Suicide
A permanent solution to a
temporary problem.
Suicide facts
• Every four hours in America a child
commits suicide (Children’s Defense Fund,
1999)
• An estimated 10-25% of the students in
any high school are at risk for suicide in
any given school year (Hahn, cited in
“Suicide in Children,” 1998)
Suicide Facts
• In 1995, according to the CDC (1998a)
2,227 American children ages 10-19 year
old committed suicide, and it is estimated
that for every completed suicide there are
100-200 suicide attempts (“Suicide Facts,”
1998)
Suicide Facts
• The United States has the highest suicide
rate of 26 industrialized nations studied by
the federal government, a rate that is
double that of other countries, according
to CDC medical epidemiologist Dr.
Etnienne Krug (U.S. Tops in Child Murder,”
1997).
Suicide Facts
• “Since 1950, the rates of unintentional
injury, disease, and congenital anomalies
have decreased among children in the
United States, but … suicide rate have
quadrupled” (U.S. Tops in Child Murders,”
1997).
Suicide Facts
• Suicide is the third leading cause of
death for youth between the ages of 15
and 24 and fourth for those 10-14.
• The suicide rates of those between the
ages of 10 and 14 has increased 196%
in the last 15 years.
• Overall, African Americans have had the
highest increase in suicide completion
rates in the 1990’s.
Suicide Facts
• Gay and lesbian youth are 200-300%
more likely to attempt suicide and they
may comprise 30% of youth suicide
annually.
• More teenagers died from suicide than
from cancer, birth defects, AIDS,
pneumonia, influenza, and chronic lung
disease combined.
The relationship between suicide and homicide
A poem by a school shooter
Sinking into my bed
Homicidal thoughts filling my head
Suicidal thoughts not gone, but fleeting
Because it is other people’s death I am seeing
Suicide or homicide
Into sleep I am sinking
Why me I am thinking
Homicidal and suicidal thoughts intermixing
My life’s not worth fixing
Prior to school shootings ¾ of all attackers threatened
to kill themselves, tried to kill themselves, or made
suicidal gestures.
Nine Facts about Suicidal
Individuals
• The overwhelming majority of suicidal
people (perhaps 95% of them) do not
want to die.
• The typical suicidal person wants to be
rescued but has difficulty asking for
assistance.
• The suicidal person is confused and is
searching for a strong, authoritarian
person to direct his emotional traffic.
Facts continued
• The suicidal person is in a highly
suggestible state. They will likely respond
to a voice of authority demanding that
they behave in a prescribed manner.
• Most suicidal people experience a suicidal
episode only once in their lives.
• People are acutely suicidal for only a brief
period of time.
Facts continued
• It is doubtful that anyone is constantly
suicidal for an extended period of time.
• The three important words that best
describe a suicidal person are:
– Hopeless
– Helpless
– Hapless
• The typical suicidal person is experiencing
multiple problems at the same time.
• Erosion
– Suicide is not a spontaneous activity.
– The precipitating event is not the cause of the
suicide. There is no single cause of a suicide
– only causes (plural).
• As a form of communication
– If you understand that suicide is a
demonstrative form of communication you will
be less likely to treat the suicidal person in a
punitive manner.
– If you understand that suicidal behavior is an
extreme form of communication, you will be
more likely to recognize the early warning
signs of suicidal risk.
Ambivalence
• Ambivalence is the emotional state most
closely associated with suicidal behavior.
• Suicidal individuals often feel that they
want to live and die at the same time.
• Ambivalent feelings are most prominent
shortly before the person begins to harm
himself (herself).
• The suicidal person is much more negative
about life than positive about death.
Warning signs of suicide
• Previous suicide attempts or threats
• Prolonged depression
• Means to complete the suicide have been
secured
• Preoccupation with suicide themes or
death
• Not tolerating praise or rewards
Warning signs continued
• Destructive or repetitive behavior
• Scratching, cutting, or marking on the
body
• Becoming suddenly cheerful after a period
of depression (this may indicate that the
decision to commit suicide has been
made).
Warning signs continued
• Loss of interest in pleasurable activities
• Decline in quality of school work
• Alcohol or drug use
• Marked personality and/or behavior
change
• Persistent boredom, inability to
concentrate
Warning signs continued
• Risk-taking behavior
• Physical symptoms associated with
emotion (e.g. stomach ache & fatigue)
• Putting affairs in order
• Withdrawal from friends, family or
activities
• Verbal hints
Risk factors
• Previous suicide attempts
• Current ideation, intent, and plan (resolve)
• Exposure to suicide and/or family history
of suicide
• Mental disorders – particularly mood
disorders such as depression and bipolar
disorder
• Personality disorders (conduct and
borderline)
Risk factors continued
• Influence of significant people – family
members, celebrities, peers who have died
by suicide – both through direct personal
contact or inappropriate media
representations.
