Depression and Suicide:

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Depression and Suicide Important Information for
Educators
A Safety and Violence Prevention
Curriculum Module Two
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Quiz Question 1
True or False? Most people who attempt suicide
are just looking for attention.
False Suicide attempts are rarely used as means
to get attention from others. Rather, an
individual sees suicide as the only feasible
option for ending their pain.
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Quiz Question 2
True or False? Girls attempt suicide more often
than boys.

• True
• Girls are more likely than boys to experience
  depression, to consider suicide, to make a plan
  for suicide and to attempt suicide.
• Boys have a higher rate of completed suicide than
  girls because they tend to use more lethal means
  such as guns and hanging compared to swallowing
  pills.

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Quiz Question 3
True or False?Children cant really be
depressed they dont have anything to worry
about.
False Depression is a change that occurs in the
brains chemistry and is a brain disorder.
Depression is an illness that affects how a
person thinks, reasons, feels and acts.
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Quiz Question 4
Fill in the Blank In Ohio, suicide is the ______
leading cause of death among 15-24 year olds.
a.) 2nd b.) 3rd c.) 4th d.) 5th
a.) 2nd Suicide is the second leading cause of
death for 15- to 24 year-olds in the state of
Ohio. Youth suicides in Ohio have increased 18
percent since 2001.
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Quiz Question 5
True or False? Alcohol and drug use is related
to depression and suicide.
True Students who abuse substances are often
trying to mask their emotions and use alcohol and
drugs as coping mechanisms.
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Quiz Question 6
True or False?Asking students if they are
suicidal will just put those thoughts into their
heads.

• False
• Talking with students about their suicidal
  thoughts or ideas is one of the only ways to
  accurately understand their subjective reality
  and to understand the degree to which they are
  presently depressed or thinking about suicide as
  an option.
• Asking students if they are feeling depressed or
  suicidal may show them that you care for them.

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• How do I identify a student who is experiencing
  depression?

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Recognizing Depression in Students Changes in
Behavior

• May appear irritable or angry as opposed to
  depressed
• Have volatile moods, angry outbursts, or rage
• Lose interest in activities they previously
  enjoyed
• Withdraw from family and friends
• Abuse substances

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Recognizing Depression in Students Changes in
Appearance

• Noticeable weight gain or weight loss eating
  disorders are correlated with depression.
• Changes in sleep sleeping much more or much
  less than usual
• Disheveled appearance lack of personal hygiene

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Recognizing Student Depression Changes in
Performance

• Grades dropping in school (students who have
  stress, learning disabilities, ADHD, or conduct
  disorders are at high risk for depression.)
• Lack of interest in after-school activities or
  sports
• Skipping school, coming to school late
• Delinquent behavior while at school, increases
  in disciplinary actions
• Feelings of worthlessness, guilt, difficulty
  concentrating, suicidal ideation

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Suicidal Ideation

• Suicidal ideation is present in 60 percent
• of adolescents with depression.
• In 2005, of Ohio teens polled
• 27 percent reported feeling depressed
• 18 percent reported seriously considering suicide
• 9 percent reported that they attempted suicide
  during the past year
• Source 2005 Youth Risk Behavior Survey Executive
  Summary, Ohio Department of Health, www.odh.gov

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What are warning signs for student suicide?

• Look for the same warning signs as for
  depression, and
• Thoughts or writings of death or suicide
• Giving away possessions or putting affairs in
  order
• Locating weapons
• Making comments such as, You wont have to worry
  about this when Im gone, or I wont be a
  bother to you much longer.
• Feelings of worthlessness

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• Whereas adults come to suicidal behavior often
  over the course of lengthy stressful events,
• Adolescents may become suicidal after
  experiencing an intense emotional event, a
  breakup with a boy/girlfriend, or becoming an
  outcast to friends.

