Helping DistressedSuicidal Students

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Helping Distressed/Suicidal Students

• Optimum time required 2-3 hours (depending on
  the incorporation of additional discussion
  activities)
•   Aim Educate staff members, thereby increasing
  their confidence when helping distressed and/or
  suicidal students
•   Accomplished by Raising awareness of positive
  mental health
• Introducing the issue of suicide
• Exploring the roles and responsibilities of
  staff members
• Discussing common institutional issues
  regarding distressed students
• Providing staff with an opportunity to share
  their experiences and ask advice
•   Recommended group size 8 - 20 people
•   Materials
• Registration sheet
• Presentation overheads
• Overhead projector/computer
• Evaluation sheets
• Handouts
• Myths of Suicide
• Signs of Suicide Risk
• Protocol for Staff Responding to
  Distressed/Suicidal Students
• Tips for Referring Reluctant Students
• Sources of Help in College

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Helping Distressed/Suicidal Students
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 MENTAL HEALTH IS  The emotional resilience
that enables us to enjoy life and survive pain,
disappointment and sadness. It is a positive
sense of well-being and an underlying belief in
our own and others dignity and
worth.   Definition from the UKs Health
Development Agency 
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• DO STUDENTS EXPERIENCE MENTAL HEALTH
  DIFFICULTIES?
• One in 13 Irish college students is currently
  depressed and 38 report
• having been depressed in the past (Prevalence
  of Depression in Third Level
• Students, 1998).
• The median age of a first schizophrenic episode
  is in the early to mid-20s
• for men and in the late 20s for women (DSM IV,
  1994).
• Nearly 9 of female and 13 of male students
  surveyed at the Athlone
• Institute of Technology reported that they had
  seriously considered
• attempting suicide in the previous 12 months
  (Lifestyle Survey, 2000).
• It is estimated that up to 1 of women aged
  15-30 suffer from anorexia,
• 2 from bulimia and up to 15 experience some
  form of 'binge eating
• (UKs MindOut Campaign, 2002).
•  

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AREAS IN WHICH EDUCATION CAN INFLUENCE STUDENTS
MENTAL HEALTH

• Promoting mental well being 
• Identifying vulnerable groups and possible
• preventative strategies
• Detecting students mental health problems
• Identifying effective support for students who
• have mental health problems
• Adapted from Lancaster University Student Mental
  Health Project, 2002

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SUICIDE IN IRELAND IN STUDENTS

• Republic of Ireland
• In 1976 183 suicides
• In 1998 504 suicides
• In 2000 486 suicides
• In 2001 448 suicides
• Source National Suicide Review Group
• Students
• In 2000, of the 486 suicides, 109 were 15 to 24
  years old (predominantly male) Source
  National Suicide Review Group
• Students do not have higher rates of suicide
  when compared with non-students of the
  same age Source Power (1997)
• There are not higher rates of suicides during
  exam periods dispel this myth!

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WHY IS SUICIDE AN OPTION?

• Best explained by UCLA Professor Emeritus
  father of suicidology, Dr. Edwin Shneidman
•  
• Suicide is best understood not so much as a
  movement toward death as it is a movement away
  from something and that something is always the
  same intolerable emotion, unendurable pain or
  unacceptable anguish. Reduce the level of
  suffering and the individual will choose to
  live.
•  
• PSYCHACHE

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INFLUENCING FACTORS FORMENTAL HEALTH
DIFFICULTIES

• Biological
• Psychological
• Sociological
• BIOPSYCHOSOCIAL MODEL

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PREVENTION

• It is not possible to identify who will
  experience mental health difficulties or who will
  attempt suicide. But what helps to develop
  resilience? What are protective factors?
• Students
• Healthy lifestyle
• Social support network
• College integration
• Coping skills
• Appropriate treatment
• Staff
• Kindness, empathy a listening ear
• Advice for academic personal issues
• Advice for students concerns for their peers
• Early detection of problems

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ROLE OF STAFF

• Listen, help and refer
• NOT expected to identify or diagnose students,
  cant be doctors or counsellors
• Staff are gatekeepers prevent crisis
  situations by referring students to appropriate
  professionals
• Boundaries are important and necessary
• If in doubt, refer

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RISK FACTORS FOR SUICIDAL BEHAVIOUR

• Mental illness (90 of people who die by suicide
  have a mental illness many have never been
  diagnosed)
• Previous suicide attempt
• Alcohol, drug or substance abuse
• Loss of significant other (death or relationship
  break-up)
• Family history of suicide

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INTERVENTIONWARNING SIGNS OF SEVERELYDISTRESSED
STUDENTS

• Expressing thoughts about suicide or harming
  themselves
• Expressing feelings of hopelessness or despair
• Increased isolation/social withdrawal
• Declining academic performance
• Sudden change in behaviour, mood or personality
• Giving away possessions or making final plans

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A DISTRESSED STUDENT What to Say

• Show your concern demonstrate that you want to
  understand.
• Im worried about you, and I want to help.
• If APPROPRIATE, ask about suicidal feelings. Use
  the word suicide. You cannot give someone the
  idea.
• Are you having thoughts about suicide?
• DONT try to cheer somebody up or minimise their
  problems or make them feel guilty.
• DONT SAY Youll probably feel better
  tomorrow. or Have you thought about the effect
  on your family?
• Ideally, organise for them to have an urgent
  appointment with a professional.
• I will help you get help. or You are not
  alone and others know how to help you.
• Agree a time to make contact and follow up with
  the student.
• I will ring you tomorrow morning to see how you
  get on.

