1	SUICIDE PREVENTION Community, Counseling, & Correctional Services, Inc.
2	TRAINING OBJECTIVES Differentiate between common myths an facts concerning suicide. Understand facility and employee liability issues related to suicide. Identify risk factors associated with suicidal behavior. Demonstrate effective behaviors to aid in prevention of suicide. Recognize suicidal behavior or suicide attempts and intervene according. Understand the RYO Correctional Facility Suicide Policy.
3	YOU CAN MAKE A DIFFERENCE! Alert, caring, trained line staff are probably the key factor in reducing suicide risk and providing appropriate responses. Research clearly shows that suicide is preventable. 80 - 90% of all suicides give clear and unmistakable warning signs of their intent. The teen suicide rate has increased 300% since 1950. 85% of all adolescents think about suicide at some time. Detained youth are 4 times more likely to attempt suicide.
4	SIGNIFICANT SUICIDE INDICATORS Suicide threat Verbal hints indicating self-destructive behavior or that life would be better if the youth did not exist Preoccupation with thoughts of suicide or death Previous suicide attempt Family member or close friend has attempted or completed suicide Making final arrangements, giving away possessions Sudden unexplained cheerfulness after prolonged depression Keeping guns, knives, or lethal medications in the youth's possession Breakup with boyfriend or girlfriend and withdrawal from other friendships. Chemically dependent
5	SCHOOL SUICIDE INDICATORS Failing or drop in grades Difficulty concentrating on school work Loss of interest in extra-curricular activities Social isolation New to school program Frequent referrals to office because of behavior, tardiness, truancy Academic learning difficulties
6	PHYSICAL SUICIDE INDICATORS Changes in eating or sleeping patterns Weight gain or loss Neglect of personal appearance Lethargy, listlessness Frequent physical complaints Pregnancy Prolonged or terminal illness Drug or alcohol abuse
7	FAMILY SUICIDE INDICATORS Loss of family member (anniversary of loss) through death, separation or divorce Rejection by family members Financial change, job loss Recent household move Family discord Change in immediate family or household membership Alcoholism or drug use in family Youth is a victim of physical, sexual and/or emotional abuse Running away from home Family history of emotional disturbance
8	SOCIAL & EMOTIONAL SUICIDE INDICATORS Noted personality change Depression, feelings of sadness Withdrawal, does not interact with others Agitation, aggression, rebellion Sexual problems (promiscuity, identity, pregnancy) Feelings of despair, hopelessness, helplessness Feelings of being bad or the need to be punished Unexplained accidents, reckless behavior Recent legal involvement
9	SIGNIFICANT TIMES OF DANGER FOR SUICIDE Graduation Completion of parental divorce Anniversaries of unhappy events (parental deaths, severe losses) Holidays, particularly family holidays Change in season Custody disagreements Admission to facility
10	FACT OR MYTH #1 ADOLESCENTS WHO TALK ABOUT SUICIDE ARE NOT SERIOUS ABOUT DOING IT.
11	FACT OR MYTH #2 MENTIONING SUICIDE MAY GIVE A PERSON THE IDEA.
12	FACT OR MYTH #3 SUICIDAL PEOPLE ARE INTENT ON DYING.
13	FACT OR MYTH #4 ALL SUICIDAL PEOPLE ARE MENTALLY ILL.
14	FACT OR MYTH #5 ONCE AN ADOLESCENT IS CONSIDERED SUICIDAL, HE/SHE MUST ALWAYS BE CONSIDERED SUICIDAL.
15	FACT OR MYTH #6 IF AN ADOLESCENT ATTEMPTS SUICIDE AND SURVIVES, HE/SHE WILL NOT MAKE AN ATTEMPT AGAIN.
16	FACT OR MYTH #7 IF THERE IS NOT A NOTE, IT WAS NOT A SUICIDE.
17	SUICIDE STATISTICS 70-80% of offender suicides in detention facilities are associated with depression. Suicides occur most often on Friday, followed by Monday and then Sunday. Three times as many men commit suicide as do women but women attempt suicide more often then men. The primary method used to commit suicide in a detention facility is by hanging. Men most often use guns, or hanging. Women use hanging or overdoses of poison. Offenders in correctional facilities take their own lives 3.5 times more frequently than persons in the general public.
18	SUICIDE STATISTICS, CONT. Three out of four victims make their distress known through: Actual threats Discussing methods of suicide Suicide notes Increased consumption of alcohol or drugs Basic signs of depression Risk of suicide is VERY HIGH among those who threaten suicide if no intervention is provided. Although suicide is the 11th ranking cause of death for the general public, it is the 3rd leading cause of death for young people. The most recent statistics (2001) rank Montana as the state with the second highest rate of suicides per 100,000 population.
19	GENERAL GUIDELINES FOR DEALING WITH SUICIDAL YOUTH
20	VITAL QUESTIONS TO ASK OF A POTENTIAL SUICIDE Have your problems been getting you down so much lately that you've been thinking about harming yourself? How would you harm yourself? Do you have the means available? Have you ever attempted suicide? What has been keeping you alive so far? What do you think the odds are that you'll kill yourself? What do you think that the future holds in store for you?
21	TO DO’S OF SUICIDE INTERVENTION Always try to take a positive approach by emphasizing the person's most desirable alternatives. Try to sound calm and understanding. Use constructive questions to help to separate and define the person's problems and to remove some of his confusion. To help the person to understand his situation, rephrase, important thoughts and restate them by saying: "In other words, you feel. .." Emphasize the temporary nature of the person's problems. Explain how the crisis will pass in time and therefore suicide would be a permanent solution of a problem that is only temporary.
22	THE DON’Ts OF SUICIDE INTERVENTION Don't sound shocked by anything the person tells you. Don't stress the shock and embarrassment that the suicide would be to his family before you are certain that isn't exactly what he hopes to accomplish. Don't engage in a debate with the suicidal person because you may not only lose the debate, but also the person.
23	DEALING WITH SUICIDAL YOUTH Stay with youth Follow procedural guidelines for notifying appropriate staff Listen and hear patiently Encourage expression of feelings Maintain eye contact Be supportive Follow-up with youth & supervisor
24	FACILITY AND STAFF LIABILITY ISSUES RELATED TO SUICIDE
25	DELIBERATE INDIFFERENCE HAVING ACTUAL KNOWLEDGE OF A SUICIDE RISK AND NOT TAKING STEPS OR FOLLOWING POLICY AND PROCEDURE TO ENSURE THE SAFETY OF THE INDIVIDUAL. DELIBERATE INDIFFERENCE CAN SUBJECT BOTH THE FACILITY AND THE STAFF MEMBER TO LIABILITY.
26	OTHER POTENTIAL SOURCES OF LIABILITY IN ORDER TO BE LIABLE THE STAFF MEMBER MUST BE AWARE OF THE FACTS THAT A SERIOUS RISK OF HARM EXISTS. IF THE RISK IS OBVIOUS, A STAFF MEMBER MIGHT BE LIABLE EVEN IF HE/SHE IS NOT FULLY AWARE OF THE RISK. A STAFF MEMBER COULD BE LIABLE IF EVIDENCE SHOWS THAT HE/SHE NEGLECTED TO VERIFY UNDERLYING FACTS HE/SHE STRONGLY SUSPECTED TO BE TRUE OR DECLINED TO CONFIRM INFERENCES OF RISK THAT HE/SHE STRONGLY SUSPECTED TO EXIST.