Riverside Trauma Center a service of Risk Factors & Warning Signs of Depression and Suicide in Youth...

Riverside Trauma Centera service of

Risk Factors & Warning Signs of Depression and Suicide in Youth

presented by: Waheeda Saif, LMHC

Blue Ribbon ConferenceApril 13th, 2012

Reading, MA


Waheeda Saif, LMHC


Reading, MA

Riverside Trauma CenterRiverside Trauma Centera service of:





Reading, MA

Suicide: A Major Public Health Issue

National Statistics:

• Approx. 36,000 suicide deaths annually• Every 14.6 minutes another person in this

country dies by suicide• Each day approximately 99 people will die by

suicide• Ranks as the 10th leading cause of death• 90-95% of people who complete suicide suffer

from a diagnosable mental illness – most often depression





Reading, MA

Suicidality in Adults (≥18) in the US

Centers for Disease Control 2008 data





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Youth Statistics:

• Suicide ranks as the 3rd leading cause of death for young people (ages 15-24).

• For every suicide completed by youth, it is estimated that 100 to 200 attempts are made.

• According to the CDC in 2009:– 13.8% of students had seriously considered attempting

suicide– 6.3% of students had attempted suicide one or more times

(Only 1.9% received medical attention)





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Massachusetts Statistics: • Range of 400-600 completed suicides per year

• 3X more frequent than homicides

• Suicide rate variability by: – Age – Gender– Race– Method





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Definition: Suicidal Behavior

An attempt to solve the problem of intense pain that results from skill deficits or psychopathology





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Risk Variables

Cognitive

Style

Access to

means

Family

History

Previous

Attempt(s)

Demographic

Risk Factors

Clinical

Factors

Psychosocial Factors





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How Does a Suicide Occur?

Inhibition: Strong taboo, available support, Slowed down mental state, presence of others

Facilitation:Weak taboo, method/weapon available, recent example, agitation, being alone

SURVIVAL SUICIDE





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Prevention Strategies

Inhibition: Facilitation:

SURVIVAL SUICIDE

Dr. Madelain Gould © 2001-2006 Adapted from Schaefer et al, 1996

Casefinding•Find affected individual•Provide effective treatment•Gatekeeper training

Casefinding•Crisis hotline

Casefinding•Crisis hotline

Risk factor reduction•Media education•Restriction of firearms•Postvention/Crisis Interventions•Skills training





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Depression & Suicidality

Depression is a primary risk factor for suicide and is also linked to other risk factors including:

• Use/abuse of alcohol and other drugs

• Bullying (Both victim and perpetrator)

• Social isolation

• Physical pain/poor health outcomes





Reading, MA

Signs & Symptoms of Depression:

Frequent sadness, tearfulness, crying Expressed hopelessness Decreased interest in activities; or inability to enjoy

previously favorite activities Persistent boredom; low energy Social isolation, poor communication Low self esteem and guilt Frequent complaints of physical illnesses such as

headaches and stomachaches





Reading, MA

Signs & Symptoms of Depression:

Extreme sensitivity to rejection or failure Increased irritability, anger, or hostility Difficulty with relationships Frequent absences from school or poor performance in

school Poor concentration A major change in eating and/or sleeping patterns Talk of, or efforts to run away from home





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Warning Signs of Suicidal Teens

• Suicide Threats, direct & indirect• Obsession with death• Poems, essays, and drawings that refer to death• Dramatic change in personality or appearance• Irrational, bizarre behavior• Overwhelming sense of guilt, shame or reflection• Changed eating or sleeping patterns• Severe drop in school performance• Giving away belongings

National Mental Health Association





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How to Ask:

Indirect vs. Direct• Indirect:

– “ Do you wish you could go to sleep and not wake up?”

– “Do you wish you were dead?”

• Direct:– “Have you thought about killing yourself?”





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How to ask:

WHY NOT?

“Have you thought about hurting yourself?”





Reading, MA

“You’re not thinking about suicide, are you?”

How to ask:

WHY NOT?





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The Role of Schools in Prevention & Identification

• How/where do we spot youth with emotional challenges?

• How/where in our curriculum can we address these concerns?

• Do we have procedures/policies for what to do when we’re concerned?

• How do we promote strength and resilience in our students?





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Impact for the survivors:

A recent study indicated that over 70 people are intimately and directly impacted by the death by suicide of a young person. (Berman, 2011)

But we also know that the effects go well beyond the immediate survivors.





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Those left behind may be at risk:





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6 months after exposure to peer suicide youth are at increased

psychiatric risk:

• 4x more likely to develop psychiatric disorder

• 6x more likely to develop major depression

• More likely to develop Post Traumatic Stress Disorder

• 5X higher rate of suicidal ideation (Brent, 2010)





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Common reactions in childhood bereavement

• Shock and numbness• Denial• Sadness• Anger• Anxiety• Guilt• Physical Problems/ Somatic Complaints• Decrease in academic performance





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Why grief following suicide/ homicide is more complicated

• Shock at the sudden/ unexpected death• Social stigma/ shame• Intense search for the reasons “why”• Police investigation/ media involvement• “Could this death have been prevented?”• Fear of own self destructive impulses• Violence of the death• Lengthy court action precludes “closure”• Anger at perpetrator ( scapegoating/ blaming)

(Underwood, 1997)





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Domains affected by trauma(and how might they relate to school

functioning?) Domain

Cognitive

Emotional

Social/ behavioral

Physiological

Spiritual

Symptoms

Confusion, intrusive thoughts, concentration

Shock, sorrow, anger, guilt, irritability

Withdrawal, fighting

Fatigue, stomachache, startle response, sleep

“Nothing matters,”… why would God do this?”





Reading, MA

Suggestions for School Response to childhood

bereavement

• Encourage atmosphere of open expression to all reactions

• Communicate facts clearly (then repeat)• Initiate conversations about the deceased: facilitate

through artwork, collages, tape recording, journals• Physical activity/ encourage peer activities• Flexibility (e.g. around physical complaints)• Resume routines• Support rituals for the deceased• Tutoring/temp reduction in academic load





Reading, MA

Risk Factors and Warning Signs of Depression and Suicide in Youth

Waheeda Saif, [email protected] X5617

Riverside Trauma Centerwww.riversidetraumacenter.org

Riverside Trauma Center a service of Risk Factors & Warning Signs of Depression and Suicide in Youth...

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