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Suicide Prevention and Intervention for �School Communities

Office of Safety and Prevention Partnerships

2022-2023

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AGENDA

Discuss the importance of suicide prevention
Discuss risk factors and warning signs
Clarify referral process/ “Warm hand-off”

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Why Talk About Suicide?

2^nd leading cause of death 10 – 19yo. (CDC, 2022)

For High School Students (CDC, 2022 ABES, 2021)

19.9% seriously considered suicide
15.3% made a plan
9.0% attempted

In New York 10 – 19yo (NYSDOH, 2022)

4,519 treated in Emergency Depts. for self-harm
1,709 hospitalizations for self-harm
86 suicide deaths

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In a Caring and Competent Community

We are all connected
We care about each other’s well-being
Everyone has a role to play
Everyone knows how, when and where to get help
Everyone feels comfortable at all times to get help

Suicide safety happens in the context of a competent and caring school community. Community is not just a bunch of people living or working in proximity to each other. It is about relationships and communication and concern and understanding.

In a caring community, we understand that we are all connected. We are challenged to care about each other’s wellbeing. How have we demonstrated we care about each other?

In a competent community, everyone has a role to play. Our roles are different, but everyone - Administrators, faculty and staff, parents, students and even community providers. Everyone needs to know what their role is.

In a competent school community, everyone needs to know how, and when, and where to get help. And they need to be comfortable at all times to get help.

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School Staff’s Critical Role

Understand suicide risk factors
Recognize the warning signs
Provide an initial response
Make an effective referral

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RISK FACTORS FOR YOUTH SUICIDE

INDIVIDUAL

RELATIONSHIPS

ENVIRONMENT

INDIVIDUAL

Previous Attempt
Mental health issue
Substance use

RELATIONSHIPS

Family history of suicide
Meaningful loss
Abuse
Interpersonal violence

ENVIRONMENT

Access to means
Social rejection
No access to care

SAY: Let’s review this important diagram which illustrates that there is never just one cause or risk factor for suicide; every suicide is what is called ‘multi-determined’.

As I briefly review each category what you’ll see is that risk factors are common;

most of your students will have a risk factor or two when they enter our school, maybe pick up another one during their school career, and graduate without ever even having a thought about taking their own life.

Just like risk factors for heart disease don’t mean that someone will necessarily have a heart attack, risk factors for suicide don’t mean someone will die by suicide. It just means they are at risk.

CLICK> Let’s start with individual risk. The most significant risk factor is having made a previous suicide attempt. Mental illness is also a significant risk factor. Studies report that between 75-90% of people who die by suicide have a diagnosable mental illness at the time of their deaths. For youth, the most common diagnoses are depression and anxiety. Substance use also increases risk.

CLICK>Relationship Factors include family history of suicide, sexual or physical abuse. The loss of something or someone meaningful can also go into this category, For youth, losing relationships, friendships or even status in the eyes of their peers can contribute to risk. If you think of this type of loss event and the impact it can have when shared on social media, you can understand why it can be so devastating.

CLICK> The last group is environmental. This category includes the physical, cultural, and societal environment. The most significant factor in this category is having access to lethal means, especially a firearm. Social rejection and discrimination also fit into this category and I think we are only beginning to learn how toxic it can be, especially when it occurs online. I’m sure each of you could add a story or two about kids you know who have been hurt by online interactions which is why it’s so important to teach kids at an early age the benefits and dangers in cyberspace. Finally, being in a place where you can’t get help for your problems can also contribute significantly to risk.

And the real danger comes when several risk factors interact CLICK and create something that is similar to a perfect storm.

The good news about suicide being the outcome of the interaction of many risk factors, however, is that changing just one of those risk variables, changes the level of risk and an opportunity for intervention opens up.

Take a look at the risk factors I just mentioned and see whether you can identify any of them that can be easily modified or changed. (Pause for a moment

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FEELINGS� ACTIONS� CHANGES� THREATS� SITUATIONS

WARNING SIGNS

�CLICK Again, even though a student may be exhibiting a ‘warning sign’, that does not mean he or she is definitely going to attempt suicide. Just as an understanding of risk factors can lead to identification and reduction of possible sources of risk, paying attention to warning signs can assist us in getting a student to appropriate resources in time to avoid a suicidal crisis.

