Suicide Prevention: Facts, and Myths

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Suicide PreventionFacts, and Myths

• Counseling 407
• Community Counseling
• Dr. Jeff Edwards

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• Suicides Peak in the Spring and Fall
• Suicide is a serious public health problem
  accounting for between .4 and .9 of the deaths
  in the U.S. The CDC also report that in the
  population at large it is the eighth leading
  cause of death but among adolescents, the third
  leading cause. In l998, 30,551 Americans took
  their own lives, while in 2002, 31,655 Americans
  took their own lives.
• In the most recent year for which detailed
  national data are available (1996), November and
  December rank the lowest in the number of daily
  suicides. Spring and Fall are by the far the
  riskiest seasons for suicides in the US. Although
  research indicates that suicides may increase for
  a brief period after New Years day, January still
  remains one of lowest months for suicide risk in
  the US.

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CDC Suicide Fact Sheet

• Occurrence
• Most popular press articles suggest a link
  between the winter holidays and suicides
  (Annenberg Public Policy Center of the University
  of Pennsylvania 2003). However, this claim is
  just a myth. In fact, suicide rates in the United
  States are lowest in the winter and highest in
  the spring (CDC 1985, McCleary et al. 1991,
  Warren et al. 1983).
• Suicide took the lives of 30,622 people in 2001
  (CDC 2004).
• Suicide rates are generally higher than the
  national average in the western states and lower
  in the eastern and midwestern states (CDC 1997).
• In 2002, 132,353 individuals were hospitalized
  following suicide attempts 116,639 were treated
  in emergency departments and released (CDC 2004).
  
• In 2001, 55 of suicides were committed with a
  firearm (Anderson and Smith 2003). 

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• Groups At Risk
• Males
• Suicide is the eighth leading cause of death for
  all U.S. men (Anderson and Smith 2003).
• Males are four times more likely to die from
  suicide than females (CDC 2004).
• Suicide rates are highest among Whites and second
  highest among American Indian and Native Alaskan
  men (CDC 2004).
• Of the 24,672 suicide deaths reported among men
  in 2001, 60 involved the use of a firearm
  (Anderson and Smith 2003).
• Females
• Women report attempting suicide during their
  lifetime about three times as often as men (Krug
  et al. 2002).

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• YouthThe overall rate of suicide among youth has
  declined slowly since 1992 (Lubell, Swahn,
  Crosby, and Kegler 2004). However, rates remain
  unacceptably high. Adolescents and young adults
  often experience stress, confusion, and
  depression from situations occurring in their
  families, schools, and communities. Such feelings
  can overwhelm young people and lead them to
  consider suicide as a solution. Few schools and
  communities have suicide prevention plans that
  include screening, referral, and crisis
  intervention programs for youth.
• Suicide is the third leading cause of death among
  young people ages 15 to 24. In 2001, 3,971
  suicides were reported in this group (Anderson
  and Smith 2003).
• Of the total number of suicides among ages 15 to
  24 in 2001, 86 (n3,409) were male and 14
  (n562) were female (Anderson and Smith 2003).
• American Indian and Alaskan Natives have the
  highest rate of suicide in the 15 to 24 age group
  (CDC 2004).
• In 2001, firearms were used in 54 of youth
  suicides (Anderson and Smith 2003).

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• The ElderlySuicide rates increase with age and
  are very high among those 65 years and older.
  Most elderly suicide victims are seen by their
  primary care provider a few weeks prior to their
  suicide attempt and diagnosed with their first
  episode of mild to moderate depression (DHHS
  1999). Older adults who are suicidal are also
  more likely to be suffering from physical
  illnesses and be divorced or widowed (DHHS 1999
  Carney et al. 1994 Dorpat et al. 1968).
• In 2001, 5,393 Americans over age 65 committed
  suicide. Of those, 85 (n4,589) were men and 15
  (n804) were women (CDC 2004).
• Firearms were used in 73 of suicides committed
  by adults over the age of 65 in 2001 (CDC 2004).

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•  Risk Factors
• The first step in preventing suicide is to
  identify and understand the risk factors. A risk
  factor is anything that increases the likelihood
  that persons will harm themselves. However, risk
  factors are not necessarily causes. Research has
  identified the following risk factors for suicide
  (DHHS 1999)
• Previous suicide attempt(s)
• History of mental disorders, particularly
  depression
• History of alcohol and substance abuse
• Family history of suicide
• Family history of child maltreatment
• Feelings of hopelessness
• Impulsive or aggressive tendencies

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• Barriers to accessing mental health treatment
• Loss (relational, social, work, or financial)
• Physical illness
• Easy access to lethal methods
• Unwillingness to seek help because of the stigma
  attached to mental health and substance abuse
  disorders or suicidal thoughts
• Cultural and religious beliefsfor instance, the
  belief that suicide is a noble resolution of a
  personal dilemma
• Local epidemics of suicide
• Isolation, a feeling of being cut off from other
  people 

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• Protective Factors
• Protective factors buffer people from the risks
  associated with suicide. A number of protective
  factors have been identified (DHHS 1999)
• Effective clinical care for mental, physical, and
  substance abuse disorders
• Easy access to a variety of clinical
  interventions and support for help seeking
• Family and community support
• Support from ongoing medical and mental health
  care relationships
• Skills in problem solving, conflict resolution,
  and nonviolent handling of disputes
• Cultural and religious beliefs that discourage
  suicide and support self-preservation instincts

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The following information is from David Capuzzis
book on Suicide Prevention in the Schools. He
suggests that you can make handouts or over heads
from this information to use in teaching others
about suicide.

