Adolescent Mental Health and Suicide Ideation

Adolescent Mental Health and Suicide Ideation

Patrick LeBlanc, MACE

Texas Adolescent Mental Health Facts:

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DDo you know…

Depression symptoms among high school students (grades 9-12), 2013

Percent of high school students who report they felt sad or hopeless (during the 12 months before the survey)

TX USA

Total 28% 30%

Males 20% 21%

Females 37% 39%

The Youth Risk Behavior Surveillance System (YRBS) defines felt sad or hopeless as: "felt sad or hopeless almost every day for 2 or more weeks in a row so that they stopped doing some usual activities during the 12 months before the survey."

What is suicide ideation?

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DDo you know…

Suicide ideation is a common medical term for

thoughts about suicide, which may be as detailed as a formulated plan, without

the suicidal act itself.

SSuicide is death due to an injury which was

intentionally inflicted upon the decedent by him/her

self

IIn 1999the national movement for suicide

prevention began when Dr. David Satcher, US Surgeon General, declared suicide “A National Health Problem”...especially within the youth and elderly populations.

Most suicides and suiicide attempts are reactions to iintense feelings of:

Loneliness – is an emotional state in which a person experiences powerful feelings of emptiness and isolation; a feeling of being cut off, disconnected from the world (as they know it), and alienated from other people.

Most suicides and suiicide attempts are reactions to iintense feelings of:

Worthlessness – is an emotional state in which a person feels low, and they lack any feelings of being valued by others.

Most suicides and suiicide attempts are reactions to iintense feelings of:

Hopelessness – is a spiritual/relational issue. It often stems from feeling disconnected from a higher power or other people. Connection with a higher power and other people is a key to helping individuals to withstand grief and loss. This connection allows individuals to rebound from most severe disappointments of life.

Most suicides and suiicide attempts are reactions to iintense feelings of:

Helplessness – is a condition or event where a person thinks that they have no control over their situation and whatever they do is futile such as repeated failures.

Awareness, Education & Prevention Action

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KKey to Prevention …

For Middle and High school age youth (ages 12-18), suicide is the 2nddnd leading cause of death.

For college age youth (ages 18-22), suicide is the 2nd

leading cause of death.

Over all, Suicide is the 2nddnd leading cause of death for your youth ages 10-24

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YYouth Suicide in our Nation Today

MMyths

• Suicide happens without warning.

FACTS• Eight out ten people who kill themselves give some

type of warning or clue to others.

MMyths

• Suicide happens without warning.

• There is always a note left behind.

FACTS• Eight out ten people who kill themselves give some

type of warning or clue to others.• Actually, in most cases, there is no suicide note.

MMyths

• Suicide happens without warning.

• There is always a note left behind.

• If you mention suicide to someone, you are planting the idea in his or her mind.

FACTS• Eight out ten people who kill themselves give some

type of warning or clue to others.• Actually, in most cases, there is no suicide note.• Talking about suicidal thoughts will surface the

problem. Discussing it openly can actually help, not hurt.

MMyths

• Suicide happens without warning.

• There is always a note left behind.

• If you mention suicide to someone, you are planting the idea in his or her mind.

• Someone who talks about suicide is just trying to get attention.

FACTS• Eight out ten people who kill themselves give some

type of warning or clue to others.• Actually, in most cases, there is no suicide note.• Talking about suicidal thoughts will surface the

problem. Discussing it openly can actually help, not hurt.

• More than 70% of people who kill themselves have previously threatened to do so or actually attempted. Always take this seriously!

MMyths

• Suicide happens without warning.

• There is always a note left behind.

• If you mention suicide to someone, you are planting the idea in his or her mind.

• Someone who talks about suicide is just trying to get attention.

• Only depressed people attempt suicide.

FACTS• Eight out ten people who kill themselves give some

type of warning or clue to others.• Actually, in most cases, there is no suicide note.• Talking about suicidal thoughts will surface the

problem. Discussing it openly can actually help, not hurt.

• More than 70% of people who kill themselves have previously threatened to do so or actually attempted. Always take this seriously!

• Suicidal feelings/thoughts or even attempts can occur whether you are clinically depressed or not.

GGirls attempt suicide

over three times more

than boys.

Why?

Fact

Fact

HHowever, boys complete suicide over four times more than girls.The reason for the difference…

Choice of Means

AAccording to the CDC,girls generally choose drugs or, more

recently, they have shown an increase in suffocation attempts. These methods can provide a “window of opportunity” for

intervention.Boys usually choose firearms, which are

more lethal.

GGirls are turning to more lethal means at an alarming rate. If this continues, the number of completed suicides will rise at an even higher pace.

