – 12 suicides
Marshall-12 suicides
Depression
• As many as one in every 33 children and one in eight
adolescents may have depression. (United States
Center for Mental Health Services [CMHS], 1996)
• Once a young person has experienced a major
depression, he or she is at risk of developing another
depression within the next five years. (CMHS, 1996)
• Two-thirds of children with mental health problems do
not get the help they need. (CMHS, 1996)
• About 2/3 of people who complete suicide are depressed
at the time of their deaths
Particular Risk for Suicide
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Extreme hopelessness
Lack of interest in activities
Heightened anxiety or panic attacks
Irritability and agitation
Global insomnia
Prior history of suicide attempts
Talk about suicide
Know the Danger Signals
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Prior suicide attempts
Psychiatric problems
Substance Abuse
Contagion
History of family suicide attempts
Accessibility of firearms
Other Risk Factors
• History of trauma or abuse
• Loss of a relationship (friend,
girlfriend/boyfriend, divorce of parents)
• Lack of social support
• Stigma associated with seeking help
Suicide Clues And Warning
Signs
The more clues and signs
observed, the greater the risk.
Take all signs seriously.
What about being with an
individual kid?
What should you do?
What to Do
• Take it seriously-75% of all suicides had given
some warning of their intentions
• If you think that someone is suicidal, ask them
about it
• Be willing to listen and don’t show shock or
disapproval
• Be actively involved in seeking professional help
• Avoid trying to explain away the feelings…don’t
say things like “you have a lot to live for” or “you
are just confused right now”
What is the ASAP-20
• Brief, user-friendly, structured clinical interview
• Intended for use by mental health workers
and/or school counselors to provide an initial
objective assessment of adolescent suicidal risk
• Classifies adolescent as either low, medium, or
high risk
• Organized into four domains: Historical, Clinical,
Contextual, and Protective
History of Attempt
• A suicide attempt is defined as an
intentional, self-harming act with greater
than zero probability of death (O’Carroll, et
al., 1996).
Physical/Sexual Abuse
• According to Brent (2001) “ongoing
physical or sexual abuse is a particularly
ominous precipitant… (p. 109)” for suicidal
behavior.
• The rating of physical and sexual abuse of
the adolescent should involve three
dimensions: frequency, duration, and
intensity.
Antisocial Behavior
• Adolescents displaying antisocial
behaviors have an increased risk of
suicide attempts.
• The risk is particularly high if these
individuals have encounters with the law
(Marttunen et al., 1998).
Family History
• Numerous studies have found that suicidal
behavior in family members significantly
increases the risk for adolescents attempting or
completing suicide (Gould & Kramer, 2001;
Goldman & Beardslee, 1999).
• “Family” should include relatives outside the
immediate family unit, such as grandparents.
Aunts, uncles, and cousins should also be
considered if interaction with the adolescent is
frequent and significant to him/her.
Depression
• In addition to questions about depressed
mood, also inquire about other depressive
symptoms, such as:
– Disturbances in sleep and eating patterns
– Complacency or lethargy
– Social withdraw
– Feelings of worthlessness
Hopelessness
• Hopelessness, states Fremouw et al.
(1990) is “especially indicative of suicide
risk” (p. 65).
• Hopelessness includes “feelings of
despair, lack of control, and pessimism
about the future” (Fremouw et al., 1990).
• Hopelessness is a dominant characteristic
of adolescent suicide attempters
Anger
• Anger is prevalent in most adolescents,
and many studies demonstrate that anger
is correlated significantly with adolescent
suicide.
• The emotion of anger can be externalized
and displayed as aggression. Conversely,
anger can be internalized and manifested
as depression (Myers et al, 1991).
Impulsivity
• Research suggests that impulsivity may
cause problem-solving deficits in suicidal
adolescents.
• Research by Horesh, Gotheif, Ofek,
Weizman, and Apter (1999) demonstrate
that impulsivity is a stronger risk factor of
adolescent suicide for males than females.
Substance Abuse
• Gould and Kramer (2001) suggest that
substance abuse is the most significant
difference between those who actually
attempt suicide and those with suicidal
ideation.
• Suicide completions are the result of a
combination of factors; however, studies
have found that the most deadly
combinations involve an element of
substance abuse
Recent Loss
• Interpersonal loss and conflict with peers
or family may trigger adolescent suicide
(Overholser & Spirito, 2003).
• Interpersonal loss is operationalized as
death of a loved one, the abandonment,
divorce or separation of a parent, or a
breakup from a romantic relationship.
Firearm Access
• Firearms is the most frequent method for
suicide.
• Households that contain firearms are the
strongest situational predictive factor of
committing suicide, especially for
adolescents who have made previous
suicide attempts
• 85% of WV homes have firearms
Family Dysfunction
• Fremouw et al. (1990) state that “foremost
among contributing environmental factors
[for suicide risk] is the child’s family
system” (p. 62).
• Parents of children who attempt or commit
suicide have significantly high rates of
mood disorders, substance abuse, and
psychopathology (Brent, 2001; Gould &
Kramer, 2001
Peer Problems
• Research has sited “interpersonal factors,
and specifically difficulties in peer
functioning, as precipitants to adolescents’
suicidal behavior”
• Although minimal research has focused
on this specific area, several studies have
found relationships between suicidal
behavior and social isolation, sexual
orientation, and peer rejection
School/Legal Problems
• Many studies have shown that there is an
increased risk of suicide for those
adolescents not in school and not working.
• Difficulties in school and/or impending
disciplinary crisis also increase the risk of
suicide for some adolescents.
Contagion
• Contagion is also referred to as imitation
or cluster suicide
• Contagion can be caused by the media or
by peer groups
• Contagion suicides normally occur within
two weeks of the original suicide
Protective Factors
• Reasons for Living
– How does your faith view suicide?
– What are your expectations about your life problems
improving?
– Do you think things will get better for you?
– How important is your family to you?
– Are you afraid of dying?
• Current Treatment
– Are you currently seeing a therapist, counselor, or
psychologist?
– If so, how long have you been in treatment?
Other Potential Classroom Aides
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Jason Foundation Curriculum
Signs of Suicide (SOS)
Reconnecting Youth
CAST
Lifelines
Know Your Resources
• National Suicide
Lifeline
1-800-273-8255
• WV Council for the
Prevention of
Suicide
• ASPEN Project
For More Information
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www.suicidology.org
www.sprc.org
www.afsp.org
www.spanusa.org
www.wvaspen.com
www.wvsuicidecouncil.org
WV Contacts
Bob Musick
Executive Director
WV Council for the
Prevention of Suicide
(304) 296-1731
Stephanie Belford
Director
Adolescent Suicide
Prevention and Early
Intervention Project
(304) 399-1210