• Suicide Prevention
• UNDERSTANDING THE MYTHS
• Adolescents who talk about suicide never attempt
  suicide.
• Suicide happens with no warning.
• Adolescents from affluent families attempt or
  complete suicide more often than adolescents from
  poor families.
• Once an adolescent is suicidal, he or she is
  suicidal forever.

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• If an adolescent attempts suicide and survives,
  he or she will never make an additional attempt.
• Adolescents who attempt or complete suicide
  always leave notes.
• Most adolescent suicides happen late at night or
  during the predawn hours.
• Never use the word suicide when talking to
  adolescents, because using the word gives some
  adolescents the idea.
• Every adolescent who attempts suicide is
  depressed.
• Suicide is hereditary.

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RECOGNIZING THE PROFILE

• (BEHAVIORS)
• Lack of concern about personal welfare.
• Changes in social patterns.
• A decline in school achievement.
• Difficulty in concentrating.
• Altered sleeping and eating patterns.

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Suicide Prevention in the Schools Guidelines for
Middle and High School Settings

• RECOGNIZING THE PROFILE
• (BEHAVIORS)
• Attempts to put personal affairs in order or to
  make amends.
• Use or abuse of alcohol or drugs.
• Unusual interest in how others are feeling.
• Preoccupation with death and violence themes.
• Sudden improvement after a period of depression.
• Sudden or increased promiscuity.

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RECOGNIZING THE PROFILE(VERBAL CUES)

• No universal language for communicating
  suicidal intentions.
• Ask for clarification of what you hear Could
  you say a little more about what you mean when
  you say.
• Paraphrase to communicate that you listened and
  to check accuracy You are really discouraged
  and upset about..
• RECOGNIZING THE PROFILE
• (VERBAL CUES)
• You wont be seeing me for my appointment on
  Monday.
• Im going home.
• I thought about something Im afraid to tell
  anyone about.
• Im tired.
• I wonder what death is like.
• Shell be sorry about how she treated me.

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RECOGNIZING THE PROFILE(THINKING PATTERNS AND
MOTIVATIONS)

• Motivations of suicidal adolescents can be
  understood more readily when suicide is viewed as
  fulfilling one of three primary functions
• Avoidance
• Control
• Communication

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• RECOGNIZING THE PROFILE
• (THINKING PATTERNS AND MOTIVATIONS)
• Wanting to escape an intolerable situation.
• Wanting to join someone who has died.
• Wanting to attract the attention of family or
  friends.
• Wanting to manipulate someone else.
• Wanting to avoid punishment.

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• RECOGNIZING THE PROFILE
• (THINKING PATTERNS AND MOTIVATIONS)
• Wanting to be punished.
• Wanting to control when or how death will occur.
• Wanting to end a conflict.
• Wanting to punish the survivors.
• Wanting revenge.

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RECOGNIZING THE PROFILE(PERSONALITY TRAITS)

• Low self-esteem
• Hopelessness/helplessness
• Isolation
• High stress
• Acting out
• Need to achieve
• RECOGNIZING THE PROFILE (PERSONALITY TRAITS)
• Poor communication skills
• Other-directedness
• Guilt
• Depression
• Poor problem-solving skills

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ADOLESCENT BEHAVIOR THAT MAY BESYMPTOMATIC OF
DEPRESSION

• MASKED ADOLESCENT SYMPTOMS
• Reckless behavior
• Boredom, lethargy
• Promiscuity
• Running away
• Defiance
• Truancy
• Antisocial behavior
• Drug or alcohol abuse
• Complaints of illness

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HOW YOU CAN HELP

• Assess the suicidal risk.
• Listen and paraphrase.
• Evaluate the seriousness of the young persons
  situation.
• Take every complaint and feeling the person
  expresses seriously.
• Begin to broaden the persons perspective of his
  or her past and present situation.
• Be positive in your outlook about the future.
• Evaluate available resources.
• Accompany the student to the counselor or crisis
  team member.

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Form 7 Suicide Contract

• Date
• I, ______ , (client), hereby contract with
  (therapist), that I will take the following
  actions if I feel suicidal.
• 1. I will not attempt suicide.
• 2. I will phone at .
• 3. If I do not reach , I will phone any of the
  following services
• Name/Agency Phone

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• 4. I will further seek social supports from any
  of the following people
• Name Phone
• 5. If none of these actions are helpful or not
  available, I will check-in the ER at one of the
  following
• Hospital Address Phone
• 6. If I am not able I will phone 911, or 0 for
  help.
• Clients signature Date / /
• Therapists signature Date / /
• The S.L.A.P. Scale

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The S.L.A.P. Scale