• Local epidemics of suicide that have a
contagious influence
Risk factors continued
• Co-occurring mental and alcohol and
substance abuse disorders
• Hopelessness and helplessness
• Impulsive and/or aggressive tendencies
• Barriers to accessing mental health
treatment
• Relational, social, work, or financial loss
• Physical illness
Risk factors continued
• Easy access to lethal methods, especially
guns
• Unwillingness to seek help because of
stigma attached to mental and substance
abuse disorders and/or suicidal thoughts
• Cultural and religious beliefs – for
instance, the belief that suicide is a noble
resolution of a personal dilemma
Risk factors continued
• Isolation – a feeling of being cut off from
other people
• Ineffective coping mechanisms and
inadequate problem solving skills
• A confluence of multiple stressors
(discipline, rejection/humiliation, end of
romantic relationship, conflict with family
or peers, unmet school goals
Protective Factors
• Effective problem solving and
interpersonal skills including conflict
resolution and nonviolent handling of
disputes.
• Contact with a caring adult.
• A sense of involvement/belonging to one’s
school, based on opportunities to
participate in school activities and
contribute to the functioning of the school
(effective, positive school climate).
Protective Factors continued
• Effective and appropriate clinical care for
mental, physical, and substance abuse
disorders
• Easy access to a variety of clinical
interventions and support for those
seeking help
• Restricted access to highly lethal methods
of suicide
Protective Factors continued
• Family and community support
• Support from ongoing medical and mental
health care relationships
• Cultural and religious beliefs that
discourage suicide and support selfpreservation instinct
Suicide Precipitants?
• Getting into trouble with
•
•
•
authorities (e.g., school,
police)
Breakup from boy/girl
friend
Death of a loved one
Disappointment and
rejection such as a
dispute with boy/girl
friend, failure to get a
job, or rejection from
college
• Bullying or victimization
• Conflict with family or
•
•
•
•
family dysfunction
Disappointment with
school results or school
failure
High demands at school
during examination
periods
Unwanted pregnancy,
abortion
Infection with HIV or
other sexually transmitted
Suicide precipitants?
• The anniversary of a
•
•
death of a friend or a
loved one
Knowing someone
who committed
suicide
Separation from
friends, girl
friends/boy friends
• Real or perceived loss
• Serious physical
•
illness
Serious injury that
may change the
individual’s life
course.
Common Suicide Myths
• People who talk about
•
•
•
suicide do not commit it
You should not discuss
suicide with youth
because it gives them the
idea to commit the act
Children are not capable
of implementing a suicide
plan successfully.
Suicidal youth really want
to die.
• When the depressive
•
•
mood of a child
improves, the threat
of a suicide crisis is
over
Children under the
age of six do not
commit suicide
Only white males
attempt suicide
Common Suicide Myths
• Once a youth
•
contemplates suicide
he or she should
always be considered
suicidal
Suicide is inherited or
destined through
genetics
• There is nothing
•
anyone can do to
prevent a suicide
There are usually no
warning signs of a
suicide
The Do’s of Suicide Intervention
• Take away accessibility to the means
• Adapt a positive approach, emphasize
desirable alternatives
• Sound calm and understanding
• Use constructive questions to define the
problem and remove confusion
• Rephrase the important thoughts and
feelings
The Do’s of Suicide Intervention
• Mention the family as a source of support
if appropriate
• Emphasize the temporary nature of a
person’s problems (This too shall pass).
The Don’ts of Suicide
Intervention
• Don’t sound shocked
• Don’t stress the shock, embarrassment or
pain that this could cause the family
• Don’t engage in debate
• Don’t try to physically remove a weapon
Prevention
• Identify pre-existing
risk factors:
– Individuals
– Events
• Create and maintain
•
• Alter curriculum
• Manage stress
•
– Students
– Faculty/Staff
– Parents
•
discipline plan
Teach anger
management
Conflict resolution and
mediation training
Commit to health and
safety at all levels
The role of the school
• Promote inquiry
• Construct and create
•
•
a safe environment
Identify those at risk
Create partnerships
with the community
• Become a community
•
•
•
•
– school
connectedness
Reach out to those
who are different by
choice or accident
Include parents
Train staff to listen
BE PREPARED
• www. ChildrensSafetyNetwork.org