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SEEKING SUPPORTFor Answers, Advice, Ideas,
Confirmation, Referral

• Student Support Services
• Student Health Service
• Student Counselling Service
• College Chaplains
• Senior Tutors Office
• Outside of College
• Local GP
• Accident Emergency
• Samaritans
• Self-help groups (Aware, AA, NA, etc.)
• Support Services for Staff
• Student Counselling Service
• College Chaplains
• Senior Tutors Office
• Employee Assistance Programme (EAP)

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MAKING A REFFERAL TO THE STUDENT COUNSELLING
SERVICE

• An informal process
• Non-urgent situation?
• Encourage student to make an appointment give
  the phone number
• Urgent situation?
• Assist student by dialling the phone making an
  emergency appointment with Student Counselling
  Service (or Student Health Service)
• Inform SCS of reason for referral IMPORTANT

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ISSUES OF CONFIDENTIALITY

• Do not make promises of confidentiality, only of
  support
• When to break confidentiality?
• Harm to self
• Harm to others
• Minors are at risk of abuse you have the name
  of the abuser
• If student will not see a professional, inform
  the student that you will need to speak with
  someone within College and/or family on their
  behalf
• Duty of Care legal obligation to act if student
  is at risk
• Feelings of anger betrayal invoked? Empathise
  with these feelings
• Questions/concerns? Contact the Student
  Counselling or Health Service

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APPROPRIATE ACTION FOR DEALING WITH CONCERNED
FRIENDS

• Staff may help friends choose best course of
  action
• Clarify who else knows (family, GP, counsellor)
  who needs to be told
• Encourage friends to suggest professional help
  offer contact details
• Suggest friends contact the family of a
  distressed student, if appropriate
• Staffs Duty of Care should friends choose not
  to act or if student is at immediate risk
• Boundaries friends should NOT carry worries, not
  their responsibility
• Staff may need to refer friends for professional
  help

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DEALING WITH CONCERNED FRIENDS What to Say

• Help clarify the situation. Offer to assist
  friends.
• What exactly is upsetting you? Is X getting any
  help?
• Suggest friends provide contact details to X.
• Together, lets make a list of professionals and
  their phone numbers for X.
• Encourage friends to talk with family or
  professional if urgent.
• If you feel this is life-threatening, we should
  speak with others about ensuring Xs safety.
• Remind friends that they are NOT responsible for
  X.
• You can only do so much for X you need to
  remember to look after yourself. Would you like
  to talk with someone?

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APPROPRIATE ACTION FOR DEALING WITH A CONCERNED
PARENT/RELATION

• 3 approaches Personal choice of staff members
• Complete non-disclosure
• Facilitate meeting between student family
• Non-disclosure, but address family anxieties and
  offer suggestions
• Balance between confidentiality reassurance
• If uncomfortable, refer family calls to the
  Student Counselling Service

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POSTVENTION AFTERMATH OF A SUICIDE 

• TRYING TO UNDERSTAND WHY??
• Why do people kill themselves?
• Why did God allow such a tragedy to occur?
• Why did my friend/relative die by suicide?
• Was it an accident?
• Did I really know him or her?
• Could I have done more for him or her?
• Did I miss something that he or she said?
• Why do I feel this way?
• Am I the only one who feels _________ (sad,
  angry, guilty, etc.)?
• Etc., etc., etc.

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ORGANISING THE RESPONSE

• Death Within College
• Outlined in Colleges Student Death Protocol
• College response organised by Senior Tutors
  Office/Graduate Studies Office Head of
  Department
• Student Counselling Service Chaplains involved
• Death Outside College
• Student may be affected by suicide of friend or
  relative ask how student is coping would
  they like to talk with counsellor or chaplain
• Support offered in College by Tutor, Counsellor
  or Chaplain
• Support offered in community by counsellor,
  parish priest, bereavement group, etc.

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AFTER A STUDENT SUICIDE

• Role of Staff
• Listen to students and/or parents
• Offer support AFTER the funeral to the parents
  (send card, phone)
• Acknowledge the death before class important
  for students
• Advise students of support services available for
  them
• Watch for vulnerable students
• What to say
• Listen with compassion, expect pain tears
• Dont provide simple answers for the cause of
  suicide
• Use name of deceased dont be afraid to use the
  word suicide

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SELF-CARE FOR STAFF

• Take Care of Yourself
• Share your experience and emotions with
  colleagues and/or partners
• Take part in or organise a debriefing session
• Resist coping with alcohol, drugs or cigarettes
• Reduce stress levels through
• Exercise, hot baths, family events, etc.
• Seek professional help if required