A recent trend

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DDo You Care?

Trends in Suicide Rates among Females 10-24 years, by mechanism

Texas’ Students in 2009• Almost 1 out oof 3 battled the start of

depression

• Almost 1 oout of 7 seriously considered suicide

• 1 out of 9 made a plan to commit suicide

• 1 out of 11 attempted suicide

CDC 2009 Youth Risk Behavioral Survey

TTexas Suicide Fact Sheet on Hispanic Americans

More Hispanic female students report suicidal ideation and behaviors than their non-Hispanic, white or black female counterparts

Of particular concern for Texas is that the Texas Hispanic, female student attempt rate is higher than that of the U.S. overall

Provided by the Texas Department of State Health Services

2011 YRBS Result

Hispanic/Latino Teenage Females in Texas

• Nearly 20% higher rates of “seriously considering attempting suicide.”

• 25% higher rates of “having made a suicide plan”• Nearly double the rate of having made a suicide

attempt.• Nearly double the rate of having made an attempt

requiring treatment by a doctor or a nurse.

Texas Adolescent Mental Health Facts:

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DDo you know…

Suicidal thoughts, attempts, and related injuries among high school students (grades 9-12), 2013

Percent of high school students who report they seriously considered attempting suicide (during the 12 months before the survey)

TX USA

Total 17% 17%

Males 12% 12%

Females 21% 22%

The Youth Risk Behavior Surveillance System (YRBS) defines felt sad or hopeless as: "felt sad or hopeless almost every day for 2 or more weeks in a row so that they stopped doing some usual activities during the 12 months before the survey."

Texas Adolescent Mental Health Facts:

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DDo you know…

Suicidal thoughts, attempts, and related injuries among high school students (grades 9-12), 2013

Percent of high school students who report they attempted suicide one or more times (during the 12 months before the survey)

TX USA

Total 10% 8%

Males 9% 5%

Females 12% 11%

The Youth Risk Behavior Surveillance System (YRBS) defines felt sad or hopeless as: "felt sad or hopeless almost every day for 2 or more weeks in a row so that they stopped doing some usual activities during the 12 months before the survey."

Texas Adolescent Mental Health Facts:

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DDo you know…

Suicidal thoughts, attempts, and related injuries among high school students (grades 9-12), 2013

Percent of high school students who report they attempted suicide resulting in an injury, poisoning, or overdose that had to be treated by a doctor or nurse (during the 12 months before the survey)

TX USA

Total 3% 3%

Males 3% 2%

Females 4% 4%

The Youth Risk Behavior Surveillance System (YRBS) defines felt sad or hopeless as: "felt sad or hopeless almost every day for 2 or more weeks in a row so that they stopped doing some usual activities during the 12 months before the survey."

SSuicide Risk Highest When:

• The person sees no way out and fears things may get worse.

• The predominant emotions are hopelessness and helplessness.

• Thinking is constricted with a tendency to perceive his or her situation as all bad.

• Judgment is impaired by use of alcohol or other substances.

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TThe single biggest risk factor for suicide is a history of suicide attempt and behaviors.

Over 90% of people who die by suicide have been diagnosed with a mental illness.

Some mental illnesses most commonly associated with suicide include: depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders, and eating disorders.

According to the National Alliance for Mental Illness

TThe Difference Maker is …

Identifying Signs of Concern and Risk Factors

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Four out of five completed suicides gave “clear warning signs ”

before the attempt!

AAccording to the National Mental Health Association

RRisk Factors

Although there is really no suicidal type of young person, the statistics on youth suicide do suggest that there are certain behaviors or characteristics that can alert you to an elevated risk of possible suicidal ideation.

Risk Factors

• Previous attempts

• Loow self esteem

• Depression

• Loss of close attachment/relationship

• Abused, molested oor neglected youth

• Hopelessness

• Family history of suicide

• Loners/Isolation

• Bullying

• Learning-Disabled

• Impulsivity

• Abusers of Drugs/ Alcohol

Bullying Impact

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TThe Bully

• DALLAS, TX— Tami Carmichael broke down in tears talking about the devastating moment her husband found their 13-year old son, Jon hanging in their Joshua Barn.

Carmichael says the 8th-grader, who committed suicide in March, endured years of taunting from bigger students because he was small. She says he was verbally abused and even physically assaulted. Carmichael says a group of students stripped Jon naked and stuffed him in a trash can in a locker room at Loflin Middle School.