I want to point out that the warning signs that are typically identified by the general public include telling someone of the intent to die, giving away treasured possessions, and leaving a suicide note. Unfortunately, these indicators are rare. Only a third of persons who died by suicide either told someone about their intent or left a suicide note.

So since we cannot be sure a student will actually tell someone they are thinking about killing themselves, it’s essential that you be aware of these warning signs.

�

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Your Critical BUT Limited Role

Express concern
Let student know you’d like to understand
Listen
Don’t leave the student alone
Express the need for more help

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Make an Effective Referral

Warm handoff
Contact the designee/ principal
In the event that the designee is not available to meet with the student, please contact the student’s guidance counselor.
Review Chancellor’s Regulation

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UNDERSTANDING PROTECTIVE FACTORS

Trusted Adult
School Connectedness
Social Emotional Learning
Mental Health Literacy
Access to Care
Opportunities to Contribute

SAY: Let’s not forget the good news… protective factors. These are the things in life that insulate or buffer us from stress. They exist across the life cycle- you’ve probably seen some of the research that shows that adults who have stronger social networks or connections tend to live longer than those who don’t. Well, the protective factors for youth are similar and feeling a sense of connection and belonging in both their school and community is one of them.

Feeling like they are able to make a contribution in that community is also protective and can reinforce a sense of personal value and agency. This is one of the reasons we talk about recognizing the role that students play in the competent school community.

There’s also an increasing body of research that shows that integrating social emotional skills into classroom instruction, especially in elementary school, is another critically important factor in helping them be better prepared for the challenges of adolescence. Social emotional learning includes things like self-awareness, self-management, responsible decision making, relationship skills and social awareness.

Another protective factor that recognizes that life can be hard for some kids who have emotional, behavioral or substance abuse problems is that they have access to care for those problems. Framing it in this context is both realistic and optimistic- there is an acknowledgement that some kids do have problems but they can be protected from those problems if they get treatment.

Finally, the most critical protective factor for kids is the first one on this list- a relationship with a caring adult. You’ll notice that ‘adult’ is singular, not plural, and while it is certainly wonderful when kids have a village of grownups who love and support them, all they really need to get through is one adult who’s got their backs. And, it will probably come as no surprise to you, that for many kids, that caring, trusted adult is someone in the school. Perhaps you?

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If You’re Worried about Colleague or Family Member…

Express concern
Ask directly about suicide
Listen
Make the connection to community resources

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National Suicide

Prevention Lifeline

1-800-273-8255

Crisis Text Line

Text ‘got5’ to 741-741

NYC WELL

1-888-NYCWELL

Crisis Text Line

Text ‘Well’ to 65173

SAY: And although we’ve been talking about students, I also recognize that any of us may be worried about someone in our lives at one time or another.

The steps we’ve outlined for kids are the same ones we can use for adults—

•Let the person know you are concerned about them. Talk about the reason you are concerned. If you can explain the FACTS for your concern, you’ll have a much stronger position than if you simply recite your FEELINGS of concern or worry

•Listening is strategic with adults too. Remember, we are trained as a society to be problem-solvers and not simply listeners, so this part may be harder than it sounds.

•Don’t offer reassurance or solve the problem the person is struggling with- just acknowledge their struggle and how difficult it seems to be for them.

•If you are worried they might be suicidal, don’t leave them alone and get help immediately

•If your concern doesn’t escalate to the level of suicide, be prepared to give them resources or other places to go for help.

•And lastly, follow up. This isn’t a one-off deal- you need to check back with them to see how they’ve made out. This step is just as critical as all the rest!

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Thank You!

For more information, please visit the Crisis Support page on the NYCDOE Infohub:

https://infohub.nyced.org/nyc-doe-topics/students-and-families/crisis-support