Suicidality Tajuana Williams & Emily Thomas Johnson - PowerPoint Presentation

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Suicidality

Tajuana

Williams & Emily Thomas Johnson

Rates/Statistics

USA (all ages)

38364 suicides in 2010

105.1 per day

1.6% of all deaths

Breakdown by groups

22.6% Caucasian Males, 5.9% Caucasian Females, 9.4% Nonwhite Males (8.7% AA Males), 2.5% Nonwhite Females (1.8% AA Females)

1 person every 13.7 minutes killed themselves

1 young person every 1 hour, 48 minutes killed themselves

3

rd

leading cause of death for young persons (10 – 24 years)

959, 100 annual attempts in US

1 attempt every 32 seconds

3 female attempts for every 1 male attempt

Each suicide intimately affects at least 6 other people

Rates/Statistics

Suicide Methods in USA

50.5% Firearm Suicides

24.7% Suffocation/Hanging

1.8% Cut/Pierce

17.2% Poisoning

1.1% Drowning

Mississippi

In 2010, Mississippi ranked 30

th

in comparison to other states (388 reported deaths by suicide)

Suicide rate: 21.4% male, 5.2 % female

Rates/Statistics – Mississippi Only

MMWR Surveillance Summary 2012

During 12 months prior to survey,

25.5% of students had felt sad or hopeless almost every day for 2 or more weeks in a row

34.0% females, 16.7% males

15.2% had seriously considered suicide

12.3% had made a plan about how they would attempt

8.5% had attempted suicide 1+ times

3.1% had a suicide attempt treated by a doctor or nurse

Rates/Statistics

Attempts v. Completions

Attempts to Completions in Youth = 200:1

Attempts to Completions in Elderly = 4:1

Gender Factors

Males 4x more likely to complete

Females more likely to attempt

Est. 3 female attempts to each male attempt

In the 10 – 24 age group, 81% of suicidal deaths were male, 19% of suicidal deaths were female

Rates/Statistics

LGBT Youth

In 1999, research found that LGBT youth and HS students unsure of their sexual orientation were 3.4 times more likely to have attempted suicide in the last 12 months than heterosexual peers

In 2006, LGB HS Students 2x as likely to have attempted

Among students who attempted, LGB teenagers were 2x more likely to report that they had really hoped they would die

Adoption

Adopted teens 4x more likely to have attempted suicide

8% of adopted females, and 5% of adopted males have attempted

Risk/Statistics

Racial Breakdown

Among 13 – 24 year olds, in 2009 -

22.11 per 100, 000 American Indian/Alaska Native

9.47 per 100, 000 White

6.32 per 100, 000 Asian/Pacific Islander

6.46 per 100, 000 Hispanic

5.74 per 100, 000 Black

Native American/Alaskan Native youth have the highest suicidal-related fatalities

Hispanic students more likely to report attempting suicide than their black and white, non-Hispanic peers

Risk Factors

Mental Illness

90% of suicides associated with mental disorders or addictive disorders

Depression and other affective disorders

Conduct disorders

Substance abuse

Family stress/dysfunction

Environmental factors – includes handgun in home

Situational crises

Breakup with significant other

Traumatic death of significant other

(such as suicide)

Parental divorce

Physical and/or sexual abuse

Incarceration

Family Violence

Facts for Schools

Many high school students reported that they had seriously considered suicide in the past year (CDC, 2010a).

Suicide is the third leading cause of death among teenagers (CDC, 2009)

One out of every 53 high school students (1.9%) reported having made a suicide attempt that was serious enough to be treated by a doctor or a nurse (CDC, 2010a).

The toll among some groups higher. For example, the suicide rate among 15-19 year old American Indian/Alaska Native males is 2 ½ times higher than the overall rate for males in that age group (

Hernon

, 2007).

Responding to a Student Crisis

What constitutes a Crisis?

When peer, teacher, other staff member identifies a student as potentially suicidal

A student may make a statement about suicide in writing assignments, in a drawing or indirect verbal expression, or overtly voice suicide threats or behaviors

Suicide

Suicide Is A Complexity

Suicide is the result of an untimely convergence of multiple psychiatric, psychological, social, environmental, occupational, cultural, medical, academic stressors that severely challenges an individual’s capacity to cope.

Edwin

Schneidman

, 1954

Defining Terms: Suicidal Ideation

Passive thoughts about wanting to be dead or active thoughts about killing oneself

Not accompany by preparatory behavior

Risk Factors for Youth Suicide

Behavioral Health Issues/Disorders

Depressive Disorders

Substance abuse or dependence (alcohol &other drugs)

Conduct/disruptive behavior disorders

Other D/O (Anxiety, and Personality D/O)

Previous suicide attempts

Self-Injury (without intent to die)

Genetic/biological vulnerability

Suicide Awareness Curriculum

Gatekeeper Training

Refers to training school faculty and staff about how to recognize a student potentially at-risk for suicide

How to appropriately intervene and communicate with a student potentially at risk for suicide

How to determine the level of risk

How to refer a student who is potentially suicidal

Research suggest that gatekeeper training can produce positive effects on an educator’s knowledge, attitude, and referral practices

Personal Characteristics

Hopelessness

Low self-esteem

Loneliness

Social alienation and isolation, lack of belonging

Low stress and frustration tolerance

Impulsivity

Risk taking, recklessness

Suicide Warning Signs

Suicide Note

Threats

Previous Attempts

Depression

“Masked” Depression

Final arrangements

Efforts to hurt oneself

Inability to concentrate or think clearly

Changes in physical habits and appearance

Suicidal Warning Signs Con’t

Sudden changes in personality, friends, behaviors

Death and suicidal themes

Plan/method/access

Prevention and Response

Prevention programming

Peers, Parents, Staff education

How to recognize

Establishing ways to report

Protocol setup

Responding

Assessment/Risk Definitions

In Crisis

To peers/families after

To community/media after

To student that does not complete

Student Suicides and Counselor Liability/Risk Management

School officials are required to provide a degree of protection and attention to all students

Therefore, careful scrutinizing of policies occurs following suicides

Lengths to which a school system must go will depend on jurisdiction’s precedents and statutes

Liability concerns

Negligence

Duty of care/

Forseeability

Bogust

v. Iverson (1960)

Eisel

v. Board of Education Montgomery County (1991)

Brooks v. Logan (1995)

Student Suicides and Counselor Liability/Risk Management

Liability concerns

Negligence

Breach of Duty

Causation

Damages

Wyke

v. Polk County School Board

Due Process

Constitutional Clause

Mississippi

State Bill 2770

Risk Management