"Students and staff they knew and they should have stopped it and done something. They just wanted to say it's kids being kids.“

Reported by Dawn Tongish The 33 News, May 4, 2010

TThe Bully

• Asher Brown, an eighth-grader at Hamilton Middle School in Cypress-Fairbanks ISD, fatally shot himself in the head with his stepfather's gun late last month. His mother and stepfather, Amy and David Truong, have said the boy was bullied by his classmates, who performed mock gay sexual acts on him in gym class and, on the day before his suicide, tripped him on a flight of stairs.

Reported by Ericka Mellon Houston Chronicle, October 11, 2010

TThe BullyMcKinney, TX - There are no silver linings, no let’s-look-on-the-bright-side moments to ponder in the tragic, troubling death of Raymond Howell Jr. But there is this: The 14-year-old’s suicide, which apparently was spurred on by bullying, has brought both issues to the forefront once again.

He was a constant target of bullies, according to family and friends, who said the teen was picked on at school and mocked through social media.The harassment even landed on the doorstep of his home, where kids showed up a couple of weeks ago, jumped on Raymond and posted a video of the fight on the Internet for the whole world to see, according to the family. In case you’ve not been paying attention, that’s the latest, if not the most potent, weapon bullies use today — social media.

Reported by James Ragland Dallas Morning News, April 7, 2015

SSigns of Concerns

• Talking about suicide (at any level; verbal threat)

• Preoccupied with death (strong wish to die)

• Making plans

• Giving things away

• Sudden mood swings

• Depression – moodiness, hopelessness, helplessness

• Abrupt Changes in Behavior

• Withdrawal

Verbal Clues

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SSuicide Treats

• “I would be better off dead!”

• “You won’t have me around much

longer to bother you!”

• “I wish I was dead.”

• “I am going to kill myself.”…(this is straight forward, but it happens)

In-Direct Verbal Clues

• They/she/he would be better off without me.• I want to go to sleep and never wake up.• I can’t take it anymore!• You/they won’t have to worry about me

anymore.• Nobody cares if I am dead or alive.• I am going to put an end to all of this soon.• If this is how life is, I want out.

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Verbal CluesAustin, TX ( July 17, 2015) Investigators are now considering the possibility that Grant James Thompson, 18, of Temple, who died Tuesday night in a vehicle in Austin with puncture wounds on his wrist, committed suicide by allowing a venomous cobra to bite him.

At 6:01 p.m. Tuesday, Thompson posted a two-word message on his Facebook page that said simply "I'm sorry.”

Reported by KWTXTX-X-TV News 10 Waco, TX

MMore Signs of Concerns

• Having a desire to die• Formulating a plan-including acquiring the

means to kill oneself• No regard for personal possessions• Finalizing personal affairs/saying good-bye• Themes of death in letters and notes• Obsession with death (music, poetry,

artwork)

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DDo You Care Enough to respond?

Now what?

If you have any doubt of a young person’s intentions or

any concern about their behavior, get professional help

for them immediately!

BBasic Rule to Remember

Three Easy Steps You Take Daily

1. Notice

2. Ask

3. Get Help

Steps to TakeLLearn the emergency protocol for your organization.

Does your organization have a plan for helping young people who are at risk?

Who are the key people to contact if a person needs help?Be prepared to ask questions.

If you feel a person may really be at risk, be ready to ask the hard question: “ Are you thinking of killing yourself?”

Identify staff and resources for help.Know who to contact first in your organization, then in your community. This is not a problem anyone should handle alone.

Be sure the individual's parents are appropriately notifiedNEVER keep a suicide threat or attempt secret from parents.

PPrevention

Suicide Prevention

• 211

• 911

• Jason Foundation

• ASIST (Applied Suicide Invention Skills Training)

• QPR (Questions, Persuade and Refer)

• SOS (Signs of Suicide) and Teen Screen

• Yellow Ribbon International

DData Sources• MH1

High school data are from: Centers for Disease Control and Prevention. (2014). 1991-2013 High School Youth Risk Behavior Surveillance System data. Retrieved August 28, 2014, from http://nccd.cdc.gov/YouthOnline/App/Default.aspx

• MH2

Depressive episode data are from: Substance Abuse and Mental Health Services Administration. (2013). 2011-2012 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia). Table 26. Rockville, MD. Retrieved August 28, 2014, from http://www.samhsa.gov/data/NSDUH/2k12State/Tables/NSD UHsaeTables2012.pdf

• MH3

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th Ed.). Washington, DC, American Psychiatric Association.

WWhat will you do?

Be prepared for questions or for the moment you realize a young

person you know may be at risk.

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DDo you care?

Every One Hour and Forty-Five minutes… a young person

completes suicide

TThe Difference Maker is …