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Increased Likelihood of Suicide

• History
• Previous suicide attempts or gestures
• Family history of suicidal behavior
• Survivor of child abuse (physical or sexual
  abuse)
• Individual Factors
• Substance abuse or other mental health disorders
• Conduct disorders or disruptive behaviors
• Juvenile delinquency
• Sexual orientation (homosexual, bisexual and
  trans-gendered youth are 3-5 times more likely to
  commit suicide)
• Environmental Factors
• Life stressors (interpersonal losses,
  relationships)
• Access to firearms

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Decreased Likelihood of Suicide

• Individual Factors
• Good coping skills and impulse control
• Sense of worth/confidence
• Environmental/Family Factors
• Lack of access to means of suicide
• Stable environment
• Access and care for mental/physical/substance
  disorders
• Family cohesion (family with mutual involvement,
  shared interests and emotional support)
• Responsibilities for others/pets
• School Factors
• Academic achievement
• Perceived connectedness to school
• Good relationships with other school youth
• Social integration/opportunities to participate

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• What do I do if I think a student might be
  severely depressed and considering suicide?

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Depression and Suicide

• Talk to the student Show your concern.
• If the student seems depressed, ask about his or
  her mood and feelings. Ask specific questions,
  such as
• How are you feeling right now?
• How long have you been feeling this way?
• Who can you talk to about how you are feeling?
• You may notice specific behaviors that concern
  you
• Is the student talking or writing about death or
  suicide?
• Has the student been giving away possessions?
• Has the student made final arrangements?

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Understanding Levels of Risk

• Once referred, a mental health professional will
  determine the level of risk
• Low-risk vague suicidal ideation, no specific
  plans, low-level helplessness
• Medium risk direct statements about suicide,
  some plans but still vague and no availability of
  supplies
• High-risk detailed plans with lethal method,
  made final arrangements, suicide is the only
  alternative.

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Procedures When Working with Suicidal Students

• Interaction with student
• Gather information calmly
• Communicate caring and support
• Emphasize students worth
• Do not leave students at risk alone
• Do not promise secrecy

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Procedures When Working with Suicidal Students,
cont

• Get help, following school procedures
• Get student to the school counselor or mental
  health expert
• Be sure parents are contacted
• Contact emergency services/local crisis center
  as necessary
• 911
• County emergency mental health agency
• Local suicide hotline
• National suicide hotlines for local hotline
  information
• 1-800-273-TALK (8255) and 1-800-SUICIDE
  (784-2433)

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Local Resources, Protocols, and Referral
Information

• Be familiar with school and community resources
• Sources of local information
• NAMI-Ohio
• County Behavioral Health Authority
• Local ADAMH board
• Refer to your handouts.

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Try Out Your Skills

• Role Play Turn to your neighbor. One of you is
  the teacher (Ms./Mr. Jones) and one is the
  student (Carla/Carlo).
• Carla/o seems very down in the dumps. She/he has
  been coming late to your classes and keeps
  his/her head down during the entire class. You
  notice his/her weight significantly dropping and
  his/her withdrawal from peers at school. During
  lunch, Carla/o has been going to the nurses
  office with complaints of stomach aches. In one
  of your classes, Carla/o writes a poem in which
  s/he talks about the killing the pain.
• How might you talk to Carla/o?
• Take 5-10 minutes to role play this scenario.

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Reminders

• Show care and concern
• Use concrete questions
• Remember SAL
• Specific plan and intent
• Available means
• Lethal means

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Follow-up

• Based on your conversation with Carla/o, what
  would concern you?
• What is your plan to address this situation?
• Who do you need to consult with?
• What information do you need?
• Who do you need to notify?

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Conclusion

• Educators have the capacity to substantially
  affect the life course of a student if they can
  identify and refer students who may be suicidal.
• Educators
• Should not promise secrecy or confidentiality if
  a student discloses suicidal thoughts
• Should act swiftly upon learning of student
  suicidal thoughts or behaviors
• Should take seriously student disclosures or
  threats
• Must know the resources in their schools and
  communities in order to make appropriate
  referrals.